| Objective: To observe the clinical effect of vacuum sealing drainage combined with Astragalus Injection in the treatment of diabetic foot ulcer,and then evaluate the feasibility and effectiveness of the method,explore the clinical application value of integrated traditional Chinese and Western medicine in the treatment of diabetic foot ulcer,and expand new ideas for the clinical treatment of diabetic foot ulcer.Methods: from September 2019 to January 2021,52 patients with diabetic foot ulcer were selected from the Department of orthopedics and hand surgery of Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine.According to the inclusion criteria and exclusion criteria,40 patients were selected and randomly divided into two groups: the experimental group and the control group.The patients in the two groups were given basic standardized treatment such as oral drug or insulin to control blood glucose,oral drug to control blood pressure and intravenous drip to control infection after consultation with relevant departments according to their condition before operation.The patients in the two groups were given thorough debridement of ulcer wound in the operating room under the condition of stable condition and no obvious operation contraindications.After debridement: the negative pressure group(control group)was treated with vacuum sealing drainage(VSD)and 100 ml 0.9% normal saline irrigation for bid;the combined group(experimental group)was treated with VSD and 10 ml astragalus injection dissolved in 100 ml 0.9% normal saline irrigation for bid,with20 patients in each group.All patients were treated with debridement and vacuum sealing drainage by the same medical team of orthopedics department and hand surgery department.The preoperative and postoperative sampling and experimental data collection were also completed by the same medical team.The wound depth,ulcer area,age,gender and WAN of the two groups before treatment were recorded and calculated Gerr classification and other test related baseline data;ulcer wound area at 1,2 and 3 weeks after operation,and wound healing rate at1,2 and 3 weeks after operation;bacterial clearance rate,granulation tissue coverage rate and inflammatory index values [WBC(white blood cell count),ESR(erythrocyte sedimentation rate)and CRP(C-reactive protein)] at 1 week after operation.Objective to compare and analyze the time required for wound healing or granulation tissue growth condition of diabetic foot ulcer to reach the second stage operation(skin grafting or flap transfer)after treatment.The test data of the two groups of patients were compared and analyzed by SPSS statistical software,and the test results were obtained.Combined with the current relevant research on diabetic foot ulcer,vacuum sealing drainage and astragalus injection and the relevant data of this test,the conclusion was drawn.[all patients were measured and calculated the wound area and the coverage area of fresh granulation group by the square method before treatment(calculation method: the square method was used,less than one grid was calculated as1 / 2 grid,each grid was 5mm * 5mm)].Results: 1.The results of the two groups of diabetic foot ulcer patients were compared with the wound healing rate,bacterial clearance rate,fresh granulation tissue coverage,inflammatory index(WBC,ESR and CRP)before and after treatment.2.The results of comparing the healing rate of the first week,the second week and the third week after the treatment of the two groups of diabetic foot ulcer patients showed that the treatment of the combined group could promote the growth of fresh granulation tissue and fill the soft tissue defect of the diabetic foot ulcer wound more effectively than the negative pressure group,improve the healing conditions and accelerate the wound healing.3.The results of comparison between the two groups of patients after treatment,the time required for ulcer wound healing or granulation tissue growth to reach the second stage operation(skin grafting and flap transfer),and the analysis of Wagner grade transformation results show that the combination group can improve the local healing environment of diabetic foot ulcer wound more effectively and accelerate the growth of wound granulation tissue than the negative pressure group,It is helpful to crawl the wound and cover the wound,accelerate the healing of diabetic foot ulcer,shorten the overall treatment course and healing time of the wound.The results of statistical analysis of baseline data(age,sex,ulcer area,ulcer depth,WBC,ESR,CRP,BMI and Wagner grade of wound)of diabetic foot ulcer patients before treatment showed that P value was greater than 0.05,no statistical difference,and the test was comparable.The time needed for the healing of the wound or the growth of granulation tissue to reach the surgical treatment conditions(skin grafting or flap transplantation)and the Wagner grade transformation of the two groups of diabetic foot ulcer patients after treatment showed that P < 0.05,which was statistically significant,The time needed for wound healing or granulation tissue growth in the combined group to reach the surgical treatment conditions(skin grafting or flap transplantation)was generally shorter than that of negative pressure group.The Wagner grade change of the combined group was better than that of negative pressure group.The difference between the two groups was statistically significant(P < 0.05),and the difference was statistically significant(P < 0.05)between the two groups(P < 0.05).The results of statistical analysis showed that the coverage rate,bacterial clearance rate,ESR and CRP of fresh granulation tissue were also statistically significant(P < 0.05);There was no significant difference between the negative pressure group and the combined group(P > 0.05).Conclusion: the results of this study indicate that the combination of negative pressure closure drainage and astragalus injection can promote the growth of fresh granulation tissue and granulation tissue,reduce the soft tissue exudation of local ulcer wound and reduce the inflammatory response of diabetic foot ulcer wound,The results show that the micro environment of local ulcer wound healing can be improved,soft tissue repair and skin edge crawling growth of ulcer wound can be promoted,the wound repair of ulcer covered,the healing of diabetic foot ulcer wound can be accelerated,and the overall treatment course and wound healing time of diabetic foot ulcer can be shortened,so as to not only reduce the pain of diabetic foot ulcer patients,but also improve the quality of life of patients;It can also reduce the family economic and mental burden of patients,and to a certain extent reduce the social and economic burden,which has certain clinical application and research value. |
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