阳和汤加味联合伤口治疗仪治疗Wagner 2~3级糖尿病足临床研究
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R587.2

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佛山市医学科技攻关项目(2020001004583-01)


Clinical Study on Modified Yanghe Tang Combined with Wound Therapeutic Apparatus for Diabetic Foot of Wagner 2 to 3 Grades
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    摘要:

    目的:观察在常规疗法基础上采用阳和汤加味方内服联合伤口治疗仪治疗 Wagner 2~3 级糖尿病足的临床疗效。方法:选取 90 例阳虚寒凝夹瘀毒型 Wagner 2~3 级糖尿病足患者,采用随机数字表法分为2 组各 45 例,2 组均给予常规控制血糖、控制感染、改善血液循环、营养支持及清创换药等治疗,对照组用伤口治疗仪治疗,观察组内服阳和汤加味方,并联合伤口治疗仪治疗,2 组均治疗 4 周。观察 2 组患者治疗前后中医证候评分、创面渗液 pH 值、C-反应蛋白(CRP)水平、D-二聚体水平、创面细菌种类及数量的变化,比较 2 组患者的创面愈合时间、创面疼痛程度[疼痛数字评价量表(NRS)评分]、治疗费用及临床疗效、创面愈合疗效。结果:治疗 4 周,观察组临床疗效、创面愈合总有效率均高于对照组(P<0.05)。观察组创面愈合时间早于对照组,治疗费用低于对照组,差异均有统计学意义 (P<0.01)。治疗第 7、14、21 天,2 组NRS 评分、创面渗液 pH 值、CRP 水平、D-二聚体水平均较治疗前下降,创面的细菌种类和数量均较治疗前减少,差异均有统计学意义(P<0.05);观察组 3 个时间点的 NRS 评分、创面渗液 pH 值、CRP 水平、D-二聚体水平均低于同期对照组,创面的细菌种类和数量均少于同期对照组,差异均有统计学意义(P<0.05)。结论:在常规疗法基础上采用阳和汤加味方内服联合伤口治疗仪治疗阳虚寒凝夹瘀毒型 Wagner 2~3 级糖尿病足患者,可以有效减轻疼痛,减轻炎症程度、抑制细菌生长,优化创面愈合环境,改善血液高凝状态,从而促进创面愈合,且治疗费用较低,有助于减轻患者的家庭经济负担。

    Abstract:

    Abstract: Objective: To observe the clinical effect of oral administration of modified Yanghe tang combined with wound therapeutic apparatus on the basis of routine treatment for patients with diabetic foot of Wagner 2 to 3 grades. Methods:A total of 90 cases of patients with diabetic foot of Wagner 2 to 3 grades of yang deficiency and cold congealing with blood stasis and toxin type were selected,and were divided into two groups according to the random number table method,with 45 cases in each group. Both groups were given routine treatment including control of blood sugar and infection,improvement of circulation, nutritional support and debridement and dressing change; the control group was treated with wound therapeutic apparatus,and the observation group was given the oral administration of modified Yanghe tang combined with wound therapeutic apparatus. Both groups were treated for four weeks. Chinese medicine syndrome scores,pH values of wound exudate,levels of C-reactive protein(CRP) and D-dimer, and species and number of bacteria on wound surface before and after treatment in the two groups were observed,wound healing time,pain degree evaluated by Numerical rating scale(NRS) scores,treatment cost,clinical effects and wound healing effects in the two groups were compared. Results:After four weeks of treatment,clinical effects and total effective rates of wound healing in the observation group were higher than those in the control group,differences being significant(P<0.05). The wound healing time in the observation group was earlier than that in the control group,treatment cost was fewer,differences being significant(P<0.01). On the 7 th , 14 th and 21 th days of treatment, the NRS scores, pH values of wound exudate,CRP levels and D-dimer levels in the two groups were decreased when compared with those before treatment, and the species and number of bacteria on wound surface were decreased, differences being significant(P<0.05). The NRS scores,pH values of wound exudate,CRP levels and D- dimer levels at the three time points in the observation group were lower than those in the control group at the same period, and the species and number of bacteria on wound surface were fewer and lower, differences being significant(P<0.05). Conclusion:Based on routine treatment,the oral administration of modified Yanghe tang combined with wound therapeutic apparatus for patients with diabetic foot of Wagner 2 to 3 grades of yang deficiency and cold congealing with blood stasis and toxin type can effectively relieve pain, reduce degree of inflammation, inhibit bacterial growth, optimize the environment of wound healing,and improve hypercoagulable state,so as to promote wound healing. The low cost of treatment can help the patients’ family reduce the economic burden.

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李珍,任红兵,李燕辉,阳丽容,邓博,杨亮.阳和汤加味联合伤口治疗仪治疗Wagner 2~3级糖尿病足临床研究[J].新中医,2022,54(14):57-62

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  • 在线发布日期: 2022-07-21
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