前列地尔联合注射用胰激肽原酶治疗 糖尿病足溃疡的临床研究

Clinical Study on the Effect of Alprostadil Combined with Pancreatic Kininogenase for Injection in the Treatment of Diabetic Foot Ulcer

摘要:

〔摘 要〕 目的：分析研究前列地尔联合注射用胰激肽原酶治疗糖尿病足溃疡（DFU）的疗效。方法：选取漯河市 中医院 2014 年 5 月至 2019 年 5 月收治的 122 例 DFU 患者，随机分为联合组（前列地尔联合注射用胰激肽原酶治疗） 与单药组（前列地尔治疗），各 61 例。两组患者均给予常规治疗，并持续用药方案 4 周。比较两组患者的治疗效果 及不良反应情况。结果：联合组患者临床治疗总有效率为 91.80 %，显著高于单药组的 78.69 %，差异具有统计学意 义（P ＜ 0.05）。治疗 4 周后，联合组患者白细胞介素 –6（IL–6）、肿瘤坏死因子 –α（TNF–α）、超敏 C 反应蛋白 （hs–CRP）、空腹血糖（FPG）水平、尿微量白蛋白（m–Alb）水平均低于单药组，而患肢足背动脉收缩期最大血 流速度、患肢踝肱指数（ABI）以及腓总神经、腓浅神经、胫神经传导速度均高于单药组，差异均具有统计学意义 （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：前列地尔联合注射用胰激肽 原酶治疗 DFU 临床疗效理想，可加快足背动脉血流速度，减轻炎症反应。

Abstract:

〔Abstract〕Objective To observe and study the efficacy of alprostadil combined with pancreatic kininogenase for injection in the treatment of diabetic foot ulcer (DFU). Methods A total of 122 DFU patients admitted to Luohe Hospital of Traditional Chinese Medicine from May 2014 to May 2019 were randomly divided into combination group (alprostadil combined with pancreatic kinkinase for injection) and single drug group (alprostadil), with 61 cases in each group. Both groups received routine treatment and continued the medication regimen for 4 weeks. The therapeutic effect and adverse reactions were compared between the two groups. Results The total effective rate in combination group was 91.80%, which was significantly higher than 78.69% in the single drug group, the difference was statistically significant (P < 0.05). After 4 weeks of treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), fasting plasma glucose (FPG) and microalbuminuria (m-Alb) in combination group were lower than those in the single drug group, the maximum systolic blood flow velocity of dorsal foot artery, anklebrachial index (ABI) and conduction velocity of common peroneal nerve, superficial peroneal nerve and tibial nerve of affected limb were higher than those in the single drug group, the differences were all statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Alprostadil combined with pancreatic kininogenase for injection can achieve an ideal clinical efficacy in treating DFU, and it can accelerate the blood flow velocity of dorsal pedal artery and relieve the inflammatory response.