Qingrejiedu Hoop Confining Treatments For Phase 2 B Infective Diabetic Foot Ulcer Clinical Research

Objective:The aim of this study was to observe the effect of encircling the lesion by heat-clearing and detoxicating medicine in patients with infected diabetic foot ulcers in grade2stage B, and provide a method to treat the pristine diabetic foot.Methods:In this clinical experimental study,60pat ients with infected diabet ic foot ulcers in classification of Texas grade2stage B were grouped in treatment group and control group. They received the normal treatment either, and the treatment group received the external treatment by encircling the lesion with heat-clearing and detoxicating medicine (composed by rhubarb and amur corktree bark) until healing was achieved or until the end of three months. Treatments were given every day. Digital camera and image analysis software imageJ were used as outcome measures, computed as the area of the ulcer. Before the treatment, we measured FBG, HbAlc, Hepatic function and renal function. Before and after treatment, we measured the general condition of patients, recording symptom scoring. The area and depth of the ulcer were measured each seven days. The temperature of skin was measured each three days. During the28days of treatment, we observed the safety index. After the end of trail, we collected the data and analyzed the statistic.Result:The total efficiency in patients in treatment group and control group was respectively93.3%and73.3%(P<0.05). The area of the ulcer in the treatment group was better than the control group (P<0.05). Time*group promoted that the effect of time was changed in the different group. The effect was better on area at d7and d14. The domain of flare in the treatment group has a good effect on d14and d28(P<0.05). Time*group indicated that the effect of time was not change in the different group. The temperature of the skin was not notable totally (P>0.05), but significant in the d21(P<0.05). The time of edema come to reduce in the treatment group was2.63±0.76d, and5.37±2.74d in the control group (P<0.05). The bacterial culture of the ulcer said that the most common bacterial is Gram positive coccobacteria (68%), and the Staphylococcus aureus and the enterococcus were the majority. The susceptibility test showed that the quinolone and the carbapenem were the most sensitive antibiotic, and the rate came to twenty percent. The aevomycetin was only effective to four bacterials, and the cefathiamidine was ineffective neither. The improvement of Anaes and pain in the treatment group was better than which in the control group (P<0.05). The total symptom before therapy in the treatment group and control group was respectively12.17±5.74and9.7±3.37, while after the therapy the integrate was respectively3.37±3.08and5.43±2.31. There was a statistically significant difference between groups (P<0.05). The score of concrete symptom such as thirsty, constipation, abdominal distention, feeling heavy of head and body, debilitation, short breath, cardiopalmus, edema were significantly reduced in the treatment group (P<0.05).Conclusion:Encircle the lesion by heat-clearing and detoxicating medicine facilitates healing of infected diabetic foot ulcers in selected patients with the syndrome type of endoretent ion of damp heat and toxic heat flourishing. The mechanism of improving the healing was to reducing the edema.