叶酸、硫辛酸联合足底穴位按摩对高危糖尿病足患者的疗效观察

目的探讨联合应用叶酸、静脉加口服硫辛酸序贯治疗及足底穴位按摩对高危糖尿病足(DF)的康复效果。方法120例高危DF患者随机分为4组,对照组采用糖尿病基础治疗,叶酸组在对照组基础上加用叶酸,硫辛酸组在叶酸组基础上加用α-硫辛酸静脉滴注2周后口服,按摩组在硫辛酸组基础上加用足底穴位按摩治疗,疗程6个月。比较干预前后4组多伦多症状体征评分、肱踝脉搏波传导速度(ba PWV)、踝肱比(ABI)以及生活质量评分变化。结果叶酸组、硫辛酸组、按摩组同型半胱氨酸、ba PWV较对照组显著下降(P0.01);多伦多症状体征评分除叶酸组外均较对照组显著降低(P0.01);ABI除叶酸组外均较对照组显著升高(P0.01);生活质量评分除叶酸组外均较对照组显著降低(P0.01);硫辛酸组、按摩组氧化型低密度脂蛋白显著低于未用硫辛酸组(P0.01)。结论叶酸、硫辛酸联合足底按摩可以改善DF治疗效果。

Effect observation of folic acid,lipoic acid combined with plantar acupoint massage on treatment of patients with high-risk diabetic foot

Objective To investigate the rehabilitation effect of folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage on treatment of patients with high-risk diabetic foot (DF).Methods A total of 120 patients with high-risk DF were randomly divided into 4 groups.The control group was given routine therapy of diabetes.Besides the basic treatment,folic acid was given in the folic acid group.On the basis of the folic acid group,lipoic acid was used in lipoic acid group with oral taken after two weeks of intravenous drip.The massage group was treated with plantar acupoint massage on the basis of the lipoic acid group,and the treatment course was 6 months.The Toronto symptom and sign score,the brachial ankle pulse wave velocity (baPWV),the ankle brachial ratio (ABI) and the score of life quality of four groups were compared before and after the intervention.Results The homocysteine and the baPWV in the folic acid group,the lipoic acid group and the massage group were significantly lower than those in the control group (P ＜0.01).Except for the folic acid group,The Toronto symptom and sign score in the other two groups was significantly lower than that in the control group (P ＜ 0.01).Except for the folic acid group,ABI of the lipoic acid group and the massage group was significantly higher than that of the control group (P ＜0.01).The score of life quality in the lipoic acid group and the massage group were significantly lower than that in the control group (P ＜ 0.01).The oxidized low density lipoprotein in the lipoic acid group and the massage group were significantly lower than that in other two groups (P ＜ 0.01).Conclusion Folic acid,intravenous and oral lipoic acid sequential therapy combined with plantar acupoint massage can improve the effect of DF patients.