小剂量胰岛素和重组人粒细胞—巨噬细胞集落刺激因子在糖尿病足难愈性创面愈合的实验研究

发布时间：2018-04-21 13:16

本文选题：糖尿病足 + 难愈性创面　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:同药物选择,治疗糖尿病足难愈性创面,观察创面愈合情况,探讨治疗糖尿病足难愈性创面新方法。方法:将120例符合入选标准的糖尿病足患者按随机数字表法分为:空白对照组(A组)、小剂量胰岛素组(B组)、GM-CSF组(C组)和小计量胰岛素+GM-CSF组(D组),每组30例。因主、客观原因导致研究对象无法继续临床实验的剔除后,最终进入统计分析的病例数对照组29例,小剂量胰岛素组28例,GM-CSF组27例,胰岛素+GM-CSF组28例。观察治疗后3、15、26、40、51天的创面愈合情况。结果:1.创面愈合总体情况:D组在创面愈合过程中分泌物与其余三个组比较量少且相对清洁,创面愈合率在第、15、26、40、51天均高于其余三组,具有统计学差异(P0.05);2.各组创面完全上皮化时间分别为A组(105.5±1.4)d,B组(76.3±1.9)d,C组(75.6±2.0)d,D组(49.3±1.7)d,其中D组愈合时间低于其余两个实验组,且远低于空白对照组,各组间差异具有统计意义(P0.05);3.通过比较糖尿病临床分级这一因素发现,临床分级越高,所需愈合时间越长。结论:小剂量胰岛素联合人类重组粒细胞-巨噬细胞集落刺激因子(rh GM-CSF)的使用,能够更好的治疗糖尿病足难愈性创面。
[Abstract]:Objective: to treat the refractory wound of diabetic foot, observe the healing of wound and explore a new method for treating refractory wound of diabetic foot. Methods: one hundred and twenty patients with diabetic foot were randomly divided into three groups: control group (n = 30), control group (n = 30), small dose insulin group (n = 30), small dose insulin group (n = 30) and small dose insulin GM-CSF group (n = 30). Because of subjective and objective reasons, 29 cases in the control group, 27 cases in the GM-CSF group and 28 cases in the insulin GM-CSF group were involved in the statistical analysis. The wound healing was observed in 3 days after treatment. The result is 1: 1. The general situation of wound healing in group D was less and cleaner than that of the other three groups in the wound healing process. The wound healing rate in group D was higher than that in the other three groups at day 1526, 4051, with statistical difference (P 0.05). The time of complete epithelization of wounds in each group was 76.3 卤1.9 d in group A and 105.5 卤1.4 days in group B, respectively. The healing time of group D was lower than that of the other two experimental groups, and was much lower than that of the control group (P 0.053d). By comparing the clinical grade of diabetes, it was found that the higher the clinical grade, the longer the healing time. Conclusion: low dose insulin combined with human recombinant granulocyte-macrophage colony stimulating factor rh GM-CSF can better treat refractory wound of diabetic foot.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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