化腐再生散促进糖尿病足肌腱坏死创面早期修复临床研究

Clinical research of Huafu Zaisheng powder on prompting early repair of wound on diabetic foot with necrotic tendons

关键词:  化腐再生散  糖尿病足  菠萝蛋白酶  生肌象皮膏  肌腱

Key words:  Huafu Zaisheng powder  diabetic foot  bromelain  Shengji Xianpi ointment  tendons

摘要:

[目的] 观察化腐再生散对糖尿病足肌腱坏死创面早期的影响。[方法] 71例糖尿病足患者,随机分为化腐再生散+生肌象皮膏组(A组)35例,单纯生肌象皮膏组(B组)36例,对其创面适时行蚕食清创后,分别采用不同药物治疗,观察14 d后坏死肌腱脱落情况以及治疗前后血常规中白细胞以及伤口分泌物中肿瘤坏死因子-α(TNF-α)等炎性指标的变化,同时对治疗前后伤口组织进行病理分析,综合分析药物对创面早期修复的影响。[结果] A组坏死肌腱治疗后较B组脱落明显;两组白细胞均呈下降趋势,但A组下降迅速,与B组比较差异有统计学意义(P<0.05);而两组分泌物TNF-α均呈上升趋势,A组较B组升高(P<0.05);病理学检测显示换药后A组新生血管生成较B组明显。[结论] 应用化腐再生散结合生肌象皮膏换药治疗糖尿病足肌腱坏死创面,能够尽早促进坏死肌腱脱落,激活抗炎免疫机制,控制感染,促进新生肉芽组织生长,从而促进创面修复进程。

Abstract:

[Objective] To observe the early effect of Huafu Zaisheng powder in treating the diabetic foot with necrotic tendons. [Methods] The 71 patients suffering from diabetic foot were randomly divided into Huafu Zaisheng powder combined with Shengji Xianpi ointment group (Group A, 35 cases), Shengji Xianpi ointment group (Group B, 36 cases). After the timely eroded debridement for its wound, different drugs were adopted to the wound dressing for observing the liquefaction of necrotic tendons as well as the changing of inflammatory indicators of the white blood cells in blood routine test and TNF-α in the wound exudation before and after the treatment. In addition, pathological analysis was conducted on the wound tissue before and after the treatment, comprehensively analyzing the effect of drugs on the early repair of the wound. [Results] The necrotic tendons in Group A after treatment were liquefied clearer than that in Group B; the index of the white blood cell in both groups was on a declining tendency. But Group A declined promptly and had statistical significance compared with Group B (P<0.05); the level of TNF-α in secreta has rising tendency in both groups, with Group A was higher than Group B(P<0.05); the pathological examination showed that the neogenesis of new vessels was more obvious in Group A than that in Group B after wound dressing. [Conclusion] The wound dressing treatment with Huafu Zaisheng powder combined with Shengji Xianpi ointment on the wound of diabetic foot with necrotic tendons is proved to behave well in promoting the liquefaction of necrotic tendons as early as possible and in the growth of the newly born granulation tissue, in activating the anti -inflammatory immune mechanism and controlling infection, thus promote the process of wound repair.