内科

目的探讨银芪软膏联合前列地尔治疗糖尿病足溃疡患者的临床效果。方法选取2018年1月至2019年12月我院内分泌二区收治的糖尿病足溃疡患者80例作为研究对象，随机分为对照组和研究组，每组40例。在常规内科治疗的基础上，对照组患者给予外敷银芪软膏治疗，研究组患者在对照组治疗的基础上静脉滴注前列地尔治疗。比较两组患者治疗前、治疗4周后溃疡病足创面溃疡面积、肉芽组织面积、肉芽组织覆盖情况、患肢足背动脉血流动力学指标、腓总神经传导速度以及血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子（bEGF）、表皮生长因子(EGF)水平。结果治疗前，两组患者足部溃疡的溃疡面积、肉芽组织面积、肉芽组织覆盖率比较，差异无统计学意义（P＞0.05）。治疗4周后，两组患者的溃疡面积显著减小，研究组患者的溃疡面积小于对照组；两组患者的肉芽组织面积和肉芽组织覆盖率均显著增大（高），研究组患者的面积和覆盖率大（高）于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的患肢足背动脉血流速度、足背动脉血管内径和腓总神经传导速度比较差异无统计学意义（P＞0.05）。治疗4周后，两组患者患肢足背动脉血流速度、足背动脉血管内径和腓总神经传导速度显著增大，研究组患者的速度、血管内径大于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的血清VEGF、bFGF和EGF水平比较，差异无统计学意义（P＞0.05）。治疗4周后，两组患者的血清VEGF、bFGF和EGF水平均显著增高，研究组患者的水平显著高于对照组，差异有统计学意义（P＜0.05）。结论银芪软膏联合前列地尔治疗糖尿病足溃疡患者临床效果显著，能有效促进患者足部溃疡创口愈合，改善足背动脉血流，促进神经恢复。

ObjectiveTo explore the clinical effect of Yinqi ointment combined with alprostadil in the treatment of diabetic foot ulcers. MethodsA total of 80 patients with diabetic foot ulcers admitted to the Second Department of Endocrinology of our hospital from January 2018 to December 2019 were selected as the research objects, and they were randomly divided into control group and study group, with 40 cases in each group. On the basis of conventional medical treatment, patients in the control group were treated with external application of Yinqi ointment, whereas patients in the study group were treated with intravenous infusion of alprostadil. The ulcer areas of wound surface on the ulcer foot, granulation tissue areas, granulation tissue coverage, hemodynamic indicators of the dorsal artery of the affected feet, common peroneal nerve conduction velocity, and serum vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bEGF), epidermal growth factor (EGF) levels were compared between the two groups before treatment and 4 weeks after treatment. ResultThere were no statistically significant differences in the ulcer areas, granulation tissue areas, and granulation tissue coverage of the foot ulcers between the two groups before treatment (P＞0.05). After 4 weeks of treatment, the ulcer areas of the two groups significantly reduced, and the ulcer areas of the study group were smaller than those of the control group. The granulation tissue areas and granulation tissue coverage of the two groups significantly increased (higher), and the areas and coverage of the study group were larger (higher) than those of the control group, with statistically significant differences (P＜0.05). There were no statistically significant differences in the blood flow velocity of the foot dorsal artery, the vessel diameter of the foot dorsal artery, and the common peroneal nerve conduction velocity between the affected feet of the two groups before treatment (P＞0.05). After 4 weeks of treatment, the blood flow velocity of the foot dorsal artery, the vascular diameter of the foot dorsal artery and the common peroneal nerve conduction velocity in the affected feet of the two groups increased significantly. The velocity and vascular diameter of the study group were greater than those of the control group, and the differences were statistically significant (P＜0.05). The serum VEGF, bFGF and EGF levels of the two groups were not statistically significant different before treatment (P＞0.05), whereas the indicators mentioned above increased significantly 4 weeks after treatment, and the study group yielded higher levels as compared with the control group (P＜0.05). ConclusionYinqi ointment combined with alprostadil has a prominent clinical effect in the treatment of patients with diabetic foot ulcers, which can effectively promote the healing of the foot ulcers in patients, improve the blood flow of the foot dorsal artery, and promote nerve recovery.