世界中医药

目的：探讨黄氏黄油纱外敷治疗糖尿病足的疗效。方法：选取2015年6月至2017年5月湛江市第一中医医院糖尿病专科收治的符合纳入标准的糖尿病足（Ⅰ~Ⅳ级）的住院及门诊患者60例，按照随机数字表法随机分为观察组和对照组，每组30例，对照组对糖尿病常规治疗及甲钴胺胶囊；观察组在对照组的基础上加用黄氏油纱外敷。应用中医证候的变化；检测空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白（HbA1c）评估患者的糖尿病病情情况；测定双足踝肱指数（ABI）和检查糖尿病足患者感觉阈值。结果：治疗前2组糖尿病足中医证候积分差异统计学意义（P>0.05），治疗后观察组中医证候积分降低（P<0.05），且优于对照组（P<0.05）。与治疗前比较，治疗后2组血糖均降低（P<0.05），且2组的FBG、2 hPBG、HbAlc差异统计学意义（P>0.05）。治疗后ABI2组较治疗前升高（P<0.05），且观察组升高程度优于对照组（P<0.05）。治疗后2组感觉阈值下降（P<0.05），观察组比对照组的感觉阈值低（P<0.05）。结论：黄氏黄油纱治疗糖尿病足能够改善其中医症状积分，其疗效机制可能与降低ABI和感觉阈值，进而改善DF患者下肢末端血管微循环和表皮神经纤维传导有关。

English Summary:

To observe the effects and mechanism of Huang's butter gauze on diabetic foot treatment based on the theory of lung and spleen.Methods:A total of 60 cases in accordance with the inclusion criteria of diabetic foot (I-IV) admitted in the first hospital of traditional Chinese medicine diabetes clinics from June 2015 to May 2017 year were randomly divided into treatment group and control group, with 30 cases in each group.The control group was received conventional treatment of diabetes and Mecobalamin Capsules, and the treatment group was received Huangshi oil gauze application based on control group.The changes of clinical syndromes of traditional Chinese medicine were observed; fasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPBG), glycosylated hemoglobin (HbA1c) were evaluated before and after treatment in patients with diabetes; ankle brachial index determination (ABI) and sensory examination of patients with diabetic foot threshold were measured.Results:1) There was no statistically significant difference in TCM syndromes of diabetic foot between the two groups before treatment (P>0.05).After treatment, Huang's butter gauze decreased the TCM syndrome score (P<0.05), and it was better than that of the control group (P<0.05).2) Compared with before treatment, the blood glucose of the two groups decreased (P<0.05), and there was no statistically significant difference in FBG, 2 hPBG and HbAlc between the two groups (P>0.05).3) After treatment, the ABI treatment group and the control group were higher than before treatment (P<0.05), and the treatment group was superior to the control group (P<0.05).4) After treatment, the sensory threshold of the two groups decreased (P<0.05), and the sensory threshold of the treatment group was lower than that of the control group (P<0.05).Conclusion:The lung and spleen theory found Huang's butter gauze for the treatment of diabetic foot can improve the TCM symptoms based on its therapeutic mechanism, which may be related to the decrease of ABI and sensory thresholds, and improve the DF patients with distal microcirculation and nerve fiber conduction on the skin.

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