地龙提取液治疗糖尿病足的疗效观察

摘要

Objective:To observe clinical effect of earthworm extract in treating diabetic foot .Methods:Ninety two patients meeting the conclusion criteria were divided into treatment group ( n=40 ) and control group ( n=52 ) according to a random number table .Two groups both applied conventional western medicine , while treatment group gave patients extra application of earthworm extracts .Wound healing condition, clinical symptoms improvement , serum c-reactive protein (CRP), insulin growth factor (IGF-1), vascular endotheli-al growth factor ( VEGF) , and adverse events were observed .Results:The total effective rates of the treatment group and the control group were respectively 90%and 82.69%, which showed a statistically significant difference (P<0.05).The changes of the ulcer are-a, purulent secretions , and granulation tissue before and after treatment in both groups showed statistically significant differences ( P<0.05).The time of wound healing in treatment group was faster than that of the control group , which showed a statistically significant difference (P<0.05).After treatment, CRP of patients in the treatment group were lower than that of the control group , and IGF-1 was higher in the treatment group, showing statistically significant differences between the groups (P<0.05).From the seventh day of the treatment, serum VEGF of the patients in treatment group was higher than that of the control group , and there were statistically signifi-cant differences between the two groups in different time (P<0.05).There were no adverse reactions occurred in both groups .Conclu-sion:Earthworm extracts combined with routine western medicine treating diabetic foot shows safe and reliable therapeutic effects , and it is better than the single usage of western medicine in terms of improving the ulcer area , purulent secretions , and granulation tissue , ac-celerating wound healing .Its mechanism may be related to lowering CRP , upgrading the level of IGF-1 and VEGF .%目的：观察地龙提取液治疗糖尿病足的临床疗效。方法：将符合标准的92例患者按随机数字表法分为治疗组（40例）和对照组（52例）。两组均采用常规西医处理，治疗组加用地龙提取液治疗。观察患者创面愈合情况、临床症状和C反应蛋白（CRP）、胰岛素样生长因子-1（IGF-1）、血管内皮细胞生长因子（VEGF）变化情况，以及不良反应发生情况。结果：治疗组和对照组总有效率分别为90.00％、82.69％，组间比较，差异有统计学意义（ P＜0.05）。两组患者治疗后组间比较，溃疡面积、脓性分泌物和创面肉芽组织的差异均有统计学意义（ P＜0.05）。治疗组创面愈合时间快于对照组，差异有统计学意义（ P＜0.05）。治疗后治疗组CRP低于对照组，IGF-1高于对照组，组间比较，差异均有统计学意义（P＜0.05）。治疗第7 d起，治疗组患者血清VEGF高于对照组，各时间点组间比较，差异有统计学意义（ P＜0.05）。两组患者治疗过程中均未见明显不良反应。结论：地龙提取液联合常规西医对糖尿病足的临床疗效安全可靠，在改善患者溃疡面积、脓性分泌物和创面肉芽组织、加速创面愈合等方面均优于单纯西医治疗，其机制可能与降低CRP、提升IGF-1和VEGF水平有关。