| 雷 振,孟玉芬,郑菲菲.高压氧联合硫辛酸治疗糖尿病足疗效分析[J].中国烧伤创疡杂志,2024,(2):105~109. |
| DOI： |
| 中文关键词: 高压氧 硫辛酸 糖尿病足 血糖 血管内皮功能 踝肱指数 |
| 英文关键词:Hyperbaric oxygen Thioctic acid Diabetic foot Blood glucose Vascular endothelial function Ankle brachial index |
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| 中文摘要: |
| 【摘要】 目的 探究高压氧联合硫辛酸治疗糖尿病足的临床疗效。方法 选取2020年5月至 2022年5月河南省人民医院豫东分院收治的 92 例糖尿病足患者作为研究对象, 按照不同治疗方法将其分为观察组 (32 例)、对照组 (30 例) 和空白组 (30 例)。观察组患者在常规治疗的基础上行高压氧联合硫辛酸治疗, 对照组患者在常规治疗的基础上单纯行硫辛酸治疗, 空白组患者单纯行常规治疗, 对比观察3组患者临床疗效、血糖相关指标及血管功能相关因子水平与踝肱指数。结果 治疗 4 周后, 3 组患者临床疗效对比, 观察组明显优于空白组(Z= -2.429, P = 0.015), 而观察组与对照组以及对照组与空白组间无明显差异 ( Z = - 1.415、-1.299, P =0.157、 0.194)。治疗 4 周后, 3 组患者空腹血糖 (FBG)、 餐后 2 h 血糖 (2 h PBG)、 糖化血红蛋白 (HbAlc) 水平对比, 观察组均明显低于空白组 ( q = 6.574、6.162、6.339, P 均<0.001), 而观察组与对照组以及对照组与空白组间无明显差异 ( FBG: q = 3.310、3.213, P = 0.055、0.065; 2 h PBG: q = 2.840、3.270, P = 0.116、0.059; HbAlc: q = 3.230、3.059, P= 0.063、 0.083); 3 组患者血清内皮素 (ET) 水平对比, 观察组明显低于对照组与空白组 ( q = 3.443、 6.630, P = 0.044、P< 0.001), 而对照组与空白组间无明显差异 ( q = 3.137, P =0.074); 3 组患者血清降钙素基因相关肽(CGRP)、血管内皮生长因子(VEGF)水平对比, 观察组均明显高于对照组与空白组 ( CGRP: q = 3.491、6.883, P = 0.041、P< 0.001; VEGF: q = 3.467、 6.636, P = 0.042、 P <0.001), 而对照组与空白组间无明显差异 (q = 3.339、2.851, P= 0.053、0.114)。治疗 4 周后, 3 组患者踝肱指数对比, 观察组明显高于对照组与空白组 (q = 3.947、7.330, P = 0.018、 P<0.001), 而对照组与空白组间无明显差异 (q = 3.330, P= 0.054)。结论 高压氧联合硫辛酸治疗糖尿病足, 有助于控制血糖水平、 改善血管内皮功能及下肢血管病变程度, 提高治疗效果, 临床推广价值较高。 |
| 英文摘要: |
| 【Abstract】 Objective To study the therapeutic effect of hyperbaric oxygen combined with thioctic acid in treating diabetic foot. Methods 92 patients with diabetic foot admitted to Yudong Branch of Henan Provincial People’s Hospital between May 2020 and May 2022 were enrolled and divided into study group ( n = 32), control group ( n = 30) and blank group (n = 30) based on different treatments they received. Patients in the blank group only received conventional systemic treatments, whereas on the basis of conventional systemic treatments, patients in the study group were treated with hyperbaric oxygen combined with thioctic acid, and patients in the control group were treated with thioctic acid alone. Clinical efficacy, blood glucose-related indicators, the levels of vascular function-related factors and ankle-brachial index were compared between the three groups. Results After 4 weeks of treatment, the comparison among the three groups in terms of clinical efficacy showed that the study group was obviously superior to the blank group (Z = -2.429, P = 0.015), while there was no significant difference between the study group and the control group, and between the control group and the blank group (Z= -1.415 and -1.299, P = 0.157 and 0.194). After 4 weeks of treatment, the comparison among the three groups in terms of the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PBG) and glycosylated hemoglobin (HbAlc) showed that the levels in the study group were obviously lower than those in the blank group ( q = 6.574, 6.162 and 6.339, all P<0.001), while there was no significant difference between the study group and the control group, and between the control group and the blank group (FBG: q = 3.310 and 3.213, P= 0.055 and 0.065; 2 h PBG: q = 2.840 and 3.270, P= 0.116 and 0.059; HbAlc: q = 3.230 and 3.059, P = 0.063 and 0.083); the comparison among the three groups in terms of the level of serum endothelin (ET) showed that the level in the study group was significantly lower than that in the control group and the blank group (q = 3.443 and 6.630, P= 0.044, P<0.001), while there was no significant difference between the control group and the blank group (q = 3.137, P= 0.074); the comparison among the three groups in terms of the level of serum calcitonin gene-related peptide (CGRP) and vascular endothelial growth factor (VEGF) showed that the levels in the study group were both significantly higher than those in the control group and the blank group (CGRP: q = 3.491 and 6.883, P = 0.041, P<0.001; VEGF: q = 3.467 and 6.636, P = 0.042, P<0.001), while there was no significant difference between the control group and the blank group (q = 3.339 and 2.851, P= 0.053 and 0.114). After 4 weeks of treatment, the ankle-brachial index of patients in the study group was significantly higher than that in the control group and the blank group (q = 3.947 and 7.330, P= 0.018, P<0.001), but there was no significant difference between the control group and the blank group (q = 3.330, P= 0.054). Conclusion Hyperbaric oxygen combined with thioctic acid in treating diabetic foot can help control blood glucose level, ameliorate vascular endothelial function and the degree of lower extremity vascular disease, and improve curative effect, showing high value of clinical promotion. |
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