| 补益气血药膳法辅助载抗生素骨水泥治疗WagnerⅡ-Ⅳ级老年糖尿病足的效果及对血清营养学指标的影响 |
| The effect of tonifying qi and blood medicinal diet on the treatment of Wagner grade II-IV diabetic foot in the elderly with antibiotic-loaded bone cement and |
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| 中文关键词: 补益气血药膳法 载抗生素骨水泥 老年 糖尿病足 营养状态 |
| 英文关键词: Qi and blood tonifying medicinal diet Antibiotic-loaded bone cement Elderly Diabetic foot Nutritional status |
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| 中文摘要: |
| 目的 观察补益气血药膳法辅助载抗生素骨水泥治疗WagnerⅡ-Ⅳ级老年糖尿病足的效果及对血清营养学指标的影响。方法 选取郑州市第九人民医院2024年6月～2025年1月收治的WagnerⅡ～Ⅳ级老年糖尿病足患者104例,根据1:1比例随机分入两组。常规组给予载抗生素骨水泥治疗,药膳组给予补益气血药膳法辅助载抗生素骨水泥治疗。比较两组7d肉芽组织覆盖率、引流管堵塞率、II期创面修复成活率、住院时间、治疗费用以及并发症发生率。检测两组治疗前后血清营养学指标、足背动脉血流动力学指标水平,评估两组微型营养评估记录表(MNA)评分、美国足踝矫形学会(AOFAS)踝-后足评分、视觉模拟(VAS)评分差异。结果 药膳组7d肉芽组织覆盖率、II期创面修复成活率高于常规组,引流管堵塞率、住院时间、治疗费用、累计并发症发生率低于常规组(P＜0.05)。两组治疗前血清营养学指标比较无差异(P>0.05)。两组治疗后总蛋白、白蛋白、前白蛋白、血红蛋白均较前升高,且药膳组较常规组更高(P<0.05)。两组治疗前MNA评分、AOFAS评分、VAS评分比较无差异(P>0.05)。两组治疗后MNA评分、AOFAS评分均较前升高,且药膳组较常规组更高(P<0.05)；两组治疗后VAS评分均较前降低,且药膳组较常规组更低(P<0.05)。两组治疗前足背动脉血流动力学比较无差异(P>0.05)。两组治疗后血管内径、血流量均较前升高,且药膳组较常规组更高(P<0.05)；两组治疗后峰值流速均较前降低,且药膳组较常规组更低(P<0.05)。结论 补益气血药膳法辅助载抗生素骨水泥治疗WagnerⅡ-Ⅳ级老年糖尿病足可改善机体营养状态,纠正足背动脉血流动力学异常,减轻疼痛,降低并发症发生率。 |
| 英文摘要: |
| Objective: To observe the effect of the Qi and blood tonifying medicinal diet combined with antibiotic-loaded bone cement in the treatment of Wagner grade II-IV diabetic foot in the elderly and its influence on serum nutritional indicators. Methods: A total of 104 elderly patients with Wagner grade II-IV diabetic foot admitted to the Ninth People"s Hospital of Zhengzhou from June 2024 to January 2025 were randomly divided into two groups at a 1:1 ratio. The conventional group was treated with antibiotic-loaded bone cement, while the medicinal diet group was treated with Qi and blood tonifying medicinal diet combined with antibiotic-loaded bone cement. The 7-day granulation tissue coverage rate, drainage tube blockage rate, survival rate of stage II wound repair, hospital stay, treatment cost, and complication rate were compared between the two groups. Serum nutritional indicators and dorsalis pedis artery hemodynamic indicators were detected before and after treatment in both groups, and the differences in MNA score, American Orthopaedic Foot Ankle Society (AOFAS) ankle-hindfoot score, and Visual Analogue Scale (VAS) score were evaluated. Results: The 7-day granulation tissue coverage rate and survival rate of stage II wound repair in the medicinal diet group were higher than those in the conventional group, while the drainage tube blockage rate, hospital stay, treatment cost, and cumulative complication rate were lower (P < 0.05). There was no significant difference in serum nutritional indicators before treatment between the two groups (P > 0.05). After treatment, total protein, albumin, prealbumin, and hemoglobin levels in both groups increased compared with those before treatment, and the levels in the medicinal diet group were higher than those in the conventional group (P < 0.05). There was no significant difference in MNA score, AOFAS score, and VAS score before treatment between the two groups (P > 0.05). After treatment, MNA score and AOFAS score in both groups increased compared with those before treatment, and the scores in the medicinal diet group were higher than those in the conventional group (P < 0.05); VAS score in both groups decreased compared with that before treatment, and the score in the medicinal diet group was lower than that in the conventional group (P < 0.05). There was no significant difference in dorsalis pedis artery hemodynamics before treatment between the two groups (P > 0.05). After treatment, the vascular diameter and blood flow in both groups increased compared with those before treatment, and the levels in the medicinal diet group were higher than those in the conventional group (P < 0.05); the peak flow velocity in both groups decreased compared with that before treatment, and the velocity in the medicinal diet group was lower than that in the conventional group (P < 0.05). Conclusion: The Qi and blood tonifying medicinal diet combined with antibiotic-loaded bone cement can improve the nutritional status of the body, correct the abnormal hemodynamics of the dorsalis pedis artery, relieve pain, and reduce the complication rate in the treatment of Wagner grade II-IV diabetic foot in the elderly. |
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