摘要
目的探讨负压封闭引流(VSD)技术结合拔毒生肌散对糖尿病足溃疡(DFU)患者创面愈合及血清C反应蛋白(CRP)、白介素-18(IL-18)、糖原合酶激酶3β(GSK-3β)水平的影响。方法选择2023年1月—2025年5月河南中医药大学第一附属医院周围血管科收治的118例DFU患者,采用随机数字表法分为观察组及对照组,各59例。对照组行VSD技术治疗,观察组行VSD技术结合拔毒生肌散治疗,分析二者结合对患者创面愈合、CRP、IL-18、GSK-3β等指标的影响。结果治疗后观察组创面面积、创面深度、肉芽生长、创面渗出评分分别为(1.14±0.15)分、(1.23±0.15)分、(1.15±0.16)分、(1.21±0.15)分,均明显低于对照组[(1.62±0.17)分、(1.64±0.19)分、(1.72±0.19)分、(1.68±0.17)分,F=14.156、11.278、114.287、13.564,P<0.001];治疗后观察组CRP、白细胞计数(WBC)、IL-18、GSK-3β、转化生长因子(TGF-β1)、内皮抑素(ES)水平均低于对照组(P<0.001),血管内径、血流速度、阻力系数、血管内皮生长因子(VEGF)、碱性成纤维生长因子(bFGF)均高于对照组(P<0.001)。结论VSD技术结合拔毒生肌散可有效促进DFU创面愈合,调节IL-18、GSK-3β等指标,改善足背血流动力学和促进血管新生。
Objective To investigate the effects of negative vacuum sealing drainage(VSD)technology combined with Badu Shengji Powder on wound healing,serum C-reactive protein(CRP),interleukin-18(IL-18),and glycogen synthase kinase 3β(GSK-3β)levels in patients with diabetic foot ulcer(DFU).Methods A total of 118 DFU patients admitted to the department of peripheral vascular,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,from January 2023 to May 2025,were separated into the observation group(n=59,VSD technology+Badu Shengji Powder)and the control group(n=59,VSD technology).The effects of the combination on wound healing,CRP,IL-18,GSK-3β,and other indices were analyzed.Results Wound area,wound depth,granulation growth and wound exudation scores of both groups significantly decreased after treatment,and the above scores in the observation group[(1.14±0.15)points,(1.23±0.15)points,(1.15±0.16)points and(1.21±0.15)points]were significantly lower than the other group[(1.62±0.17)points,(1.64±0.19)points,(1.72±0.19)points and(1.68±0.17)points,F=14.156,11.278,114.287,13.564,all P<0.001];After treatment,CRP,white blood cell count(WBC),IL-18,GSK-3β,transforming growth factor(TGF-β1)and endostatin(ES)in the observation group were significantly lower than those in the control group(P<0.001),while vascular diameter,blood flow velocity,resistance coefficient,vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)significantly higher(P<0.001).Conclusion VSD technology combined with Badu Shengji Powder can effectively promote DFU wound healing,regulate IL-18,GSK-3β,and other indicators,improve the hemodynamics of the back of the foot,and promote angiogenesis.
作者
樊波波
马海涛
蔡高坡
代雪娜
王汉杰
周涛
FAN Bobo;MA Haitao;CAI Gaopo;DAI Xuena;WANG Hanjie;ZHOU Tao(Department of Peripheral Vascular Surgery,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan 450000,China)
出处
《中华全科医学》
2025年第12期2033-2037,共5页
Chinese Journal of General Practice
基金
河南省中医药科学研究专项课题(2022JDZX053)。
