术后联合木丹颗粒对于糖尿病足施行胫骨横向搬移患者的临床疗效

目的 探究木丹颗粒在重建下肢血运、恢复神经传导方面对于糖尿病足胫骨横向搬移术后患者临床疗效的影响。 方法 选取2017年10月—2018年12月西安交通大学第一附属医院骨科收治的32例糖尿病足患者,采用随机数字表法分为对照组和观察组,每组16例。2组患者均行胫骨横向搬移术,观察组术后口服木丹颗粒继续治疗,对照组口服安慰剂进行对比,持续8周,比较2组糖尿病足患者术后相关结果评价指标,如术后溃疡愈合时间、足部皮温、疼痛评分、足背动脉血流速度、腓总神经感觉及运动传导速度、外周血细胞因子水平,并记录治疗过程中的并发症及不良反应发生情况。 结果 32例病例均得到随访,随访时间平均为5.6个月(4~9个月)。观察组与对照组相比,术后溃疡愈合时间明显缩短,术后皮温、足背动脉血流速度及术后疼痛症状的缓解程度也优于对照组,同时,腓总神经感觉、运动传导速度及外周血细胞因子水平也较对照组有所提高,差异有统计学意义(均P<0.05)。 结论 施行胫骨横向搬移的糖尿病足患者,术后口服木丹颗粒能够有效缓解疼痛,提高血流动力学指标,促进神经传导,促进溃疡创面的快速愈合,并在预防溃疡复发及骨折的形成方面有一定的增益效果,可能是糖尿病足患者施行胫骨横向搬移术后一种良好的补充强化治疗方式。 

Clinical effect of postoperative combined with Mudan Granule on diabetic foot patients undergoing tibial lateral bone transfer

Objective To investigate the clinical effect of Mudan Granule in reconstructing lower limb blood transport and nerve conduction of diabetic foot patients undergoing tibial lateral bone transfer. Methods A total of 32 patients with diabetic foot admitted to the hospital from October 2017 to December 2018 were selected and divided into control group and experimental group using random number table method, with 16 cases in each group. All patients were received transverse tibial bone transport. After operation, the experimental group were received Mudan Granule orally and the control group were received placebo for 8 weeks. Ulcer healing time, foot skin temperature, VAS pain score, blood flow velocity of dorsal foot artery, total peroneal nerve sensation, motor conduction velocity, peripheral blood VEGF and PDGF levels of patients were compared between the two groups. The complications and adverse reactions during treatment were recorded. Results All 32 cases were followed up for an average of 5.6 months(4-9 months). Compared with the control group, the ulcer healing time of the experimental group was significantly shortened. The improvement of skin temperature, blood flow velocity of dorsal foot artery and relief degree of postoperative pain symptoms of the experimental group were better than the control group. Meanwhile, the total peroneal nerve sensory, motor conduction velocity and the level of peripheral blood cytokines of the experimental group were increased compared with the control group(all P<0.05). Conclusion After tibial lateral bone transfer, oral administration of Mudan Granules can effectively relieve pain, improve the hemodynamic index and promote the nerve conduction and rapid healing of ulcer wound. Meanwhile, it has certain effect in preventing ulcer recurrence and fracture formation, which may be a good complementary and intensive treatment for diabetic foot patients after transverse tibial bone transport.