【摘要】 目的观察温阳活血汤联合穴位注射治疗糖尿病足(瘀血阻络)疗效的临床观察,以期为临床治疗糖尿病足提供有效治法。方法将113例结糖尿病足(瘀血阻络)患者根据随机数字表法分为治疗组57例和对照组56例,对照组采用常规西药治疗,控制血糖、合理饮食,控制血压、血脂,改善微循环,营养神经,并对患足行清创、换药及抗感染等治疗;治疗组在对照组基础上给予温阳活血汤联合丹参注射液注射足三里,连续治疗30 d,观察两组中医证候量表评分(肢体麻木、肢体刺痛、肢体感觉、舌象)、血清神经生长因子水平(NGF)、足背动脉内径及血流速度、CRP、肿瘤坏死因子、白介素-6、不良反应等。结果①两组治疗后治疗组完全缓解率为49. 1%,部分缓解为40. 3%,总缓解率为96. 4%;对照组完全缓解率为30. 3%,部分缓解为35. 7%,总缓解率为85. 7%,两组总缓解率比较,差异有统计学意义(P <0. 05);②两组治疗后足背动脉内径及血流速度、中医证候量表评分比较(肢体麻木、肢体刺痛、肢体感觉、舌象),差异有统计学意义(P <0. 05);③两组治疗后NGF、CRP、肿瘤坏死因子、白介素-6比较,差异有统计学意义(P <0. 05)。结论温阳活血汤联合穴位注射治疗糖尿病足(瘀血阻络)确有良好疗效,值得临床应用推广与研究探讨。更多还原

【Abstract】 Objective To observe the clinical observation on the effect of wenyang huoxue decoction combined acupoint injection on diabetic foot( blood stagnation in collateral) and serum inflammatory factor and provide the effective therapeutic method for the treatment of diabetic foot. Methods According to the random number table,113 patients with diabetic foot( blood stagnation in collateral) were divided into a treatment group( 57 cases) and a control group( 56 cases).In the control group,the routine western medication,blood glucose control,rational diet,the control of blood pressure and blood lipid,the improvement in microcirculation and nerve nourishment were used,as well as foot debridement,dressing and anti-infection. In the treatment group,on the base of the treatment as the control group,wenyang huoxue decoction and danshen injection at Zusanli( ST36) were combined. The treatment was given consecutively for 30 days. The score of TCM symptom scale( limb numbness,limp stabbing pain,limp sensation and tongue condition),serum nerve growth factor( NGF),the internal diameter of dorsal pedal artery and blood flow velocity,CRP,tumor necrosis factor( TNF),IL-6 and adverse reactions were observed in the two groups. Results 1. After treatment,the complete remission was 49. 1%,the partial remission 40. 3% and the total remission 96. 4% in the treatment group and they were 30. 3%,35. 7% and 85. 7%separately in the control group. The difference was significant statistically in comparison of the total remission between the two groups( P < 0. 05). 2. The differences were significant in the internal diameter of dorsal pedal artery and blood flow velocity and the score of TCM symptom scale( limb numbness,limp stabbing pain,limp sensation and tongue condition) between the two groups after treatment( P < 0. 05). 3. The differences were significant in NGF,CRP,TNF and IL-6 between the two groups after treatment( P < 0. 05). Conclusion The combined treatment with wenyang huoxue decoction and acupoint injection achieves the satisfactory effect on diabetic foot( blood stagnation in collateral) and this therapy deserves to be promoted and explored in clinical application.更多还原