MEBT/MEBO结合中医辨证治疗糖尿病足溃疡的临床效果观察(1)
【摘要】 目的：观察皮肤再生医疗技术(MEBT/MEBO)结合中医辨证治疗糖尿病足溃疡的临床效果。方法：将确诊为糖尿病足溃疡的患者，按随机数字表法分为观察组和对照组，在基础治疗的基础上，观察组予MEBT/MEBO结合中医辨证治疗，对照单纯组予外用重组牛碱性成纤维细胞生长因子(bFGF)治疗，治疗2个疗程后，比较两组患者治疗前后临床症状评分与临床疗效。结果：治疗后，观察组的临床症候积分(15.13±2.47)分，高于对照组的(13.87±2.29)分，差异有统计学意义(t=24.892 8，P<0.05)。治疗后，观察组总有效率90%，高于对照组的70%，差异有统计学意义(字2=5.00，P<0.05)。结论：MEBT/MEBO联合中医辨证治疗糖尿病足溃疡的效果确切，优于单纯使用外用重组牛碱性成纤维细胞生长因子治疗。
【关键词】 MEBT/MEBO； 中医辨证治疗； 糖尿病足溃疡
doi：10.14033/j.cnki.cfmr.2018.11.006 文献标识码 A 文章编号 1674-6805(2018)11-0012-03
The Observation on Clinical Efficacy of MEBT/MEBO Combined with TCM Syndrome Differentiation and Treatment of Diabetic Foot/FU Jun，HUANG Zhonghai，SHI Jie.//Chinese and Foreign Medical Research，2018，16(11)：12-14
【Abstract】 Objective：To observe clinical efficacy of skin regenerative medical technology(MEBT/MEBO) combined with TCM syndrome differentiation and treatment of diabetic foot.Method：The diabetic foot patients were randomly divided into observation group and control group.On the basis of the basic treatment，the observation group received MEBT/MEBO therapy combined with TCM syndrome differentiation and treatment，the control group was treated with Recombinant Bovine Basic Fibroblast Growth Factor for External Use(bFGF) treatment alone.After 2 courses of treatment，the clinical symptom score and clinical effecacy were compared between the two groups before and after treatment.Result：After treatment，the clinical syndrome score of the observation group was (15.13±2.47)points，higher than (13.87±2.29)points of the control group，the difference was statistically significant(t=24.892 8，P<0.05).After treatment，the total effective rate of the observation group was 90%，higher than 70% of the control group，the difference was statistically significant(字2=5.00，P<0.05).Conclusion：The efficacy of MEBT/MEBO combined with TCM syndrome differentiation and treatment of diabetic foot is exact，and it is better than the bFGF.
【Key words】 MEBT/MEBO； TCM syndrome differentiation and treatment； Diabetic foot
First-author’s address：The First Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 538001，China
糖尿病作為全球最主要的慢性、非传染性疾病，对人类的健康和生活质量影响重大。我国糖尿病患者基数占全球比例的第一位，但目前糖尿病足溃疡的治疗受多方面因素影响无法大范围推广。传统医学在治疗皮肤溃疡方面具有疗效好、经验丰富的特点。本文旨在明确糖尿病足溃疡辨证分型，提出皮肤再生医疗技术(MEBT/MEBO)联合中医辨证处理溃疡的临床治疗方案，系统进行中医药治疗糖尿病性溃疡的临床研究，评价其临床有效性，以进一步明确中医药治疗优势，使之更好地服务于广大人民群众。
1 资料与方法
1.1 一般资料
选取2016年7月-2017年7月在笔者所在医院外五科门诊及病房符合纳入标准的糖尿病足溃疡患者80例。纳入标准，(1)符合如下诊断标准：第一，参照《糖尿病中医防治指南糖尿病足溃疡》，具备前2条，并结合后3～7条中任何1条即可确诊。①糖尿病患者有肢端血管和/或神经病变和/或合并感染者；②糖尿病患者肢端有湿性坏疽或干性坏疽的临床表现和体征，并符合1～5级坏疽标准者；③踝/臂血压指数0.9以下者；④超声检查，提示肢端血管变细，血流量减少造成缺血或坏疽者；⑤血管造影，CTA、MRA提示血管腔狭窄或阻塞，并有临床表现者；⑥电生理检查，周围神经传导速度减慢或肌电图、体感诱发电位异常改变者；⑦X线检查，骨质疏松脱钙、骨质破坏、骨髓炎或关节病变、手足畸形及夏科关节等改变者[1]。第二，中医证型诊断标准参照《糖尿病中医防治指南糖尿病足溃疡》拟定。①湿热毒蕴，筋腐肉烂证采用四妙勇安汤合茵栀莲汤加减以清热利湿，解毒化瘀；②热毒伤阴，瘀阻脉络证采用顾步汤加减以清热解毒，养阴活血；③气血两虚，络脉瘀阻证采用生脉散合血府逐瘀汤加减以补气养血，化瘀通络；④肝肾阴虚，瘀阻脉络证采用六味地黄丸加减以滋养肝肾，活血通络；⑤脾肾阳虚，痰瘀阻络证采用金匮肾气丸加减以温补脾肾，化痰通脉[1]。(2)年龄在18～80岁的住院或门诊患者。(3)自愿受试，已签署知情同意书。排除标准：(1)妊娠期妇女及肿瘤患者。(2)3个月内全身使用皮质类固醇、免疫抑制剂。(3)自身免疫性疾病。(4)严重肝肾功能不全。本研究经医院伦理委员会批准。采用随机数字表法按1∶1分为对照组和观察组，各40例。对照组中，男19例，女21例；年龄45～72岁，平均(56.0±5.14)岁；, 百拇医药(付军 黄仲海 施洁)
