CAJ | 학술논문

目的：探讨补阳还五汤联合空气波压力治疗仪治疗糖尿病足0级的临床疗效及其作用机制。方法：将203例糖尿病足0级病变患者随机分为治疗组（53例）、对照1组（49例）、对照2组（50例）和对照3组（51例）。在一般治疗的基础上，治疗组采用补阳还五汤联合空气波压力治疗仪治疗，对照1组以前列腺素E1治疗，对照2组以补阳还五汤治疗，对照3组以空气波压力治疗仪治疗。疗程4周，通过观察治疗前后临床症状、体征及生化指标（如P-选择素、L-选择素等）的变化，评价、总结其疗效。结果：治疗组显效25例，良好14例，改善8例，无效6例，总有效率88.7%；对照1组显效7例，良好10例，改善27例，无效5例，总有效率为89.8%；对照2组显效1例，良好12例，改善25例，无效12例，总有效率为76.0%；对照3组显效1例，良好10例，改善27例，无效13例，总有效率为74.5%；四组疗效差异有显著性（x2＝10.994，P＝0.012），治疗组与对照1组疗效优于对照2、3组。治疗组与对照1组比较差异有显著性（Z＝-2.147，P＝0.032），治疗组的显效率高于对照1组。治疗组与对照1组在血脂、血液流变学、P-选择素、L-选择素等指标治疗后较治疗前均有明显改善（P<0.05），且优于对照2和3组（P<0.05）。结论：补阳还五汤联合空气波压力治疗仪通过调节脂质代谢，降低血液黏稠度，抗血小板活化，改善受损的血管内皮功能来减缓糖尿病足的进程；其治疗糖尿病足0级廉、简、便、效，适于临床推广应用。
목적：탐토보양환오탕연합공기파압력치료의치료당뇨병족0급적림상료효급기작용궤제。방법：장203례당뇨병족0급병변환자수궤분위치료조（53례）、대조1조（49례）、대조2조（50례）화대조3조（51례）。재일반치료적기출상，치료조채용보양환오탕연합공기파압력치료의치료，대조1조이전렬선소E1치료，대조2조이보양환오탕치료，대조3조이공기파압력치료의치료。료정4주，통과관찰치료전후림상증상、체정급생화지표（여P-선택소、L-선택소등）적변화，평개、총결기료효。결과：치료조현효25례，량호14례，개선8례，무효6례，총유효솔88.7%；대조1조현효7례，량호10례，개선27례，무효5례，총유효솔위89.8%；대조2조현효1례，량호12례，개선25례，무효12례，총유효솔위76.0%；대조3조현효1례，량호10례，개선27례，무효13례，총유효솔위74.5%；사조료효차이유현저성（x2＝10.994，P＝0.012），치료조여대조1조료효우우대조2、3조。치료조여대조1조비교차이유현저성（Z＝-2.147，P＝0.032），치료조적현효솔고우대조1조。치료조여대조1조재혈지、혈액류변학、P-선택소、L-선택소등지표치료후교치료전균유명현개선（P<0.05），차우우대조2화3조（P<0.05）。결론：보양환오탕연합공기파압력치료의통과조절지질대사，강저혈액점주도，항혈소판활화，개선수손적혈관내피공능래감완당뇨병족적진정；기치료당뇨병족0급렴、간、편、효，괄우림상추엄응용。
Objective: To discuss the clinical effect and mechanism of action of diabetes feet degree 0 treated by the Buyang Huanwu decoction with air wave pressure therapeutic equipment. Methods:To divide randomly 203 cases of patients with diabetes feet degree 0 into treatment group (53 cases), control group 1 (49 cases), control group 2 (50 cases), and control group 3 (51 cases). Based on the general treatment, the cooperation treatment of Buyang Huanwu decoction and air wave pressure therapeutic equipment was used in treatment group. Prostaglandin E1 was used for the treatment in control group 1;Buyang Huanwu decoction treatment was used in control group 2; and air wave pressure therapeutic equipment was used in control group 3. The therapeutic period was 4 weeks. Evaluate and summarize the therapeutic effect by observing the clinical symptoms, signs and biochemical indices before and after the treatment. Results:In treatment group, 25 cases were effective, 14 cases were good, 8 cases were improved and 6 cases were ineffective, the total efficiency was 88.7%;In control group 1, 7 cases were effective, 10 cases were good, 27 cases were improved and 5 cases were ineffective, the total efficiency was 89.8%;In control group 2, 1 case was effective, 12 cases were good, 25 cases were improved and 12 cases were ineffective, the total efficiency was 76.0%;In control group 3, 1 case was effective, 10 cases were good, 27 cases were improved and 13 cases were ineffective, the total efficiency was 74.5%. There were significant differences in therapeutic effect among 4 groups (x2=10.994, P=0.012). The therapeutic effect of treatment group and control group 1 were better than that of control group 2 and 3. There was a significant difference between treatment group and control group 1 (Z=-2.147, P=0.032), and the obvious efficiency of treatment group was higher than that of control group 1. After the treatment, in treatment group and control group 1, indices of blood lipids, haemorheology, P-selectin and L-selectin were remarkably improved (P<0.05), and which were better than that in control group 2 and 3 (P<0.05). Conclusion:The cooperation treatment of Buyang Huanwu decoction and air wave pressure therapeutic equipment can slow the progression of diabetes feet through adjusting lipid metabolism, decreasing blood viscosity, anti-platelet activating, and improving damaged vascular endothelial function;which is cheap, simple, convenient and effective for the treatment of diabetes feet degree 0 and suitable for clinical application.