| 生肌玉红膏联合封闭负压引流术对糖尿病足患者溃疡创面血管新生及氧化应激指标的影响 |
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| 作者姓名： | 刘佳莅 姜伟华 夏成勇 乔威 |
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| 作者单位： | 江苏省中医院 血管外科, 江苏 南京 210029,江苏省中医院 血管外科, 江苏 南京 210029,江苏省中医院 血管外科, 江苏 南京 210029,江苏省中医院 血管外科, 江苏 南京 210029 |
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| 基金项目： | 江苏省干部保健科研项目（BJ2014013） |
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| 摘 要： | 目的 探讨生肌玉红膏联合封闭负压引流术（racuum sealing drainage，VSD）对糖尿病足溃疡创面血管新生及氧化应激指标的影响。方法 选取70例糖尿病足溃疡患者随机分为两组，每组35例。所有患者均给予常规清创处理及VSD，观察组加用生肌玉红膏联合负压引流术治疗。观察比较两组患者治疗后创面愈合时间、创面愈合率、踝肱指数变化情况；评价创面血管内皮生长因子（vascular endothelial growth factor，VEGF）、碱性成纤维生长因子（basic fibroblast growth factor，bFGF）、内皮抑素（endostatin，ES）表达情况及超氧化物歧化酶（superoxide dismutase，SOD）、丙二醛（malondialdehyde，MDA）、晚期蛋白氧化产物（advanced oxidation protein products，AOPP）等氧化应激指标。结果 与对照组相比，治疗后观察组患者创面愈合时间缩短，创面愈合率及踝肱指数升高，差异均有统计学意义（P<0.05）；观察组创面VEGF、bFGF表达的平均吸光度值高于对照组（P<0.05），创面ES的水平明显低于对照组（P<0.05）；观察组SOD水平高于对照组，MDA、AOPP水平低于对照组（P<0.05）。1年随访发现对照组患者溃疡复发率高于观察组（P<0.05），但两组患者的截肢率及病死率差异无统计学意义（P>0.05）。结论 生肌玉红膏联合VSD可以缩短糖尿病足溃疡创面愈合时间，促进创面的修复，其作用机制可能与调节VEGF、bFGF、ES、SOD、MDA、AOPP等因子表达，促进溃疡创面血管新生，改善机体氧化应激有关。
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| 关 键 词： | 糖尿病足 生肌玉红膏 封闭负压引流术 血管新生 氧化应激 |
| 收稿时间： | 2018/9/16 0:00:00 |
Effect of Shengji Yuhong Plaster Combined with Vacuum Sealing Drainage on Wound Angiogenesis and Oxidative Stress Indices in Patients with Diabetic Foot Ulcers |
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| Authors: | LIU Jiali JIANG Weihu XIA Chengyong and QIAO Wei |
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| Affiliation: | Department of Vascular Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, China,Department of Vascular Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, China,Department of Vascular Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, China and Department of Vascular Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu 210029, China |
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| Abstract: | Objective To investigate the effect of Shengji Yuhong Plaster combined with vacuum sealing drainage (VSD) on wound angiogenesis and oxidative stress indices in patients with diabetic foot ulcers. Methods A total of 70 patients with diabetic foot ulcers were randomly divided into observation group and control group, with 35 patients in each group. All patients received routine debridement and VSD, and the patients in the observation group were given Shengji Yuhong Plaster combined with negative pressure drainage in addition to routine debridement and VSD. The two groups were compared in terms of wound healing time, wound healing rate, change in ankle-brachial index, expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and endostatin (ES) in wound, and oxidative stress indices including superoxide dismutase (SOD), malondialdehyde (MDA), and advanced oxidation protein products (AOPP). Results Compared with the control group, the observation group had a significantly shorter wound healing time and significantly higher wound healing rate and ankle-brachial index (P<0.05). Compared with the control group, the observation group had significantly higher mean optical density of VEGF and bFGF and a significantly lower level of ES in wound (all P<0.05), as well as a significantly higher level of SOD and significantly lower levels of MDA and AOPP (all P<0.05). Follow-up at 1 year showed that the control group had a significantly higher ulcer recurrence rate than the observation group (P<0.05), while there were no significant differences in amputation rate and mortality rate between the two groups (P>0.05). Conclusion Shengji Yuhong Plaster combined with VSD can shorten the wound healing time of diabetic foot ulcers and promote wound repair, possibly by regulating the expression of VEGF, bFGF, ES, SOD, MDA, and AOPP, promoting ulcer wound angiogenesis, and improving oxidative stress. |
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| Keywords: | diabetic foot Shengji Yuhong Plaster vacuum sealing drainage angiogenesis oxidative stress |
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