【关键词】 MEBT/MEBO； 中医辨证治疗； 糖尿病足溃疡
doi：10.14033/j.cnki.cfmr.2018.11.006 文献标识码 A 文章编号 1674-6805(2018)11-0012-03
The Observation on Clinical Efficacy of MEBT/MEBO Combined with TCM Syndrome Differentiation and Treatment of Diabetic Foot/FU Jun，HUANG Zhonghai，SHI Jie.//Chinese and Foreign Medical Research，2018，16(11)：12-14
【Abstract】 Objective：To observe clinical efficacy of skin regenerative medical technology(MEBT/MEBO) combined with TCM syndrome differentiation and treatment of diabetic foot.Method：The diabetic foot patients were randomly divided into observation group and control group.On the basis of the basic treatment，the observation group received MEBT/MEBO therapy combined with TCM syndrome differentiation and treatment，the control group was treated with Recombinant Bovine Basic Fibroblast Growth Factor for External Use(bFGF) treatment alone.After 2 courses of treatment，the clinical symptom score and clinical effecacy were compared between the two groups before and after treatment.Result：After treatment，the clinical syndrome score of the observation group was (15.13±2.47)points，higher than (13.87±2.29)points of the control group，the difference was statistically significant(t=24.892 8，P<0.05).After treatment，the total effective rate of the observation group was 90%，higher than 70% of the control group，the difference was statistically significant(字2=5.00，P<0.05).Conclusion：The efficacy of MEBT/MEBO combined with TCM syndrome differentiation and treatment of diabetic foot is exact，and it is better than the bFGF.
【Key words】 MEBT/MEBO； TCM syndrome differentiation and treatment； Diabetic foot
First-author’s address：The First Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 538001，China
糖尿病作為全球最主要的慢性、非传染性疾病，对人类的健康和生活质量影响重大。我国糖尿病患者基数占全球比例的第一位，但目前糖尿病足溃疡的治疗受多方面因素影响无法大范围推广。传统医学在治疗皮肤溃疡方面具有疗效好、经验丰富的特点。本文旨在明确糖尿病足溃疡辨证分型，提出皮肤再生医疗技术(MEBT/MEBO)联合中医辨证处理溃疡的临床治疗方案，系统进行中医药治疗糖尿病性溃疡的临床研究，评价其临床有效性，以进一步明确中医药治疗优势，使之更好地服务于广大人民群众。
1 资料与方法
1.1 一般资料
选取2016年7月-2017年7月在笔者所在医院外五科门诊及病房符合纳入标准的糖尿病足溃疡患者80例。纳入标准，(1)符合如下诊断标准：第一，参照《糖尿病中医防治指南糖尿病足溃疡》，具备前2条，并结合后3～7条中任何1条即可确诊。①糖尿病患者有肢端血管和/或神经病变和/或合并感染者；②糖尿病患者肢端有湿性坏疽或干性坏疽的临床表现和体征，并符合1～5级坏疽标准者；③踝/臂血压指数0.9以下者；④超声检查，提示肢端血管变细，血流量减少造成缺血或坏疽者；⑤血管造影，CTA、MRA提示血管腔狭窄或阻塞，并有临床表现者；⑥电生理检查，周围神经传导速度减慢或肌电图、体感诱发电位异常改变者；⑦X线检查，骨质疏松脱钙、骨质破坏、骨髓炎或关节病变、手足畸形及夏科关节等改变者[1]。第二，中医证型诊断标准参照《糖尿病中医防治指南糖尿病足溃疡》拟定。①湿热毒蕴，筋腐肉烂证采用四妙勇安汤合茵栀莲汤加减以清热利湿，解毒化瘀；②热毒伤阴，瘀阻脉络证采用顾步汤加减以清热解毒，养阴活血；③气血两虚，络脉瘀阻证采用生脉散合血府逐瘀汤加减以补气养血，化瘀通络；④肝肾阴虚，瘀阻脉络证采用六味地黄丸加减以滋养肝肾，活血通络；⑤脾肾阳虚，痰瘀阻络证采用金匮肾气丸加减以温补脾肾，化痰通脉[1]。(2)年龄在18～80岁的住院或门诊患者。(3)自愿受试，已签署知情同意书。排除标准：(1)妊娠期妇女及肿瘤患者。(2)3个月内全身使用皮质类固醇、免疫抑制剂。(3)自身免疫性疾病。(4)严重肝肾功能不全。本研究经医院伦理委员会批准。采用随机数字表法按1∶1分为对照组和观察组，各40例。对照组中，男19例，女21例；年龄45～72岁，平均(56.0±5.14)岁；, 百拇医药(付军 黄仲海 施洁)