Retrospective Study On The Treatment Of Diabetic Foot With Integrated Traditional Chinese And Western Medicine Based On The Second Phase Of Dialectical

Objective:Through the retrospective analysis from September 2012 to December 2018 during the epidemiological data of 25 cases of diabetic foot(DF)patients clinical data and laboratory examination,and the second phase of the dialectical to evaluate the curative effect of the treatment of diabetic foot,sum up the clinical characteristic of diabetic foot,for the prevention and treatment of diabetic foot provides a feasible method and train of thought.Methods:From September 2012 to December 2018,25 patients with diabetic foot who were hospitalized in the department of orthopedics of Ruikang hospital affiliated to Guangxi college of TCM were selected.Detailed medical history was reviewed.General examination was performed,including blood routine,liver function,kidney function,coagulation function,electrolyte,bacterial culture + drug sensitivity test,electrocardiogram,ankle-brachial index,etc.Basic treatment was carried out for 25 diabetic foot patients included in the study :(1)internal medical consultation,blood glucose control,fasting blood glucose around7.0mmol/L,and postprandial blood glucose within l0mmol/L;(2)anti-infection;(3)change dressing to keep the wound clean.Angelica Niantong decoction was taken at the acute stage,one dose per day,twice a day.Chronic remission period: after infection control,continue to control blood glucose,stop using antibiotics for treatment,change medicine every other day,take Shentong Zhuyu decoction plus or minus prescription,one dose per day,divided into two times.The indexes of intermittent claudication,pain,numbness,coldness and heaviness of diabetic foot were compared before treatment,2 weeks after treatment and 4 weeks after treatment.Scoring indexes of wound area,wound depth and wound condition;Wound healing time,hospitalization time,hospitalization cost were counted.Results:(1)There were 19 DF patients over 50 years old,accounting for76%.The diabetics mellitus(DM)course of 5 to 10 years was 40%.84% of the patients had a delay of more than 7 days.Trauma,burn and shoe problems are the three major factors of diabetic foot.Before treatment,Hb1 AC and GLU were basically high.PCT,CRP and ESR all increased to varying degrees.The positive rate of bacterial culture was 96%,while the positive rate of WangerII-IV DF patients were 100%.(2)Combined with varying degrees of lower extremity ischemia.After 2 weeks of the treatment,compared with before and 4 weeks of the treatment compared with after 2 weeks,the wound area,wound depth,skin temperature andwound condition score of the patients were all improved,P<0.05,and the difference was statistically significant.After 2 weeks of the treatment,compared with before and 4 weeks of the treatment compared with after 2weeks,intermittent claudication,pain sensation,numbness sensation,cold heaviness sensation and total score of symptoms were all improved,P<0.05,and the difference was statistically significant.The total effective rate was 96.00% according to the scores of symptom efficacy and wound efficacy after treatment.(3)The average wound healing time of the 25 DF patients was(25.4±8.2)days,the average hospitalization time was(27.8±7.4)days,and the average hospitalization cost was(9692.4±3825.8)yuan,0 adverse reactions.Conclusion:(1)In this study,it was found that the incidence of DF was higher in male DM patients with disease course of more than 5 years,age of more than 50 years and poor blood glucose control.Trauma,shoe problems and burns were the three major inducing factors,most of which were combined with wound infection.The above viewpoints are consistent with modern literature research.(2)On the basis of modern medical treatment,combined with the second phase of traditional Chinese medicine dialectic,the use of integrated traditional Chinese and western medicine in the treatment of diabetic foot is a wound healing fast and symptoms recovery good treatment.(3)In this study,the more serious the condition of DF patients,the longer the wound healing time andhospitalization time,and the higher the hospitalization cost;no adverse reactions,safety level 1.