摘要
目的应用能量多普勒超声评价温通散薰洗法治疗糖尿病足的临床疗效。方法将临床明确诊断的96例糖尿病足患者(Wagner糖尿病足分级0和1级)随机分入温通散组和对照组,每组48例。对照组患者仅给予前列地尔20μg静脉注射,每日1次;温通散组患者则于此基础上加用温通散熏洗治疗,每日1次,疗程为4周。所有患者均于治疗前后应用彩色多普勒超声诊断仪先行二维超声检查,观察足背动脉的供血情况,测量血管内膜-中层厚度,观察血管内膜有无回声粗糙、斑块,以及血管腔有无狭窄和闭塞;再应用彩色多普勒超声诊断仪自带的能量多普勒超声功能,观察血管腔内有无血流信号和血流动力学改变。结果温通散组治疗后的足背动脉舒张期反向血流速度为(1.6±0.3)cm/s,显著高于同组治疗前的(0.9±0.2)cm/s(P<0.05),增幅为77.8%;对照组治疗后的足背动脉舒张期反向血流速度为(1.2±0.1)cm/s,显著高于同组治疗前的(1.0±0.2)cm/s(P<0.05),增幅为20.0%。温通散组治疗后足背动脉舒张期反向血流速度的增幅显著高于对照组(P<0.05)。温通散组治疗有效率为60.4%(29/48),显著高于对照组的29.2%(14/48,P<0.05)。结论温通散熏洗治疗0和1级糖尿病足可获得较满意的疗效。根据能量多普勒血流成像结果可评估糖尿病足患者足背动脉的供血情况,对早期诊断和治疗糖尿病下肢血管病变具有临床应用价值。
Objective To evaluate the clinical effect of WenTongSan fumigation for diabetic foot by power Doppler ultrasound. Methods A total of 96 patients diagnosed as diabetic foot （Wagner diabetic foot classification 0 and l） were randomly divided into WenTongSan group and control group （n = 48）. All patients received intravenous injection of 20 g alprostadil once daily for 4 weeks. Additionally, WenTongSan fumigation was carried out once daily for 4 weeks in the WenTongSan group. Two-dimensional ultrasonograph was performed by color Doppler ultrasonic diagnostic instrument before and after treatment, and the blood supply of dorsalis pedis artery, echo and plaque in vascular intima, stenosis and occlusion of vascular cavity were observed~ the intimal- middle thickness was measured. Moreover, intracavitary blood flow signal and hemodynamic changes were observed by power Doppler ultrasound examination. Results In the WenTongSan group, diastolic reverse blood flow velocity measured in dorsalis pedis artery after treatment was （ 1.6± 0.3） cm/s, which was significantly higher than that before treatment （1.0.9 ± 0.2] cm/s, P〈0.05, with an increase of 77.8 % ）. In the control group, diastolic reverse blood flow velocity measured in dorsalis pedis artery after treatment was （ 1.2± 0. 1 ） cm/s, which was also significantly higher than the value before treatment （[1.0± 0.2] cm/s, P〈0.05, with an increase of 20.0%）. The blood flow velocity growth in the WenTongSan group was signficantly greater than that in the control group （P,〈0.05）. The effective rate of WenTongSan group was significantly higher than that of control group （60.4% [29/48] vs. 29.2% [14/48], P〈0.05）. Conclusion WenTongSan fumigation can effectively treat diabetic foot （0 s and 1 s level）. The blood flow of dorsalis pedis artery can be clearly observed by energy Doppler ultrasound in patients with diabetic foot. The examination is valuable for early diagnosis and treatment of diabetic lower extremity vascular lesions.
出处
《上海医学》
CAS
CSCD
北大核心
2014年第7期599-601,共3页
Shanghai Medical Journal
关键词
能量多普勒超声
糖尿病足
温通散
足背动脉
Power Doppler ultrasound
Diabetic foot
WenTongSan fumigation
Dorsal artery of foot
