[1]潘旭月,陈兆军,祁印泽,等.基于中医辨证分型应用中药外用制剂促进糖尿病足溃疡愈合的临床研究[J].中国中医骨伤科杂志,2024,32(01):36-41.[doi:10.20085/j.cnki.issn1005-0205.240107]
　PAN Xuyue,CHEN Zhaojun,QI Yinze,et al.Clinical Study on Diabetes Foot Ulcer Treated with External Application of Traditional Chinese Medicine Based on the Differentiation of Symptoms[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(01):36-41.[doi:10.20085/j.cnki.issn1005-0205.240107]
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基于中医辨证分型应用中药外用制剂促进糖尿病足溃疡愈合的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年01期
页码:
36-41
栏目:
临床研究
出版日期:
2024-01-15

文章信息/Info

Title:
Clinical Study on Diabetes Foot Ulcer Treated with External Application of Traditional Chinese Medicine Based on the Differentiation of Symptoms
文章编号:
1005-0205(2024)01-0036-06
作者:
潘旭月1; 陈兆军1; 祁印泽1; 魏芳远1△
1北京中医药大学第三附属医院手足外科(北京,100029)
Author(s):
PAN Xuyue1; CHEN Zhaojun1; QI Yinze1; WEI Fangyuan1△
1Department of Hand and Foot Surgery,Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China.
关键词:
中药外用;  糖尿病足;  辨证分型
Keywords:
external use of traditional Chinese medicine;  diabetes foot;  differentiation of symptoms
分类号:
R274.39
DOI:
10.20085/j.cnki.issn1005-0205.240107
文献标志码:
A
摘要:
目的:探讨基于中医辨证分型应用中药外用制剂促进糖尿病足溃疡愈合的疗效。方法:选取2019年7月至2022年7月住院的糖尿病足患者,随机分为治疗组和对照组。治疗组根据中医三期辨证分型,采用清创换药+相应中药外用制剂,对照组采用单纯清创换药的方法。对比观察两组患者在临床综合疗效、患肢疼痛视觉模拟量表(VAS)评分、创面愈合时间等结果的差异。结果:纳入符合标准的病例90例,其中治疗组及对照组各45例,两组病例基本资料及病情差异无统计学意义(P>0.05)。临床综合疗效方面:治疗组治愈13例,显效25例,有效3例,无效4例,总有效率为91%; 对照组治愈5例,显效20例,有效2例,无效18例,总有效率为60%,两组疗效比较差异有统计学意义(P<0.05)。两组患者在治疗后2周、1个月及3个月时VAS评分均较前改善,治疗组VAS评分由治疗前的(6.31±1.01)分降至治疗后2周的(3.11±1.09)分、1个月时的(1.49±0.81)分和3个月时的(0.51±0.84)分,对照组疼痛评分由治疗前的(6.47±1.18)分降至2周后的(4.18±1.45)分、1个月时的(2.58±0.89)分及3个月时的(2.00±1.38)分,两组之间差异有统计学意义(P<0.05)。治疗组创面愈合时间方面明显优于对照组,差异有统计学意义(P<0.05),但治疗组组内不同分型的VAS评分及创面愈合时间差异无统计学意义(P>0.05)。结论:根据中医三期辨证分型来合理应用中药外用制剂可促进糖尿病足溃疡愈合。
Abstract:
Objective:To explore the curative efficacy of external application of Chinese medicine on promoting the healing of diabetes foot ulcer based on the differentiation of symptoms and signs of traditional Chinese medicine(TCM).Methods:Patients diagnosed with diabetes foot from July 2019 to July 2022 were randomly collected and divided into treatment group and control group.The treatment group was treated with debridement and external used Chinese medicine according to the three-stage differentiation of traditional Chinese medicine,while the control group was treated with simple debridement.Clinical comprehensive efficacy,visual analogue scale(VAS)score of limb pain and wound healing time were compared between the two groups.Results:90 cases were included,comprised 45 cases in the treatment group and 45 cases in the control group.There was no significant statistical difference between the two groups in the basic line.In terms of clinical comprehensive efficacy,for the treatment group,13 cases were cured,25 cases were markedly effective,3 cases were effective,and 4 cases were ineffective,with the total effective rate of 91%; in the control group,5 cases were cured,20 cases were markedly effective,2 cases were effective,and 18 cases were ineffective,the total effective rate was 60%.There was significant difference between the two groups(P<0.05).The VAS score of the two groups was improved at 2 weeks,1 month and 3 months after treatment.The VAS score of the treatment group decreased from(6.31±1.01)points before treatment to(3.11±1.09)points at 2 weeks and(1.49±0.81)points at 1 month and(0.51±0.84)points at 3 months after treatment.The pain score of the control group decreased from(6.47±1.18)points before treatment to(4.18±1.45)points at 2 weeks and(2.58±0.89)points at 1 month and(2.00±1.38)points at 3 months after treatment.However,there was significant difference between the two groups(P<0.05).The wound healing time of the treatment group was significantly shorter than the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in VAS and wound healing time of different types between the treatment groups(P>0.05).Conclusion:Rational application of TCM external preparations according to TCM syndrome differentiation can promote the healing of diabetes foot ulcers.

