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新型局部甲状腺素和甲状腺素-胰岛素制剂治疗轻中度糖尿病足溃疡的疗效:一项随机、三盲临床试验。

Efficacy of the Novel Formulation of Topical Liothyronine and Liothyronine-insulin in Mild to Moderate Diabetic Foot Ulcer: A Randomized, Triple-blind Clinical Trial.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.

Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Curr Med Chem. 2024;31(21):3232-3243. doi: 10.2174/0929867330666230523155739.

Abstract

BACKGROUND

Diabetic foot ulcer (DFU) is one of the challenging complications of chronic diabetes.

OBJECTIVE

The study aimed to investigate whether liothyronine (T3) and liothyronineinsulin (T3/Ins) topical preparations could significantly reduce the healing time of DFU.

METHODS

A prospective, randomized, placebo-controlled, patient-blinded clinical trial was conducted on patients with mild to moderate DFU, over a lesion area of no greater than 100 cm. The patients were randomized to receive T3, T3/Ins, or honey cream 10% as the routine of care twice a day. Patients were examined for tissue healing weekly for 4 weeks, or until the total lesion clearance was observed, whichever was earlier.

RESULTS

Of 147 patients with DFUs, 78 patients (26 per group) completed the study and were included in the final evaluation. At the time of study termination, all participants in each of the T3 or T3/Ins groups were free of symptoms based on the REEDA score, while about 40% of participants in the control group were detected with each of grades 1, 2, or 3. A significant difference was observed on days 7, 14, and 21 of consumption of topical preparations (p-value < 0.001). The mean time to complete wound closure in the routine care group was about 60.6 days, while it was 15.9 and 16.4 days in T3 and T3/Ins groups, respectively. Within the T3 and T3/Ins groups, significant earlier wound closure was detected at day 28 (p-value < 0.001).

CONCLUSION

T3 or T3/Ins topical preparations are effective for wound healing and acceleration of wound closure in mild to moderate DFUs.

摘要

背景

糖尿病足溃疡(DFU)是慢性糖尿病的一种极具挑战性的并发症。

目的

本研究旨在探讨三碘甲状腺原氨酸(T3)和三碘甲状腺原氨酸胰岛素(T3/Ins)局部制剂是否能显著缩短 DFU 的愈合时间。

方法

一项前瞻性、随机、安慰剂对照、患者盲法临床试验在轻度至中度 DFU 患者中进行,病变面积不超过 100cm2。患者随机接受 T3、T3/Ins 或 10%蜂蜜乳膏作为常规护理,每天两次。每周检查患者组织愈合情况,持续 4 周,或直至观察到总病变清除,以先发生者为准。

结果

147 例 DFU 患者中,78 例(每组 26 例)完成研究并纳入最终评估。研究结束时,T3 或 T3/Ins 组的所有参与者根据 REEDA 评分均无症状,而对照组约有 40%的参与者存在 1、2 或 3 级症状。在使用局部制剂的第 7、14 和 21 天,观察到显著差异(p 值<0.001)。常规护理组完全愈合的平均时间约为 60.6 天,而 T3 和 T3/Ins 组分别为 15.9 和 16.4 天。在 T3 和 T3/Ins 组中,第 28 天的伤口闭合明显更早(p 值<0.001)。

结论

T3 或 T3/Ins 局部制剂对轻度至中度 DFU 的伤口愈合和加速伤口闭合有效。

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