Liang Xinyu, Xu Yongcheng, Zhang Yaxu, Feng Xia, Wang Yuzhen, Zhao Cheng, Cao Yemin
Department of Peripheral Vascular, Shanghai TCM-Integrated Hospital, Shanghai, China.
Shanghai University of Traditional Chinese Medicine, Shanghai, China.
J Wound Care. 2024 Jan 2;33(1):22-27. doi: 10.12968/jowc.2024.33.1.22.
Patients with diabetes who undergo a kidney transplant are at a great risk of undergoing amputations, usually associated with severe infection and necrosis. The treatment of severe diabetic foot necrosis is challenging in clinic, and the function of the limb is often hugely compromised. A 74-year-old male who had been diagnosed with severe post-renal transplant diabetic foot necrosis refused the option of below-knee amputation from previous surgeons, and requested to keep his left foot. The patient was treated with integrated traditional Chinese medicine (TCM) and Western medicine, with positive results. TCM therapeutic principles included 'clearing heat, removing toxicity, regulating Qi, resolving dampness, activating stagnant blood and nourishing yin as well as tonifying Qi and blood'. Treatment with Western medicine included wound debridement, internal fixation or joint fusion, and use of insulin, antibiotics and vasodilators. The patient was treated with a staged and diverse approach (i.e., a combination of TCM and Western medicine, surgical management and education for diabetic foot care), which ultimately helped the patient achieve limb salvage and regain normal function. A combination therapy of Western medicine and TCM may be a promising approach to heal diabetic foot ulcers.
接受肾移植的糖尿病患者面临着截肢的巨大风险，这通常与严重感染和坏死有关。临床上，严重糖尿病足坏死的治疗具有挑战性，肢体功能往往会受到极大损害。一名74岁男性被诊断为肾移植术后严重糖尿病足坏死，他拒绝了之前外科医生提出的膝下截肢方案，并要求保留左脚。该患者接受了中西医结合治疗，取得了积极效果。中医治疗原则包括“清热、解毒、理气、祛湿、活血化瘀、滋阴益气养血”。西医治疗包括伤口清创、内固定或关节融合，以及使用胰岛素、抗生素和血管扩张剂。该患者接受了分阶段、多样化的治疗方法（即中西医结合、手术治疗和糖尿病足护理教育），最终帮助患者保住了肢体并恢复了正常功能。中西医结合疗法可能是治疗糖尿病足溃疡的一种有前景的方法。
