重组人表皮生长因子联合硫辛酸治疗糖尿病足的临床观察

摘要

OBJECTIVE:To investigate the clinical efficacy and safety of recombinant human epidermal growth factor(rhEGF) combined with lipoic acid in the treatment of diabetic foot. METHODS:A total of 68 patients with diabetic foot were randomly divid-ed into observation group and control group with 34 cases in each group. Both groups were given conventional therapy and Lipolic acid injection 0.6 ml added into Sodium chloride injection 250 ml. ivgtt(protecting form light),qd;observation group was additionally giv-en rhEGF for external use 1 ml and vaseline on the wounds,gauze dressing,qd. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,ulcer area,the expression of Bcl-2 and Bax were compared between 2 groups as well as the occurrence of ADR. RESULTS:The total effective rate of observation group(94.1%)was significantly higher than that of control group(67.6%),with statistical sig-nificance (P<0.05). Before treatment,there was no statistical significance in ulcer area,the levels of Bcl-2 and Bax between 2 groups(P>0.05). After treatment,ulcer area decreased significantly, the level of Bcl-2 increased significantly in 2 groups,while the level of Bax decreased significantly;the improvement of observation group was more significant than that of control group,with statis-tical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLU-SIONS:rhEGF combined with lipoic acid is effective for diabetic foot with good safety.%目的：考察重组人表皮生长因子（rhEGF）联合硫辛酸对糖尿病足患者的临床疗效及安全性。方法：选取68例糖尿病足患者按照随机数字表法分为观察组和对照组，各34例。两组患者均给以基础治疗和硫辛酸注射液0.6 ml加入0.9％氯化钠注射液250 ml，ivgtt（避光），qd；观察组患者在此基础上给予rhEGF外用溶液1 ml均匀喷洒创面，给予凡士林涂抹创面，用医用干纱布包扎，qd。两组患者疗程均为7 d。比较两组患者的临床疗效、溃疡面积、B淋巴细胞瘤基因2（Bcl-2）、Bcl-2相关X蛋白（Bax）蛋白表达水平，以及不良反应发生情况。结果：观察组患者总有效率（94.1％）明显高于对照组（67.6％），差异有统计学意义（P＜0.05）。治疗前，两组患者溃疡面积、Bcl-2和Bax水平比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者溃疡面积均明显缩小，Bcl-2水平较治疗前均明显升高，Bax水平明显降低，且观察组患者的改善程度明显大于对照组，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：rhEGF联合硫辛酸治疗糖尿病足临床疗效较好，且完全性较好。