Effect of ultrasonic debridement combined with traditional Chinese medicine foot bath on Wagner grade 2 and 3 ulcer of diabetic foot
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摘要:目的
观察超声清创术联合中药足浴对糖尿病足Wagner 2、3级溃疡的治疗效果。
方法选取60例糖尿病足Wagner 2、3级患者为研究对象，随机分为观察组和对照组，每组30例。观察组采用超声清创术联合中药足浴治疗，对照组给予机械外科清创处理, 4周后记录2组患者伤口愈合情况、超敏C反应蛋白和降钙素原的变化情况，并观察总体治疗效果。
结果治疗4周后，观察组创面面积为(1.86±0.61) cm2, 创面缩小率为(86.13±12.36)%, 对照组创面面积为(4.53±0.87) cm2, 创面缩小率为(52.28±14.57)%。观察组创面面积小于对照组，创面缩小率高于对照组，差异有统计学意义(P＜0.05)。治疗后，观察组超敏C反应蛋白、降钙素原分别为(6.42±1.82) mg/L、(0.21±0.16) ng/L, 低于对照组的(12.38±2.46) mg/L和(0.35±0.32) ng/L, 差异均有统计学意义(P＜0.05)。观察组治疗总有效率为83.33%, 高于对照组的56.67%, 差异有统计学意义(P＜0.05)。
结论超声清创术联合中药足浴治疗糖尿病足Wagner 2、3级溃疡可促进肉芽组织生长和创面愈合，改善患肢血液循环，值得临床推广应用。
Abstract:ObjectiveTo observe the therapeutic effect of ultrasound debridement and traditional Chinese medicine foot bath in Wagner grade 2 or grade 3 ulcer of diabetic foot.
MethodsA total of 60 patients with Wagner grade 2 or grade 3 ulser in diabetic foot were selected and randomly divided into observation group (30 patients) and control group(30 patients). The observation group was treated with ultrasonic debridement combined with traditional Chinese medicine foot bath, and the control group was treated with mechanical surgical debridement. Four weeks later, the wound healing and the changes of hypersensitive C reactive protein and procalcitonin levels of the two groups were recorded, and the overall treatment effect was observed.
ResultsAfter 4 weeks of treatment, the wound area of the observation group was (1.86±0.61) cm2, and the wound reduction rate was (86.13±12.36)%, while the wound area of the control group was (4.53±0.87) cm2, and the wound reduction rate was (52.28±14.57)%. The wound area of the observation group was smaller than that of the control group, and the wound reduction rate was higher than that of the control group (P < 0.05). After treatment, high sensitivity C-reactive protein and procalcitonin in the observation group were (6.42±1.82) mg/L and (0.21±0.16) ng/L, respectively, which were lower than (12.38±2.46) mg/L and (0.35±0.32) ng/L in the control group (P < 0.05). The total effective rate of treatment in the observation group was 83.33%, which was higher than 56.67% of the control group, and the difference was statistically significant (P < 0.05).
ConclusionTreatment of ultrasonic debridement and Chinese medicine foot bath can promote granulation tissue growth, wound healing and improve blood circulation of affected limb, which is worth of clinical promotion and application.
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Keywords:
- ultrasonic debridement /
- Chinese medicine foot bath /
- Wagner grade /
- diabetic foot /
- ulcer area /
- wound
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表 1 2组一般资料和相关指标水平比较(x±s)[n(%)]
指标 对照组(n=30) 观察组(n=30) 男 12(40.00) 19(63.33) 女 18(60.00) 11(36.67) 年龄/岁 54.60±13.53 57.85±9.51 腰围/cm 86.55±9.36 89.24±11.32 臀围/cm 100.43±7.89 99.80±12.41 体质量指数/(kg/m2) 25.84±3.62 25.16±3.64 心率/(次/min) 80.85±7.05 78.41±14.10 糖尿病病程/年 7.53±3.52 8.64±4.05 糖尿病足病程/年 1.82±0.41 1.68±0.30 收缩压/mmHg 138.61±12.53 136.28±15.09 舒张压/mmHg 76.63±11.81 78.69±12.22 空腹血糖/(mmol/L) 8.16±1.54 8.29±1.66 2 h餐后血糖/(mmol/L) 11.62±2.08 11.53±2.09 糖化血红蛋白/% 7.89±1.52 7.27±1.27 甘油三酯/(mmol/L) 1.68±0.46 2.06±1.35 总胆固醇/(mmol/L) 4.62±1.39 5.28±1.67 
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表 2 2组治疗前后血清炎症指标水平比较(x±s)
组别 超敏C反应蛋白/(mg/L) 降钙素原/(ng/L) 治疗前 治疗后 治疗前 治疗后 观察组 26.54±2.43 6.42±1.82*# 1.45±0.20 0.21±0.16*# 对照组 23.73±2.62 12.38±2.46* 1.52±0.18 0.35±0.32* 与治疗前比较, * P＜0.05; 与对照组比较, #P＜0.05。
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表 3 2组临床疗效比较[n(%)]
组别 n 治愈 显效 好转 无效 总有效 观察组 30 8(26.67) 17(56.67) 4(13.33) 1(3.33) 25(83.33)* 对照组 30 5(16.67) 12(40.00) 7(23.33) 6(20.00) 17(56.67) 与对照组比较, * P＜0.05。
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