摘要
目的:探讨三黄血竭方治疗糖尿病足溃疡疗效及对创面分泌物中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-10(IL-10)含量的影响。方法:选取糖尿病足溃疡患者共120例,随机分为常规清创组(n=60)和三黄血竭方组(n=60),常规清创组给予清创换药治疗,三黄血竭方组在清创换药时给予三黄血竭方外敷治疗,清创处理同常规清创组。对比两组治疗前及治疗28 d后的中医症状积分,评估两组治疗28 d的中医症候疗效,比较两组治疗前及治疗14 d后的创面面积、溃疡深度及创面分泌物中TNF-α、IL-1β、IL-10水平,观察两组不良反应。结果:与治疗前比较,两组治疗后的患足红肿、足部溃烂、创面脓液臭秽、肌腱坏死、疼痛、发热及口渴7项中医症状积分和总分呈现显著降低趋势(均P<0.05);且与常规清创组比较,三黄血竭方组上述中医症状评分降低更显著(均P<0.05)。三黄血竭方组中医症候总有效率显著高于常规清创组(P<0.05)。治疗后,两组创面面积较治疗前缩小(均P<0.05),三黄血竭方组改善显著优于常规清创组(P<0.05);两组创面溃疡深度较治疗前显著变浅(均P<0.05),三黄血竭方组改善显著优于常规清创组(P<0.05)。与治疗前比较,两组治疗后的创面分泌物中TNF-α、IL-1β含量显著降低,IL-10含量显著升高(均P<0.05);治疗后三黄血竭方组TNF-α、IL-1β、IL-10含量改善优于常规清创组(均P<0.05)。两组均未出现明显不良反应。结论:三黄血竭方治疗糖尿病足溃疡能有效改善患者症状,缩小创面面积,改善溃疡深度,并可能通过抑制创面分泌物中TNF-α、IL-1β含量以及上调IL-10水平,以减轻创面炎症,临床安全性良好。
Objective:To investigate the therapeutic effect of Sanhuang Xuejie prescription on diabetic foot ulcer and its influence on tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-10(IL-10)contents in wound secretions.Methods:120 patients with diabetic foot ulcer were enrolled as the study subjects and were randomly divided into conventional debridement group(n=60)and Sanhuang Xuejie prescription group(n=60).The conventional debridement group was given debridement and dressing change treatment,and the Sanhuang Xuejie prescription group was given Sanhuang Xuejie prescription plaster for external application during debridement and dressing change with the same debridement treatment in conventional debridement group.The TCM symptoms scores were compared between the two groups before treatment and after 28 days of treatment.The efficacy of TCM symptoms in the two groups after 28 days of treatment was evaluated.The wound area,ulcer depth and the level of TNF-α,IL-1β,IL-10 in the wound secretions of the two groups were compared before treatment and after 14 days of treatment,and the adverse reactions were observed between the two groups.Results:After treatment,the scores of seven items of TCM symptoms such as foot redness and swelling,foot ulceration,foul wound pus,tendon necrosis,pain,fever,thirst and total score in both groups showed significant downward trends compared with those before treatment(all P<0.05),and the above scores of of TCM symptoms in Sanhuang Xuejie prescription group were significantly declined compared to conventional debridement group(all P<0.05).The total effective rate of TCM syndromes was significantly higher in Sanhuang Xuejie prescription group than that in conventional debridement group(P<0.05).After treatment,the wound area in the two groups was significantly reduced compared to before treatment(all P<0.05),and the wound area in Sanhuang Xuejie prescription group was significantly smaller than that in conventional debridement group(P<0.05).The depth of wound ulcer in both
作者
杨越
于文霞
何青敏
王猛
苏雪
YANG Yue;YU Wenxia;HE Qingmin;WANG Meng;SU Xue(Diabetes DepartmentⅠ,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou 061012,China)
出处
《陕西中医》
CAS
2023年第12期1740-1744,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
河北省中医药管理局中医药类科研计划项目(2021346)。
