加味黄芪桂枝五物汤治疗0-1级糖尿病足的临床研究

发布时间：2019-04-27 01:41

【摘要】：目的：糖尿病足(Diabetic Foot,DF)是糖尿病的严重慢性并发症之一,其具有很高的致残性和治疗费用,严重降低了患者的生活质量。本研究通过观察加味黄芪桂枝五物汤治疗0-1级DF的临床疗效,来探讨治疗前期DF的有效方法,极大减少其向后期DF发展的可能性,促进DF患者伤口愈合。其意义在于：1.发挥中医药简、便、廉、效等优势,在起到治疗效果的同时极大地减轻患者经济负担；2.体现中医“治未病”的思想,未雨绸缪,在DF前期进行有效的中药干预,及时截断病程,极大地改善患者生活质量；3.本研究为经方治疗DF及DF的预防提供了客观的研究材料,同时也为今后作进一步的研究打下了基础。本研究通过挖掘经方并根据DF前期的特点进行化裁,观察加味黄芪桂枝五物汤治疗气虚血瘀兼肌肤脉络痹阻证的DF疗效,寻找治疗DF合适的经方。方法：于广州中医药大学第一附属医院内分泌科住院病人中选取51例符合入组标准的患者,随机分成治疗组和对照组,采取自愿原则,先填写基本信息表,进行诸如年龄、性别、病程等一般基础资料的差异比较,提示了两个研究组基线一致具有可比性后,在3个星期的研究时间内,治疗组服用加味黄芪桂枝五物汤,对照组口服弥可保片及静滴前列地尔注射液。对两组病人的FBG、2hPBG、血液流变学、ESR、ABI等指标的治疗前后比较,以及参照全身症状量表及足部症状量表(见附录3、4)进行全身及足部症状治疗前后评分,总体评价二者治疗糖尿病足的临床疗效。所有资料分析使用软件SPSS22在计算机中完成,统计方法计数资料用卡方检验或者秩和检验,计量单位均以均值±标准差(x±s)表示,组间采有独立样本t检验,组内采用配对样本t检验,不符合正态分布者,组间、组内采用非参数检验,P0.05有显著性差异,P0.01有非常显著性差异。结果：通过对治疗组、对照组治疗前后组内组间的比较,可初步认为本方对血糖的改善无明显治疗作用；本方对血液流变学里的多项指标的改善程度较单纯的西医治疗更明显；对ABI的改善本方相较于西药组的治疗有明显的优势；对中医证侯的改善优于西药组。总体上,本方对治疗0-1级DF的疗效优于对照组。结论：从临床结果来看,本方对治疗DF前期的疗效优于对照组,值得进一步研究中药联合西药的临床疗效。
[Abstract]:Aim: diabetic foot (Diabetic Foot,DF) is one of the serious chronic complications of diabetes mellitus. It has high disability and treatment cost, which seriously reduces the quality of life of the patients. The purpose of this study was to observe the clinical efficacy of modified Huangqi Guizhi Wuwu decoction in the treatment of 0 ~ 1 grade DF, to explore the effective methods for the treatment of early stage DF, to greatly reduce the possibility of its development to the later stage of DF, and to promote wound healing in patients with DF. Its meaning is: 1. Giving full play to the advantages of simplicity, convenience, cheapness, efficiency and other advantages of traditional Chinese medicine can greatly lighten the economic burden of patients at the same time as it plays a therapeutic effect; 2. Reflect the thought of "cure no disease" of traditional Chinese medicine, make a good plan in advance, carry on effective Chinese medicine intervention in the early stage of DF, cut off the course of disease in time, greatly improve the quality of life of the patients; 3. This study provides an objective research material for the prevention of DF and DF, and lays a foundation for further research in the future. In this study, the therapeutic effect of modified Huangqi Guizhi Wuwu decoction on qi deficiency, blood stasis and skin choroidal obstruction was observed by digging the meridian formula and making use of the characteristics of pre-DF, in order to find a suitable recipe for treatment of DF. Methods: 51 inpatients in the Department of Endocrinology of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine were randomly divided into two groups: treatment group and control group. The difference of general basic data, such as gender, course of disease and so on, suggested that after the baseline of the two research groups was consistent and comparable, the treatment group was given modified Huangqi Guizhi Wuwu decoction during three weeks of study period, the treatment group was treated with modified Huangqi Guizhi Wuwu decoction. The control group took Mecobao tablets and intravenous injection of alprostadil. The indexes of FBG,2hPBG, hemorheology and ESR,ABI in the two groups were compared before and after treatment, and the whole body and foot symptoms before and after treatment were evaluated with reference to the whole body symptom scale and the foot symptom scale (see Appendix 3, 4). To evaluate the clinical efficacy of the two methods in the treatment of diabetic foot. All data were analyzed in computer with software SPSS22. The statistical data were counted by chi-square test or rank sum test. The units of measurement were expressed as mean 卤standard deviation (x 卤s), and the independent sample t-test was used between groups, and the statistical data were counted by chi-square test or rank-sum test. Paired sample t-test was used in the group, and non-parametric test was used in the group. There was significant difference between the two groups (P0.05), and there was a very significant difference between the two groups (P0.01). Results: through the comparison between the treatment group and the control group before and after treatment, it can be concluded that the prescription has no obvious therapeutic effect on the improvement of blood glucose, and the improvement degree of several indexes in the hemorheology of the prescription is more obvious than that of the simple western medicine treatment. The improvement of ABI was superior to that of western medicine group, and the improvement of TCM syndrome was better than that of western medicine group. Overall, the efficacy of the prescription in the treatment of grade 0 1 DF is better than that of the control group. Conclusion: according to the clinical results, the curative effect of this prescription is better than that of the control group in the pre-treatment of DF. It is worth further studying the clinical curative effect of the combination of traditional Chinese medicine and western medicine.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】