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硼基凝胶治疗糖尿病足溃疡的效果:一项前瞻性、随机对照试验。

The effect of the boron-based gel on the treatment of diabetic foot ulcers: A prospective, randomized controlled trial.

机构信息

Department of Genetics and Bioengineering, Faculty of Engineering, Yeditepe University, Istanbul, Turkey.

Stem cell and regenerative medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

J Trace Elem Med Biol. 2023 Sep;79:127261. doi: 10.1016/j.jtemb.2023.127261. Epub 2023 Jul 5.

Abstract

BACKGROUND

Chronic ulcers represent impaired healing capacity with high mortality in the elderly or patients with systemic disorders such as diabetes. Boron is an effective agent in wound healing by promoting cell migration and proliferation and reducing inflammation in the wound area. This study aimed to evaluate the therapeutic effect of a sodium pentaborate-based topical formulation compared to control on the treatment of diabetic foot ulcers.

METHODS

A prospective, double-blind, randomized controlled trial was conducted to apply randomly the topical sodium pentaborate 3% gel or topical conventional remedy (control) by patients diagnosed with diabetic foot ulcers. The 171 eligible participants aged 18-75 years received the allocated medicines twice a day for a month with an allocation ratio of 3:1. Twenty-five days and two months after the end of the trial, participants were reinvestigated for their ulcer condition and any recurrence. Wagner's classification of diabetic foot ulcers was applied to this purpose (0-5).

RESULTS

161 participants (57 females, 104 males; mean age: 59.37) completed this study. After the intervention, most participants in the intervention group had a lower ulcer grade than the control group (adjusted mean difference (95% CI): - 0.91 (-1.1 to -0.73); p < 0.001). Moreover, most participants in the intervention group (n = 109 (90.8%)) were treated at a higher rate than the control group (n = 5 (12.2%)) after intervention (adjusted odds ratio (95% CI): 0.008 (0.002-0.029); p < 0.001). There was no case of recurrence in the intervention group while its rate was (n = 2 (40%)) in the control group (p < 0.001).

CONCLUSION

The present study suggests that topical sodium pentaborate gel may help treat and decrease the grade of diabetic foot ulcers and prevent the recurrence of diabetic foot ulcers.

摘要

背景

慢性溃疡代表着愈合能力受损,老年人或患有糖尿病等系统性疾病的患者死亡率较高。硼是一种有效的伤口愈合剂,可促进细胞迁移和增殖,并减少伤口区域的炎症。本研究旨在评估与对照相比,基于五硼酸钠的局部制剂治疗糖尿病足溃疡的治疗效果。

方法

进行了一项前瞻性、双盲、随机对照试验,通过患者诊断为糖尿病足溃疡,随机应用局部 3%五硼酸钠凝胶或局部常规疗法(对照)。171 名符合条件的年龄在 18-75 岁的参与者每天接受两次分配的药物治疗,为期一个月,分配比例为 3:1。试验结束后 25 天和两个月,对参与者的溃疡情况和任何复发情况进行重新调查。为此目的,应用 Wagner 糖尿病足溃疡分类(0-5)。

结果

161 名参与者(57 名女性,104 名男性;平均年龄:59.37 岁)完成了这项研究。干预后,干预组大多数参与者的溃疡等级低于对照组(调整后的平均差异(95%CI):-0.91(-1.1 至-0.73);p<0.001)。此外,干预后,干预组(n=109(90.8%))大多数参与者的治疗率高于对照组(n=5(12.2%))(调整后的优势比(95%CI):0.008(0.002-0.029);p<0.001)。干预组无复发病例,而对照组(n=2(40%))有复发病例(p<0.001)。

结论

本研究表明,局部五硼酸钠凝胶可能有助于治疗和降低糖尿病足溃疡的等级,并预防糖尿病足溃疡的复发。

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