自然重建与动静结合理论下运用海桐皮汤熏洗治疗糖尿病足溃疡疗效研究

目的:观察在自然重建及动静结合理论指导下,胫骨横向骨搬移术后联合海桐皮汤熏洗治疗糖尿病足溃疡的临床疗效。方法:选取2017年5月—2019年01月本院足踝外科糖尿病足单侧溃疡住院患者共30例,溃疡创面均在踝关节以下,根据Wagner经典分级法属于1~4级,其中男性20例,女性10例,年龄(65.22±3.14)岁,病程(13.19±4.21)年,运用以上理论方法治疗,于治疗前后观察对比其溃疡创面愈合时间,皮温改变,下肢血管血流超声分析变化,踝肱指数(ABI)改变,密歇根神经病变筛选法(Michigan neuropathy screening instrument,MNSI)评分评定患者外周血管和外周神经恢复情况以及观察并发症情况。结果:治疗后,在为期18个月的随访中,除1例意外事故死亡患者外,其余29例患者均获得有效随访,29位患者患肢溃疡创面均愈合,下肢功能得到有效改善,未出现复发。结论:在自然重建动静结合理论指导下的胫骨横向骨搬移配合海桐皮汤熏洗治疗糖尿病足溃疡,可促进患肢外周血管修复再生和外周神经功能修复,且并发症少,此方法可靠有效,临床值得推广。

Study on the Effect of fumigating and washing with Haitongpi Decoction on diabetic foot ulcer under the theory of natural reconstruction and dynamic and static combination

Objective:To observe the clinical effect of transverse tibial bone transfer combined with Haitongpi Decoction fumigation in the treatment of diabetic foot ulcer under the guidance of the theory of natural reconstruction and combination of dynamic and static.Methods:from May 2017 to January 2019,a total of 30 hospitalized patients with unilateral diabetic foot ulcer in foot and ankle surgery of our hospital were selected.The ulcer wounds were all below the ankle joint.According to Wagner’s classical classification method,they belonged to grade 1-4,including 20 males and 10 females,with an age of(65.22±3.14)years and a disease course of(13.19±4.21)years The wound healing time,skin temperature,blood flow of lower limbs were analyzed by ultrasound,ankle brachial index(ABI)was changed,and the recovery of peripheral blood vessels and peripheral nerves was evaluated by Michigan neuropathy screening instrument(MnSi)score.Results:after treatment,in the 18 month follow-up,except for 1 patient died of accident,the remaining 29 patients were effectively followed up.The wounds of 29 patients with limb ulcer healed,the lower limb function was effectively improved,and no recurrence occurred.Conclusion:in the treatment of diabetic foot ulcer,the lateral tibial bone transfer combined with Haitongpi Decoction fumigation and washing under the guidance of the theory of combining dynamic and static reconstruction with Haitongpi decoction can promote the repair and regeneration of peripheral blood vessels and the repair of peripheral nerve function of the affected limbs,with less complications.This method is reliable and effective and worthy of clinical promotion.