上海中医药大学附属曙光医院,上海市浦东新区张衡路528号,201203
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收稿:2021-12-13,
修回:2022-02-20,
纸质出版:2022-05-17
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施陈燕,黄仁燕,黄何尘等.紫朱软膏联合奚氏中医外科技术治疗糖尿病足溃疡36例临床观察[J].中医杂志,2022,63(10):956-961.
SHI Chenyan,HUANG Renyan,HUANG Hechen,et al.Zizhu Ointment (紫朱软膏) Combined with XI's External Medicine Technique of Traditional Chinese Medicine in Treating 36 Cases of Diabetic Foot Ulcers[J].Journal of Traditional Chinese Medicine,2022,63(10):956-961.
施陈燕,黄仁燕,黄何尘等.紫朱软膏联合奚氏中医外科技术治疗糖尿病足溃疡36例临床观察[J].中医杂志,2022,63(10):956-961. DOI: 10.13288/j.11-2166/r.2022.10.012.
SHI Chenyan,HUANG Renyan,HUANG Hechen,et al.Zizhu Ointment (紫朱软膏) Combined with XI's External Medicine Technique of Traditional Chinese Medicine in Treating 36 Cases of Diabetic Foot Ulcers[J].Journal of Traditional Chinese Medicine,2022,63(10):956-961. DOI: 10.13288/j.11-2166/r.2022.10.012.
目的
2
探讨紫朱软膏联合奚氏中医外科技术治疗糖尿病足溃疡的疗效及作用机制。
方法
2
108例糖尿病足溃疡患者随机分对照组、外治组和联合组,每组36例。对照组采用常规外科换药技术联合重组牛碱性成纤维细胞生长因子外用溶液治疗,外治组采用奚氏中医外科技术联合重组牛碱性成纤维细胞生长因子外用溶液治疗,联合组采用奚氏中医外科技术联合紫朱软膏治疗。各组均治疗14天。观察治疗前后糖尿病足溃疡面积、中医症状评分(包括疮面分泌物、肉芽颜色、肤温、腐臭味)及血清中性粒细胞(NE)、超敏C反应蛋白(hs-CRP)、血清淀粉样蛋白(SAA)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)水平。
结果
2
与本组治疗前比较,治疗后各组疮面分泌物、肉芽颜色、腐臭味及肤温评分,血清NE、hs-CRP、SAA水平均明显降低,bFGF水平明显升高,外治组及联合组溃疡面积均减小,VEGF水平显著升高(
P
<0.05或
P
<0.01);与对照组比较,治疗后联合组溃疡面积差值明显增大,疮面分泌物及腐臭味评分明显降低,外治组及联合组血清hs-CRP、SAA水平明显降低,VEGF和bFGF水平明显升高(
P
<0.05)。治疗后联合组与外治组各指标比较,差异均无统计学意义(
P
>0.05)。
结论
2
奚氏中医外科技术联合紫朱软膏可通过改善糖尿病足溃疡患者炎症反应、升高血管生成因子表达而促进疮面愈合,在促进溃疡面积缩小、改善疮面分泌物及腐臭味方面优于常规外科换药技术联合重组牛碱性成纤维细胞生长因子。
Objective
2
To explore the effect and mechanism of
Zizhu Ointment
(紫朱软膏) combined with XI's external medicine technique of traditional Chinese medicine (TCM) in treating diabetic foot ulcers (DFU).
Methods
2
Totally 108 patients with DFU were randomly divided into control group, external treatment group and combination group, with 36 cases in each group. The control group was treated with conventional surgical dressing changing technology combined with topical solution of recombinant bovine basic fibroblast growth factor (bFGF); the external treatment group was treated by XI's external medicine technique of TCM combined with topical solution of recombinant bovine bFGF, and the combination group was treated by XI's external medicine technique combined with
Zizhu Ointment
. All groups were treated for 14 days. The ulcer area, TCM symptom score regarding ulcer secretion, granulation color, skin temperature and rancid smell, and laboratory indexes including neutrophils (NE), high-sensitivity C-reactive protein (hs-CRP), serum amyloid (SAA), bFGF and vascular endothelial growth factor (VEGF) were assessed before and after treatment.
Results
2
After treatment, the ulcer secretion, granulation color, rancid smell and skin temperature, as well as serum NE, hs-CRP, and SAA levels significantly decreased, while the bFGF level increased in all three groups; the ulcer area and VEGF level significantly increased in the external treatment group and the combination group (
P
<0.05 or
P
<0.01). Compared to those in the control group, the ulcer area, ulcer secretion and rancid smell were significantly reduced in the combination group, and serum hs-CRP and SAA levels significantly decreased while VEGF and bFGF levels increased in the external treatment group and the combination group (
P
<0.05). There were no significant differences between the external treatment group and the combination group in all outcome measures (
P
>0.05).
Conclusion
2
XI's external treatment technique of TCM combined with
Zizhu Ointment
promotes the healing of ulcers in DFU patients by improving the inflammatory response and promoting the expression of angiogenic factors, and has better effects in reducing the ulcer area and improving ulcer secretion and rancid smell than conventional surgical dressing changing technology combined with topical solution of recombinant bovine bFGF.
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