化腐再生法治疗糖尿病足肌腱坏死的初步机制

目的:观察化腐再生法对糖尿病足坏死肌腱的化除及对伤口的愈合的初步机制。方法:107例糖尿病足患者,随机分为化腐再生组35例,化腐组36例,再生组36例,针对其创面情况适时行蚕食清创,而后分别采用不同药物换药治疗,在治疗0、3、7、14天分别提取伤口分泌物进行各项生化指标及pH值检测,并对化腐再生组分泌物行扫描电镜检测,观察三种换药方法对糖尿病足肌腱坏死创面康复的影响,并分析其初步机制。结果:8周后观察化腐再生组坏死肌腱治疗后较其他两组脱落明显;创面分泌物中的总蛋白、总氨基酸、总DNA、总一氧化氮(NO)及溶菌酶含量随时间延长显著增加,其中各项指标化腐再生组均高于其他两组,差异有统计学意义(P<0.05);化腐再生组各阶段分泌物pH值更加符合伤口愈合pH值曲线;分泌物电镜观察显示化腐再生法处理过的伤口分泌物逐渐浓稠,白细胞活性增强。结论:应用化腐再生法治疗能够明显调动起有益于伤口修复的活性因子,并顺应伤口愈合规律,提供适宜伤口修复的外环境,从而促进糖尿病肌腱坏死伤口愈合。

Preliminary Mechanism of the Method of Huafu Zaisheng in Treating Diabetic Foot with Tendons Necrosis

Objective:To observe the preliminary mechanism of the Huafu Zaisheng method in liquefying the necrotic tendons and promoting the healing of the wound on the diabetic foot.Methods:107 patients suffering from diabetic foot were randomly divided into Huafu Zaisheng group(35 cases),Huafu group(36cases),Zaisheng group(36cases),then had eroded debridement timely for its wounds.After that,different drugs were used for the wound dressing,collecting the exudation from the wound at the time of four points after wound dressing:0d,3d,7d,14d.Then detect biochemical index and pH of the exudation in different points,and detect the exudation of Huafu Zaisheng group with scanning electron microscopy.Then observe the effect of wound healing in diabetic foot with tendons necrosis using the three kinds of wound dressing for the analysis.Results:The necrotic tendons of Huafu Zaisheng group were liquefied clearer than the that of other two groups;the content of total protein,total amino acids,total DNA,total nitric oxide(NO)and lysozyme increased significantly through time,each index in Huafu Zaisheng group was higher than that in the other groups,the difference was of significance in statistics science(P<0.05).The pH of exudation of Huafu Zaisheng group was more in line with the pH curve of wound healing,the electron microscopy showed that the exudation turned thick gradually and the white blood cell activity increased using the method of Huafu Zaisheng.Conclusion:The treatment of Huafu Zaisheng can mobilize the active factor that is beneficial to wound repairing,provide the external environment that benefits for wound repairing and company with the law of wound healing,thus it can promote healing of diabetic wound with tendons necorsis.