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MEBT/MEBO治疗糖尿病足截肢术后创面的临床研究
Clinical Research on MEBT / MEBO in the Treatment of Postoperative Wounds after Diabetic Foot Amputation

黄　欣,舒清峰,唐乾利,何晓微,葛　斌,李杰辉,吴标良.MEBT/MEBO治疗糖尿病足截肢术后创面的临床研究[J].中国烧伤创疡杂志,2018,(6):381~387.

DOI：

英文关键词:MEBT/ MEBO Diabetic foot Wagner grade Ⅳ Amputation Wound

基金项目:

作者	单位
黄　欣	广西中医药大学第一附属医院
舒清峰	右江民族医学院
唐乾利	右江民族医学院
何晓微	广西中医药大学第一附属医院
葛　斌	右江民族医学院
李杰辉	广西中医药大学第一附属医院
吴标良	右江民族医学院

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中文摘要:

【摘要】　目的　探讨皮肤再生医疗技术(moist exposed burn therapy/moist exposed burn ointment, MEBT/MEBO) 对Wagner 4级糖尿病足截肢术后创面的修复作用。方法　按照随机数字表法将2016年3月—2018年3月广西中医药大学第一附属医院收治的49例Wagner 4级糖尿病足患者随机分为治疗组(24例) 与对照组(25例), 其中治疗组患者于截肢术后采用MEBT/MEBO 治疗术后创面, 对照组患者于截肢术后采用重组牛碱性成纤维细胞生长因子凝胶治疗术后创面, 对比观察两组患者患肢的静息痛、麻木、感觉迟钝、足背动脉搏动、足背动脉平均血流速度(Vm) 以及踝肱指数(ABI) 的改善程度。结果　(1) 治疗70 d后, 所有患者患肢的静息痛、麻木、感觉迟钝及足背动脉搏动情况均明显改善, 其中治疗组患者患肢静息痛、麻木及感觉迟钝的改善程度均明显优于对照组, P均<0.05, 差异具有统计学意义; 足背动脉搏动改善程度无明显差异, P>0.05, 差异无统计学意义。(2) 治疗70 d后, 两组患者患肢足背动脉Vm及ABI均明显改善, 其中两组患者患肢足背动脉Vm及ABI与治疗前对比, P均<0.05, 差异具有统计学意义; 两组患者患肢足背动脉Vm 组间对比, P>0.05, 差异无统计学意义; 两组患者患肢ABI 组间对比, P<0.05, 差异具有统计学意义。结论　MEBT/MEBO能够有效促进Wagner 4级糖尿病足截肢术后创面神经及血管的再生修复, 提高血流速度, 增加血流量, 改善缺血缺氧导致的静息痛、麻木、感觉迟钝等症状, 疗效显著, 值得临床推广应用。

英文摘要:

【Abstract】　Objective　To explore the repair effect of MEBT/ MEBO on postoperative wounds after the amputation of Wagner grade Ⅳ diabetic foot. Methods　Forty-nine diabetic foot patients of Wagner grade Ⅳ, admitted into The First Affiliated Hospital of Guangxi University of Chinese Medicine between March 2016 and March 2018, were randomly divided into treatment group (24 patients) and control group (25 patients). The postoperative wounds after amputation in the treatment group were managed with MEBT/MEBO while that in the control group was given Recombinant Bovine Basic Fibroblast Growth Factor (rb-bFGF) Gel, and the improvement degrees of rest pain, numbness, dysesthesia, dorsal arterial pulse,mean flow velocity of dorsal artery (Vm) and ankle-brachial index (ABI) of the affected limbs were compared between the two groups. Results　(1) After 70 days of treatment, the condition of rest pain, numbness, dysesthesia and dorsal arterial pulse of the affected limbs all markedly improved in all patients. The improvement degrees of rest pain, numbness and dysesthesia in the treatment group were all significantly superior to that in the control group, all P<0.05, but the improvement degree of dorsal arterial pulse didn’t show statistically significant difference as compared between the two groups, P>0.05. (2) After 70 days of treatment, mean flow velocity of dorsal artery (Vm) and ankle-brachial index (ABI) of the affected limbs both improved obviously in the two groups. As compared with that before treatment, the improvements of Vm and ABI in each group both showed statistically significant difference, all P <0. 05. The comparison of Vm improvement between the two groups showed no statistically significant difference, P > 0. 05, but the comparison of ABI improvement between the two groups showed statistically significant difference, P < 0. 05. Conclusion　MEBT/ MEBO in the treatment of postoperative wounds after the amputation of Wagner grade Ⅳ diabetic foot can effectively promote the regenerative repair of wound nerves and vessels, accelerate blood flow velocity, increase blood flow volume and improve symptoms such as rest pain, numbness and dysesthesia caused by ischemia and hypoxia, deserving to be promoted in clinical practice.