Clinical Study On Treating Diabetic Foot With Tongxinluo And Its Effect On Microcirculation

Objective: Based on collateral theory as the instruction,the syndrome differentiation and treatment of diabetic foot,through the observation of tongxinluo capsule on blood stasis type winding resistance in patients with diabetic foot before and after treatment of symptom scores,transcutaneous oxygen pressure(Tc PO2)and weighted integral nailfold microcirculation,To evaluate the clinical effect of tongxinluo capsule on qi-deficiency and collaterals obstruction type diabetic foot and its effect on microcirculation,for the clinical application of tongxinluo provide feasibility basis for treatment of diabetic foot.Methods: Patients with diabetic foot who were hospitalized and outpatient in endocrinology department of hebei yiling hospital from April 2018 to December 2018 were collected.62 patients with diabetic foot with qi-deficiency and collaterals obstruction type were selected and randomly divided into control group and experimental group with 31 patients in each group by random number table method,the patients were randomly divided into two groups,control group with experimental group in each group of 31 cases.Control group treated by routine western medicine,based on experimental group in the control group with 4 grain of tongxinluo capsule/time,3 times/day of oral,3months for a period of treatment,observation of two groups of patients with diabetic foot before and after treatment of TCM symptom scores,transcutaneous oxygen pressure and weighted integral nailfold microcirculation change,after a course of analysis to assess the therapeutic effect of tongxinluo on diabetic foot and its influence on nailfold microcirculation.Results: 1)Symptom score and curative effect changes: the score of the control group before and after treatment was6.93±1.51,10.00±3.08:;the score of the experimental group before and after treatment was: 7.03±1.47,11.73±2.26;the score of the two groups before and after treatment was compared within the group,and the symptom score after treatment was improved(P=0.00).The total effective rate of the control group and the experimental group after treatment was 72.4% and 93.3%,respectively.The total effective rate of the two groups was compared,and the experimental group was better than the control group(P=0.032).2)Comparison of clinical indicators: the transcutaneous oxygen pressure before and after the treatment in the control group was: 32.1±3.59,34.17±4.64;and the transcutaneous oxygen pressure before and after the treatment in the experimental group was:33.40±4.83,41.87±5.64;and the intra-group comparison before and after the treatment in the two groups showed that the percutaneous partial pressure of oxygen in the control group and the experimental group increased(P=0.002,P=0.000),and the percutaneous partial pressure of oxygen between the two groups showed that the experimental group was superior to the control group(P=0.000).The weighted integral of nail fold microcirculation in the control group(before treatment: total integral:3.04±0.77;flow integral:3.63±1.14,loop weekly integral:1.90±0.80;After treatment: total integral:6.08±1.17,flow integral:3.04±0.77,loop weekly integral:1.50±0.82)decreased(P=0.000,P=0.000,P=0.011),and morphological integral(1.82±0.69,1.53±0.38)remained unchanged(P=0.58)before and after treatment.Weighted integral of nail fold microcirculation in experimental group(before treatment: total integral7.38±2.10,morphological integral:1.39±0.70,flow integral:4.21±1.41,loop weekly integral: 1.78±0.90;After treatment: total integral : 5.49±0.99,morphological integral:1.13±0.36,flow integral:2.91±0.61,loop weekly integral:1.46±0.55)all decreased(P=0.016,P=0.000,P=0.011,P=0.000).Comparing the microcirculation between the two groups,the experimental group was superior to the control group(P=0.043).Conclusion: Tongxinluo capsule can improve transcutaneous oxygen pressure microcirculation,local blood flow,clinical symptoms and curative effect in diabetic foot patients,and there is no adverse reaction.