当归补血汤合二妙散加减联合负压封闭引流技术治疗糖尿病足的疗效观察

目的:探讨当归补血汤合二妙散加减联合负压封闭引流(vacuum sealing drainage,VSD)技术治疗糖尿病足(diabetic foot,DF)临床疗效。方法:将秦皇岛军工医院内分泌科2019年2月至2020年3月收治的80例DF患者由随机数字表法分为对照组(40例)和观察组(40例)。对照组患者给予基础治疗、清创换药和VSD技术治疗,观察组患者在对照组的基础上采用当归补血汤合二妙散加减治疗。观察并比较两组患者的临床疗效、间歇性跛行距离增加值、肢体抬高试验(Buerger试验)降低值、踝肱指数(ABI)、创面愈合时间和住院时间、疼痛视觉模拟评分(visual analogue scale,VAS)及血液流变学情况。结果:观察组患者的治疗总有效率为97.50%(39/40),明显高于对照组的77.50%(31/40),差异有统计学意义(χ²=7.314,P=0.007)。观察组患者的创面愈合时间及住院时间明显短于对照组,间歇性跛行距离增加值、Buerger试验降低值均高于对照组,差异均有统计学意义(P<0.05)。相比治疗前,两组患者治疗后的VAS评分明显降低,ABI明显升高;且观察组患者的VAS评分明显低于对照组,ABI明显高于对照组,上述差异均有统计学意义(P<0.05)。相比治疗前,两组患者治疗后的全血高切黏度、全血低切黏度、纤维蛋白原及血浆黏度水平明显降低,且观察组患者明显低于对照组,上述差异均有统计学意义(P<0.05)。结论:当归补血汤合二妙散加减联合VSD技术治疗DF的临床疗效确切,能有效减轻患者疼痛,改善其临床症状和指标,调控血液黏度,缩短创面恢复时间和住院时间。

Efficacy of Danggui Buxue Decoction and Ermiao Powder Combined with Vacuum Sealing Drainage in the Treatment of Diabetic Foot

OBJECTIVE:To probe into the clinical efficacy of Danggui Buxue decoction and Ermiao powder combined with vacuum sealing drainage(VSD)in the treatment of diabetic foot(DF).METHODS:Totally 80 patients with DF admitted into Qinhuangdao Jungong Hospital from Feb.2019 to Mar.2020 were extracted to be divided into the control group(n=40)and the observation group(n=40)via the random number table.The control group was treated with basic treatment,debridement and VSD technology,while the observation group received Danggui Buxue decoction and Ermiao powder on the basis of the control group.The clinical efficacy,intermittent claudication distance increment,decrease of Buerger test,ankle brachial index(ABI),wound healing time and length of stay,visual analogue scale(VAS)score and hemorheological indicators of two groups were observed and compared.RESULTS:The total effective rate of the observation group was 97.50%(39/40),significantly higher than that of the control group 77.50%(31/40),the difference was statistically significant(χ²=7.314,P=0.007).The wound healing time and length of stay of the observation group were significantly shorter than those of the control group,while intermittent claudication distance increment and decrease of Buerger test were higher than those of the control group,the differences were statistically significant(P<0.05).Compared with before treatment,the VAS score decreased significantly and ABI increased significantly in two groups after treatment.The VAS score in the observation group was significantly lower than that in the control group,the ABI was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Compared with before treatment,the whole blood viscosity high shear,whole blood viscosity low shear,fibrinogen and plasma viscosity levels in two groups after treatment decreased significantly,and the observation group was significantly lower than the control group,the differences were statistically significant(P<0.05).CONCLUSIONS:The clinical efficacy of Danggui Buxue decoction and Ermiao powder combined with VSD in the treatment of DF is significant,which can effectively alleviate patients’pain,improve the clinical symptoms and indicators,regulate the blood viscosity,and shorten the wound recovery time and length of stay.