归龙丸方对0级糖尿病足血清基质金属蛋白酶-9、血清同型半胱氨酸的影响研究

摘要

目的 观察归龙丸方早期干预0级糖尿病足(DF)的临床疗效及对周围神经传导速度、血管功能的影响.方法 将80例0级DF患者按随机数字表随机分为治疗组和对照组各40例.在基础治疗(口服降糖药或胰岛素注射降糖等)的基础上,治疗组加用归龙丸方治疗,对照组加用西洛他唑口服治疗,观察两组患者治疗前后临床症状评分、踝/肱动脉比(ABI)、双下肢腓总神经传导速度、血清基质金属蛋白酶-9(MMP-9)、血清同型半胱氨酸(Hcy)的变化.结果 两组患者临床症状评分治疗后与治疗前比较,差异均有统计学意义(P＜0.05);治疗组优于对照组,差异有统计学意义(P＜0.05).治疗组治疗后ABI评分与治疗前比较,差异有统计学意义(P＜0.05);对照组患者治疗前后ABI评分间差异无统计学意义(P＞0.05);治疗组治疗后ABI评分与对照组比较,差异有统计学意义(P＜0.05).治疗后两组患者腓总神经感觉神经传导速度(SCV)、运动神经传导速度(MCV)与治疗前相比,差异均有统计学意义(P＜0.05);治疗组与对照组比较,差异亦有统计学意义(P＜0.05).两组患者治疗后血清MMP-9、Hcy水平与治疗前比较,差异有显著统计学意义(P＜0.01),治疗组与对照组比较,差异亦有统计学意义(P＜0.05).结论 归龙丸方具有温阳养血、活血通络的作用,可以提升ABI评分,提高神经传导速度,降低血清MMP-9、Hcy水平,改善0级DF患者的临床症状,疗效优于西洛他唑.%Objective To observe the therapeutic effects and influence on peripheral nerve conduction velocity and the blood vessel function of Guilong Pill Formulation in early intervention of patients with Wagner grade 0 diabetic foot ( DF ) . Methods Eighty cases suffered from Wagner grade 0 DF were randomized into treatment group and control group, with forty cases each. In addition to basic therapy ( blood sugar control with oral western medication or insulin injection ), the treatment group was treated with Guilong Pill Formulation while the control group was treated with cilostazol. Changes of clinical symptom scores, ankle brachial index ( ABI ), nerve conduction velocity of common peroneal nerves, serum matrix metalloproteinases - 9 ( MMP - 9 ) levels and serum homocysteine ( Hcy ) levels before and after treatment were compared between the two groups. Results Clinical symptoms scores improved in both groups after treatment ( P < 0. 05 ) with the treatment group superior to the control group ( P < 0. 05 ) . ABI scores improved obviously after treatment in the treatment group ( P < 0. 05 ) while no significant improvement was observed in the control group ( P > 0. 05 ); ABI scores increased significantly in the treatment group in comparison to the control group after treatment ( P < 0. 05 ) . Sensory nerve conduction velocity ( SCV ) and motor nerve conduction velocity ( MCV ) of common peroneal nerve improved after treatment in both groups ( P < 0. 05 ), with the treatment group superior to the control group ( P < 0. 05 ) . Levels of serum MMP - 9 and Hcy were significantly reduced after treatment in both groups ( P < 0. 01 ), with more remarkable changes in the treatment group compared to the control group ( P <0. 05 ) . Conclusion Guilong Pill Formulation exhibits the functions of warming Yang - nourishing blood and activating blood dredging collaterals, which increases ABI scores, improves peripheral nerve conduction velocity, reduces serum MMP - 9 and Hcy levels and thus improves the clinical symptoms of patients with Wagner grade 0 diabetic foot. Guilong Pill Formulation is more effective than cilostazol.