Clinical Effects Observation Of Combination Of Yuebai Zhenzhu San And Ku Die Zi Injection On Diabetic Foot Ulcers Patients

ObjectiveTo observe the clinical effection of traditional chinese medicine internal and external treatment (Yue Bai Zhen Zhu San combinate with ku Die Zi Injection) based on the Western medicine on (Diabetic foot ulcers DFU) patients. Comparing the ulcers Healing conditions,the impact of clinical symptoms,ABI,lipids, Hemorheology and Nerve conduction velocity before and after treatment,to explot the Mechanism and the Clinical value of traditional chinese medicine internal and external treatment.Methods:1.clinical data:Select the 60 inpatients diagnosed as Diabetic foot (Wagner grading method 1-3),60 patients were randamly divided into 3 groups.A group 20 cases, B group 20 cases,C group 20 cases.The gender,age and the duration of diabetic foot of these 3 groups have no significant differencese(P<0.05).2.exciusion standard:patients under the age of 35,or over the age of 75; women in period of Pregnancy or Lactation;patients that complicated with DKA,DLAorNHDC; patients that severe liver and kidney dysfunction,or complicated with serious cardiac insufficiency. 3.Treatment:3 groups of patients all do the conventional treatment as diet control,exercise appropriate,as experimental service before the hypoglycemic drugs,of glycemic control in a more satisfactory level (fasting glucose≤8.0mmol/L,2hPG<10. 0mmol/L).on the base of it,patients of group A was given Broad-spectrum antibiotics once a day,or choosed more sensitive antibiotics according to the Secretion culture of the ulcers,and topical application of Rivanol gauze.Each dressing was changed every 2 to 3 days,and used gauze drainage in necessary. Based on the treament of antibiotics,patients of group B was given Yue Bai Zhen Zhu San applicated on topic,coverd with Sterile gauze and changed dressing every 2 to 3 days.group C added Ku Die Zi Injection 40 ml Intravenous drip once a day on zhe base of goup B. these 3 groups all take 14 month as a course, and Interval between two adjacent course of 5 days.obsered the situation of Healing,the Symptoms and Blood supply of lower limb after 2 month treatment.4.Efficacy assessment standards:4.1 Standard of ulcers Healing:clnical heal:the ulcers completely healed; significant effective:ulcers healed for up to 60%; effective: ulcers Healed for up to 30%; Invalid:patients's ulcers dont healed,and even Deteriorat.4.2 Traditional Chinese Medicine symptom-sign:to observe the changes of chinese medicine symptom and sign befor and after treatment.5.Relevant laboratory indicators:all the patients Income grouped take the ABI,hemorheology, lipids,,nerve conduction velocity, befor and after treatment. 6.Security observation:6.1 Laboratory examinations:blood, urine, stool routine, Liver and kidney function,Coagulation function, ECG examination, examinate that befor and after treatment6.2 Adverse reactions:to concern that if there was any discomfort happened on patients in and after the treatment,combined the other laboratory examinations to evaluat the security of this method.7.Statistical Methods:Use SPSS16.0 statistical analysis software calculation. All measurement data expressedn with x±s (mean±standard deviation),aplicate t test,ANOVA test;Count information is X2 test;grading information use Ridit analysis.Result1.After the treatment ulcers on three groups of patients have all got better,the efficacy of group B and group C were better than group A,and the situation of ulcer healing were more Satisfacted.(P<0.05)the efficacy compared of group B and group C have no conspectus difference.(P>0.05)2. Compare the clinical symptoms and signs of three groups before treatment,there was no significant difference between them(P >0.05).and the main symptoms and signs have got improved after treatment(P<0.05).the group given the treatment of Yuebai Zhenzhu San combine with Ku Die Zi injection have the best efficacy among these three groups(P<0.05).the sort of efficacy among these three groups was C>B>A。3.Lipids level of the patients in this topic have lowered to varying degrees,Among them, TG, LDL-C level Reduce of the most significant(P<0.05),but HDL-C level have no significant difference before and after treatment(P>0.05).blood lipid analysis results after treatment of three groups showed that compared with group A and group B, group C have make more obvious reduce in the lipid level,and there was a significant difference.4. The whole blood viscosity, high shear,low shear,RBC aggregation index were conspicuous difference before and after treatment (P<0.05).Compared with group B and group A,the whole blood viscosity, high shear, low shear,RBC aggregation index were obviously descend(P<0.05),and Compared with group C and group A, the whole blood viscosity, high shear, low shear, RBC aggregation index were descend more apparently(P<0.01).there was no significant difference between group B and group C5. Nerve conduction velocity of patients in three groups have no difference before treatment(P>0.05),and they all have got improvement after treatment(P<0.05).but group B and C have more significant efficacy than group A(P<0.05),and there was no difference between them (P<0.05).6. Patients's ABI level of these three groups were obviously improved before and after treatment(P<0.05).Comparison of the three groups results after treatment show that there was significant difference among the three groups(P<0.05)7. The three groups of patients have no obvious adverse reactions and liver and kidney dysfunction, the blood, urine,stool routine and ECG examination showed no obvious abnormalities during the treatment.All the patients completion of the treatment smoothly.ConclusionThis topic prompted that YueBaiZhenZhuSan combined with KuDieZi injection can help to promote wound healing of diabetic foot ulcers, can improve the clinical symptoms and signs in patients with diabetic foot.Reduction the TCM syndrome score,particularly for limb fat cold and resting pain,can improve nerve conduction velocity in patients in DF patients,improve their nerve electrophysiological abnormalities.It can also reduce the Plasma viscosity under different shear,bring down RBC aggregation index, improving micro circulation. It can rise Patients's ABI level, increase in limb arterial blood supply,and lower the lipid level,especially TG, and LDL-C levels.There was no obvious adverse reactions and liver and kidney dysfunction appeared during the course of treatment.Patients suffering small and inexpensive.It has good clinical value.