Xu Da, Chu Tongbin, Tao Guilu
Department of Endocrinology, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang 311800, China.
Department of Wound Repairment, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116000, China.
Evid Based Complement Alternat Med. 2021 Oct 23;2021:2938625. doi: 10.1155/2021/2938625. eCollection 2021.
Diabetic foot ulcers (DFUs) have a high disability rate and have a great impact on patients and society, and the search for effective and economical treatment options is a major clinical concern. In this study, 112 patients with DFU admitted to two hospitals from October 2018 to November 2020 were randomly divided into 56 cases each in the single group treated with Prontosan gel dressing and the joint group treated on silver ion dressing combined with Prontosan gel dressing. Both groups of patients were evaluated for efficacy after 30 days of treatment. The number of days for debridement, granulation tissue growth time, epithelial tissue formation time, and wound healing time were observed and recorded in both groups. The trauma area, visual analogue score (VAS), and levels of inflammatory factors such as vascular endothelial adhesion molecule-1 (VCAM-1), interleukin-6 (IL-6), tumor necrosis factor- (TNF-), and C-reactive protein (CRP) were recorded before and after treatment in both groups. The occurrence of adverse reactions such as edema, fever, infection, and rash during treatment was recorded in both groups for safety assessment. Comparison of the abovementioned data showed that the clinical efficacy of the joint group was significantly higher than that of the single group. The number of days to clear wounds, granulation tissue growth time, epithelial tissue formation time, and wound healing time were significantly lower in the joint group than in the single group. The trauma area, VAS score, VCAM-1, IL-6, TNF-, and CRP levels decreased in both groups after treatment compared with the pretreatment levels, with the joint group being lower than the single group. The results also showed that the difference in the overall incidence of adverse reactions between the two groups was not statistically significant, and the incidence was low and transient. In addition to the usual treatment regimen of blood glucose control and improvement of microcirculation for patients with DFU, combined treatment with silver ionomer dressings and Prontosan gel dressings can promote ulcer healing and improve foot wound regression. It has a stronger antibacterial effect and can more effectively reduce the inflammatory response of the ulcerated surface with fewer adverse effects, making it an effective and safe method for the treatment of DFU, and has implications for promotion.
糖尿病足溃疡（DFUs）致残率高，对患者和社会影响巨大，寻找有效且经济的治疗方案是临床主要关注点。本研究将2018年10月至2020年11月期间两所医院收治的112例DFU患者随机分为两组，每组56例，单一组采用普朗托散凝胶敷料治疗，联合组采用银离子敷料联合普朗托散凝胶敷料治疗。两组患者治疗30天后评估疗效。观察并记录两组患者的清创天数、肉芽组织生长时间、上皮组织形成时间及伤口愈合时间。记录两组患者治疗前后的创面面积、视觉模拟评分（VAS）以及血管内皮黏附分子-1（VCAM-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）等炎症因子水平。记录两组患者治疗期间水肿、发热、感染、皮疹等不良反应的发生情况进行安全性评估。上述数据比较显示，联合组临床疗效显著高于单一组。联合组的清创天数、肉芽组织生长时间、上皮组织形成时间及伤口愈合时间均显著低于单一组。两组治疗后创面面积、VAS评分、VCAM-1、IL-6、TNF-α和CRP水平均较治疗前降低，联合组低于单一组。结果还显示，两组不良反应总发生率差异无统计学意义，且发生率低且短暂。对于DFU患者，除常规控制血糖和改善微循环的治疗方案外，银离子敷料联合普朗托散凝胶敷料联合治疗可促进溃疡愈合，改善足部伤口转归。其抗菌作用更强，能更有效地减轻溃疡面的炎症反应，不良反应更少，是一种治疗DFU的有效且安全的方法，具有推广意义。
