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中药外洗治疗糖尿病足多发感染创面的临床研究:研究方案临床试验(符合SPIRIT标准)

Clinical study for external washing by traditional Chinese medicine in the treatment of multiple infectious wounds of diabetic foot: Study protocol clinical trial (SPIRIT compliant).

作者信息

Zhang Yuan, Yuan Haipo, Kang Jian, Xie Hongyan, Long Xinhua, Qi Luguang, Xie Chunguang, Gong Guangming

机构信息

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu.

Neijiang Hospital of Traditional Chinese Medicine, Neijiang, Sichuan Province, P.R. China.

出版信息

Medicine (Baltimore). 2020 Apr;99(17):e19841. doi: 10.1097/MD.0000000000019841.

Abstract

BACKGROUND

Diabetic foot (DF) is among the most serious complications of type 2 diabetes. DF infection (DFI) is a key factor in the deterioration and development of DF, so controlling infection plays an important role in the treatment of the disease. Traditional Chinese medicine foot bath has been widely used in China as a complementary and alternative therapy to improve circulation and infection control of DF. However, the existing evidence shows that its efficacy and safety are still insufficient. We report a study protocol about a multicenter, double-blind, randomized, placebo controlled trial which aims to make well-designed clinical trials to evaluate the efficacy and safety of herbal medicine foot bath decoction (FBD) and explore the mechanism of external washing of Chinese herbs in DFI.

METHODS

This study is a multicenter, double-blind, randomized, placebo controlled clinical trial in which 60 eligible participants were randomly divided into an experimental group and control group at a 1:2 ratio. Both groups received the same basic treatment for DF disease, the experimental group used FBD and ordinary dressing changes, while half of the patients in the control group received placebo and ordinary dressings, and the other half received placebo and silver ion dressings. Patients in both groups will be evaluated weekly for efficacy during the intervention. The primary efficacy indicators include the types of wound pathogens, interleukin 6 and tumor necrosis factor α. Secondary efficacy indicators included blood glucose, blood lipids, wound area, lower extremity blood vessel diameter, blood flow speed, walking speed, walking distance, and traditional Chinese medicine syndrome scores. We will also conduct a safety evaluation of the drug at the end of the trial.

DISCUSSION

This multicenter, double-blind, randomized, placebo clinical trial not only provides data on the efficacy and safety of FBD, but also provides a novel treatment strategy for clinicians and DF patients.

摘要

背景

糖尿病足(DF)是2型糖尿病最严重的并发症之一。糖尿病足感染(DFI)是糖尿病足恶化和发展的关键因素,因此控制感染在该病的治疗中起着重要作用。中药足浴在中国已被广泛用作辅助和替代疗法,以改善糖尿病足的血液循环和控制感染。然而,现有证据表明其疗效和安全性仍不足。我们报告一项关于多中心、双盲、随机、安慰剂对照试验的研究方案,旨在进行精心设计的临床试验,以评估中药足浴汤剂(FBD)的疗效和安全性,并探索中药外洗治疗糖尿病足感染的机制。

方法

本研究是一项多中心、双盲、随机、安慰剂对照临床试验,60名符合条件的参与者按1:2的比例随机分为实验组和对照组。两组均接受相同的糖尿病足疾病基础治疗,实验组使用FBD并进行常规换药,而对照组一半患者接受安慰剂和常规敷料,另一半患者接受安慰剂和银离子敷料。两组患者在干预期间每周进行疗效评估。主要疗效指标包括伤口病原体类型、白细胞介素6和肿瘤坏死因子α。次要疗效指标包括血糖、血脂、伤口面积、下肢血管直径、血流速度、步行速度、步行距离和中医证候评分。我们还将在试验结束时对药物进行安全性评估。

讨论

这项多中心、双盲、随机、安慰剂临床试验不仅提供了FBD疗效和安全性的数据,还为临床医生和糖尿病足患者提供了一种新的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af9a/7220697/c115f444cbf9/medi-99-e19841-g001.jpg

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