清热解毒活血通络法治疗糖尿病足30例临床观察

目的观察清热解毒活血通络法治疗糖尿病足（DF）的临床疗效。方法将60例DF患者随机分为2组,治疗组30例采用中药口服、外洗、中药换药治疗,对照组30例予常规换药治疗。3个月后观察2组治疗前后患肢创面愈合情况,检测创面生长因子、足背动脉血流和管径、下肢周围神经神经传导功能以及血液流变学变化。结果治疗组总有效率（96.67%）优于对照组（76.67%,P〈0.01）。2组治疗后溃疡面积均较治疗前明显缩小（P〈0.01）,碱性成纤维细胞生长因子（bFGF）、血管内皮细胞生长因子（VEGF）表达升高（P〈0.01）,腓肠神经、腓总神经传导速度、足背动脉内径及血流速度均明显改善（P〈0.01,P〈0.05）,全血黏度（高切）、血浆黏度、纤维蛋白原降低（P〈0.01,P〈0.05）,且治疗组更明显（P〈0.01,P〈0.05）。结论综合应用清热解毒活血通络法,内外结合治疗DF,可改善血管和神经功能,降低血黏度,加速溃疡愈合。

Clinical observation of Qingrejiedu Huoxuetongluo recipe on diabetic foot

Objective To study the mechanism of action of Qingrejiedu Huoxuetongluo recipe on diabetic Foot. Methods 60 cases of diabetic foot were randomly divided into treatment group and control group. 30 cases in treatment group were treated by Oral medicine, external washing, and dressing medicine treatment. 30 cases in con- trol group received conventional dressingg medicine. The limb wound area and growth factor, dorsal artery blood flow and diameter changes, lower extremity peripheral nerve function in nerve conduction and blood rheology examination were observed before and after treatment. Three months was as a treatment cycle. After a course data was collected for statistical analysis. Results The total effective rate in treatment group （96.67%） was higher than that in control group （76.67% , P 〈 0.01 ）. The ulcer area after treatment were significantly reduced compared with those before treatment in two groups （ P 〈 0.01 ）, effect of the treatment group was more than that in the control group （ P 〈 0. O1 ）. BFGF and VEGF expression after treatment were significantly increased in two groups （ P 〈 0.01 ）. Sural nerve, common peroneal nerve conduction velocity, dorsalis pedis artery diameter and blood flow velocity after treat- ment were significantly improved in two groups （ P 〈 0. 01, P 〈 0. 05 ）, blood viscosity and fibrinogen after treatment were reduced in two groups （ P 〈 0. 01, P 〈 0.05 ）. The decrease of the treatment group was more obvious than that of the control group （ P 〈 0.01, P 〈 0.05 ）. Conclusion Qingrejiedu Huoxuetongluo recipe on diabetic foot can promote vessel and nerve function improvement, reduce blood viscosity and accelerate wound healing.