参考文献/References:

[1] 张海霞,李 旗,田福玲,等.中医药治疗糖尿病足研究进展[J].海南医学院学报,2020,26(8):637-640.
[2] SCHAPER N C,VAN NETTEN J J,APELQVIST J,et al.Prevention and management of foot problems in diabetes:a summary guidance for daily practice 2015,based on the IWGDF guidance documents[J].Diabetes Metab Res Rev,2016,32(S1):7-15.
[3] ZHANG S S,TANG Z Y,FANG P,et al.Nutritional status deteriorates as the severity of diabetic foot ulcers increases and independently associates with prognosis[J].Exp Ther Med,2013,5(1):215-222.
[4] 肖智慧,曹刚,黄强,等.糖尿病足的中医研究进展[J].中医药信息,2018,35(2):100-103.
[5] 中华医学会糖尿病学分会,中华医学会感染病学分会,中华医学会组织修复与再生分会.中国糖尿病足防治指南(2019年版)[J].中华糖尿病杂志,2019,11(2):92-108.
[6] 中国中西医结合学会周围血管病专业委员会.中西医结合防治糖尿病足中国专家共识[J].血管与腔内血管外科杂志,2019,5(5):379-402.
[7] BREIVIK H.Fifty years on the visual analogue scale(VAS)for pain-intensity is still good for acute pain,but multidimensional assessment is needed for chronic pain[J].Scand J Pain,2016,11:150-152.
[8] 王可仪,欧益,刘春香,等.中医药治疗糖尿病足临床研究结局指标分析[J].中国中药杂志,2021,46(15):4008-4015.
[9] SCHAPER N C,VAN NETTEN J J,APELQVIST J,er al.Practical guidelines on the prevention and management of diabetic foot disease(IWGDF 2019 update)[J].Diabetes Metab Res Rev,2020,36(Suppl 1):e3266.
[10] 刘建琴,许樟荣.糖尿病足的预防与患者的自我管理[J].中国医刊,2017,52(2):14-17.
[11] 许樟荣,王玉珍.糖尿病足的综合防治和分级管理[J].中国医刊,2017,52(2):11-14.
[12] 张娟.中西医结合治疗糖尿病足临床研究[J].内蒙古中医药,2020,39(6):160-162.
[13] 王军,张庚扬,侯玉芬,等.糖尿病足溃疡期中医综合外治方案规范的多中心临床研究[J].北京中医药大学学报(中医临床版),2013,20(2):15-18.
[14] 牛胜男,李国信,梁茂新,等.糖尿病足中医辨证存在的问题与对策[J].中华中医药杂志,2022,37(8):4319-4322.
[15] 蒋竹奕,谢颖,杨川.中国糖尿病足溃疡患者预后危险因素研究进展[J].中国糖尿病杂志,2020,28(7):550-554.
[16] 王冠,刘明,栾耀芳,等.四黄洗药汤治疗糖尿病足溃疡疗效观察[J].陕西中医,2017,38(11):1558-1559.
[17] 杨静,任星,付国静,等.中医药治疗糖尿病足的临床研究证据图分析[J].中国中药杂志,2022,47(14):3943-3949.

备注/Memo

备注/Memo:
基金项目:2017年北京中医药大学青年教师项目(2017-JYB-JS-119)
△通信作者 E-mail:footwfy@126.com
更新日期/Last Update: 2024-01-15