摘要
目的 观察当归四逆汤加减治疗糖尿病足(Diabeticfoot,DF)的疗效及对患者血液流变学的改善作用。方法 选取2021年3月—2023年3月期间在黑龙江中医药大学附属第一医院确诊并接受非手术治疗的DF患者82例,按随机数字表法分为对照组和观察组,每组各41例。对照组予以常规治疗,观察组给予常规治疗联合当归四逆汤加减方剂治疗。治疗8周后评价两组患者临床综合疗效,评价中医证候评分、创面局部症状评分,检测糖代谢相关指标[空腹血糖(Fasting postprandial blood glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)、糖化血红蛋白(Glycosylated hemoglobin A1c,HbA1c)],监测足远端动脉血流速度及踝肱指数(Ankle brachial index,ABI),检测血液流变学指标[全血黏度、血浆黏度(Plasma viscosity,PV)],检测血清炎症因子[白介素-1β(Interleukin-1β,IL-1β)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]、血管内皮生长因子(Vascular endothelial growth factor,VEGF)和低氧诱导因子-1(Hypoxia inducible factor-1α,HIF-1α)。结果 治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,观察组降分幅度优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者创面面积、肉芽形态、渗出、疼痛评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组创面面积、肉芽形态、渗出、疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FPG、2 h PG、HbA1c指标均较治疗前降低,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。治疗后两组患者胫后动脉、足背动脉的平均血流速度及ABI均较治疗前升高,差异有统计学意义(P<0.05);且观察组胫后动脉、足背动脉的平均血流速度及ABI均明显高于对照组,差异有统计学意义(P<0.
Objective To observe the curative effect of Modified Danggui Sini Decoction in the treatment of diabetes foot(DF)and the improvement of hemorheology.Method A total of 82 patients with DF admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from March 2021 to March 2023 were randomly divided into two groups:the control group(41 patients with DF)that received routine treatment,and the observation group(41 patients with DF)that received routine treatment combined with Modified Danggui Sini Decoction.After 8 weeks of treatment,the comprehensive clinical efficacy of two groups was evaluated.The traditional Chinese medicine(TCM)syndrome score and local symptom score of the wound were assessed,glucose metabolism related indicators[fasting postprandial blood glucose(FPG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin A1c(HbA1c)]were detected,the distal foot artery blood flow velocity and ankle brachial index(ABI)were monitored,and the hemorheological indicators[whole blood viscosity,plasma viscosity(PV)]as well as serum inflammatory factors[interleukin-1]β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],vascular endothelial growth factor(VEGF)and hypoxia inducible factor-1α(HIF-1α)were detected.Results After treatment,the TCM syndrome scores of both groups of patients decreased significantly compared to before treatment,and the difference was statistically significant(P<0.05).The observation group had lower score than the control group,with a greater reduction in scores in the observation group compared to the control group,and the difference was statistically significant(P<0.05).After treatment,the wound area,granulation morphology,exudation,and pain scores of both groups of patients were significantly decreased compared to before treatment,and scores of the observation group were lower than the control group,with statistically significant differences(P<0.05).After treatment,the FPG,2 h PG,and HbA1c of the two groups of patients decreased significan
作者
解子其
杨泽慧
万颖
李媛
丁戊坤
高杰
XIE zi-qi;YANG Ze-hui;WAN Ying;LI Yuan;DING Wu-kun;GAO Jie(Heilongjiang University of Chinese Medicine,Haerbin Heilongjiang 150040;Department of Peripheral Vascular Disease,First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Haerbin Heilongjiang 150040)
出处
《世界中西医结合杂志》
2024年第4期805-811,共7页
World Journal of Integrated Traditional and Western Medicine
基金
2022年黑龙江省自然科学基金资助项目(LH2022H075)
国家中医考试2022年科研课题(TC2022044)
2022年黑龙江省中医药科研项目(ZHY2022-184)
2023年黑龙江省教育科学规划重点课题(GJB1423477)
2022年黑龙江省“双一流”学科协同创新成果建设项目(培育项目A档,LJGXCG2022-102)
2022年黑龙江省卓越研究生培养模式改革创新项目(36)
黑龙江省双一流学科项目(21010)
2022年度高等教育本科教育教学改革研究重点委托项目(SJGZ20220102)。
关键词
糖尿病足
当归四逆汤
血虚寒凝证
血液流变学
Diabetes Foot
Danggui Sini Decoction
Blood Deficiency Cold Coagulation Syndrome
Hemorheology
