CAJ | 학술논문

目的：观察清热解毒活血通络法治疗糖尿病足（ DF）的临床疗效。方法将60例DF患者随机分为2组，治疗组30例采用中药口服、外洗、中药换药治疗，对照组30例予常规换药治疗。3个月后观察2组治疗前后患肢创面愈合情况，检测创面生长因子、足背动脉血流和管径、下肢周围神经神经传导功能以及血液流变学变化。结果治疗组总有效率（96．67％）优于对照组（76．67％，P＜0．01）。2组治疗后溃疡面积均较治疗前明显缩小（P＜0．01），碱性成纤维细胞生长因子（bFGF）、血管内皮细胞生长因子（VEGF）表达升高（P＜0．01），腓肠神经、腓总神经传导速度、足背动脉内径及血流速度均明显改善（P＜0．01，P＜0．05），全血黏度（高切）、血浆黏度、纤维蛋白原降低（P＜0．01，P＜0．05），且治疗组更明显（P＜0．01，P＜0．05）。结论综合应用清热解毒活血通络法，内外结合治疗DF，可改善血管和神经功能，降低血黏度，加速溃疡愈合。
목적：관찰청열해독활혈통락법치료당뇨병족（ DF）적림상료효。방법장60례DF환자수궤분위2조，치료조30례채용중약구복、외세、중약환약치료，대조조30례여상규환약치료。3개월후관찰2조치료전후환지창면유합정황，검측창면생장인자、족배동맥혈류화관경、하지주위신경신경전도공능이급혈액류변학변화。결과치료조총유효솔（96．67％）우우대조조（76．67％，P＜0．01）。2조치료후궤양면적균교치료전명현축소（P＜0．01），감성성섬유세포생장인자（bFGF）、혈관내피세포생장인자（VEGF）표체승고（P＜0．01），비장신경、비총신경전도속도、족배동맥내경급혈류속도균명현개선（P＜0．01，P＜0．05），전혈점도（고절）、혈장점도、섬유단백원강저（P＜0．01，P＜0．05），차치료조경명현（P＜0．01，P＜0．05）。결론종합응용청열해독활혈통락법，내외결합치료DF，가개선혈관화신경공능，강저혈점도，가속궤양유합。
Objective To study the mechanism of action of Qingrejiedu Huoxuetongluo recipe on diabetic Foot.Methods 60 cases of diabetic foot were randomly divided into treatment group and control group.30 cases in treatment group were treated by Oral medicine, external washing, and dressing medicine treatment.30 cases in con-trol group received conventional dressing's medicine.The limb wound area and growth factor, dorsal artery blood flow and diameter changes, lower extremity peripheral nerve function in nerve conduction and blood rheology examination were observed before and after treatment.Three months was as a treatment cycle.After a course data was collected for statistical analysis.Results The total effective rate in treatment group (96.67%) was higher than that in control group (76.67%, P <0.01).The ulcer area after treatment were significantly reduced compared with those before treatment in two groups ( P <0.01), effect of the treatment group was more than that in the control group ( P <0. 01).BFGF and VEGF expression after treatment were significantly increased in two groups ( P <0.01).Sural nerve, common peroneal nerve conduction velocity, dorsalis pedis artery diameter and blood flow velocity after treat-ment were significantly improved in two groups ( P <0.01, P <0.05), blood viscosity and fibrinogen after treatment were reduced in two groups ( P <0.01, P <0.05) .The decrease of the treatment group was more obvious than that of the control group ( P <0.01, P <0.05).Conclusion Qingrejiedu Huoxuetongluo recipe on diabetic foot can promote vessel and nerve function improvement, reduce blood viscosity and accelerate wound healing.