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目的观察亚高温辨证足浴对0级糖尿病足患者下肢动脉血管内皮功能的影响。方法采用随机数字表法将120例0级糖尿病足患者分为干预组(62例)和对照组(58例)。两组患者均予常规西医治疗;干预组在对照组的基础上给予亚高温中医辨证足浴治疗,每次30min,每日1次,持续3个月。治疗前后两组患者均测定血清一氧化氮(NO)、人活性氧(ROS)的表达量,并进行胫前动脉血管超声检查[包括胫前动脉的收缩期峰速(PSV)、舒张末期流速(EDV)、血管搏动指数(PI)和阻力指数(RI)]。结果与本组治疗前比较,治疗后两组ROS水平下降(P<0.05),对照组PSV降低,PI增高(P<0.05);干预组PSV及RI水平降低,EDV、PI及NO水平增高(P<0.05);与对照组比较,干预组治疗后PI及NO水平升高,PSV、RI及ROS水平降低(P<0.05)。结论亚高温辨证足浴干预措施能升高0级糖尿病足患者血清NO水平,降低ROS水平,有助于改善患者下肢动脉血管内皮功能。
Objective To observe the effect of differentiated bath of foot bath on arterial endothelial function of lower extremity in patients with level 0 diabetic foot. Methods 120 patients with grade 0 diabetic foot were divided into intervention group (n = 62) and control group (n = 58) by random number table method. The two groups of patients were treated with routine western medicine. The intervention group was given sub-high temperature TCM foot bath treatment on the basis of the control group, every 30 minutes, once daily for 3 months. The levels of serum nitric oxide (NO) and reactive oxygen species (ROS) in both groups before and after treatment were measured, and the anterior tibial arterial ultrasonography (including the anterior tibial artery systolic peak velocity (PSV), end diastolic velocity (EDV), vascular pulsatility index (PI) and resistance index (RI)]. Results Compared with the pretreatment group, the levels of ROS in the two groups decreased (P <0.05) and the PSV and PI in the control group decreased (P <0.05); the levels of PSV and RI, the levels of EDV, PI and NO increased P <0.05). Compared with the control group, PI and NO levels and PSV, RI and ROS levels in intervention group decreased (P <0.05). Conclusion It is concluded that hypothermia and dialectical foot bath intervention can increase serum NO level and decrease ROS level in patients with grade 0 diabetic foot and help to improve the function of lower extremity arterial vascular endothelium.