OBJECTIVE To observe the effects of Gubu decoction combined with compound Huangbai liquid on wound repair, granulation tissue growth and microvascular circulation in the foot after intervention operation for dry gangrene of diabetic foot.
METHODS A total of 80 patients with dry gangrene of diabetic foot were selected and grouped by random number table, 40 patients in the control group and 40 patients in the treatment group. The control group was treated with compound Huangbai liquid after vascular intervention operation, while the treatment group was given with Gubu decoction combined with compound Huangbai liquid. The treatment course was four weeks. Before and after the treatment, we observed and compared the changes of vascular endothelial growth factor (VEGF), transforming growth factor β1 (TGF-β1), basic fibroblast growth factor (bFGF), nitric oxide (NO), endothelin (ET-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), interleukin-13 (IL-13), tumor necrosis factor (TNF-α), fibrinogen level, the microvascular blood perfusion in the foot, NRS score, granulation tissue growth, foot wound repairment, traditional Chinese medicine (TCM) syndrome scores, as well as the clinical efficacy of the two groups.
RESULTS After treatment, microvascular blood perfusion in the foot increased in both groups (P < 0.01), but the result in the treatment group was better than that in the control group (P < 0.01). Besides, the area of wound, TCM syndrome scores and NRS score were reduced in both groups compared with those before treatment (P < 0.01). The patients in treatment group were fewer compared with the control group (P < 0.01), but the granulation tissue growth and wound repairment in the treatment group were better than in the control group (P < 0.01). The total efficiency of the treatment group was higher than that of the control group (P < 0.05). The levels of TNF-α, sVCAM-1 and IL-13 in both groups were lower than before treatment (P < 0. 01), but the treatment group showed better results (P < 0.01). The levels of fibrinogen and ET-1 in both groups were lower than before treatment (P < 0.01), but the treatment group showed better results (P < 0.01). The levels of NO were higher than before treatment (P < 0.01), but the result in the treatment group was higher than that in the control group (P < 0.05). The levels of VEGF, TGFβ1 and bFGFβ1 in both groups were higher than the control group (P < 0.05). The levels of VEGF, TGFβ1 and bFGF in the two groups were higher than before treatment (P < 0.01), but the levels in the treatment group were higher than those in the control group (P < 0.01).
CONCLUSION The combination of Gubu decoction and Huangbai liquid in the post-interventional operation for dry gangrene of diabetic foot can enhance the level of growth factors, suppress inflammation, improve microvascular circulation and endothelial function of the foot, relieve pain, promote granulation tissue growth and wound repairment, and improve clinical efficacy.
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