Lan Xiaodong, Huang Zhenjia, Zheng Yan, Huang Zhiyong, Tang Yong, Zhou Tao, Wang Chao, Ma Yan, Li Dan
Department of Burn and Plastic Surgery, Chengdu Second People's Hospital, Chengdu, China.
Department of Medical Plastic and Cosmetic, The Third People's Hospital of Chengdu (The Affiliated Hospital of Southwest Jiaotong University), College of Medicine, Southwest Jiaotong University, Chengdu, China.
Int Wound J. 2024 Dec;21(12):e70104. doi: 10.1111/iwj.70104.
Diabetic ulcers are chronic wounds that are notoriously difficult to treat, leading to significant physical and psychological distress and increased healthcare costs. Their multifactorial aetiology necessitates long-term interdisciplinary collaboration and various complementary treatment measures. While numerous studies suggest that electrical stimulation (ES) positively impacts diabetic ulcer healing, the robustness and consistency of these findings require further evaluation to optimize clinical application. We searched databases including PubMed, the Cochrane Library, Embase, Web of Science and the China National Knowledge Infrastructure (CNKI). Only randomized clinical trials (RCTs) comparing ES treatment to placebo or conventional treatment were included. Extracted information included objective healing measures and data for assessing effect sizes. Ten RCTs involving 451 patients met inclusion criteria. ES improved ulcer healing rate compared to control or placebo (MD 20.37, 95% CI: 16.89-23.85, p <0.001) and increased the number of healed ulcers (RR 1.45, 95% CI: 1.18-1.78, p <0.001), with both results being statistically significant. The observed benefits are likely due to the positive effects of ES on the vascular and neurological functions of the lower limbs in patients with diabetic ulcers. Both low-frequency, moderate-intensity alternating current and low-intensity or high-voltage direct current have demonstrated efficacy in promoting ulcer healing. The results suggest ES may be a promising approach of managing diabetic ulcers. However, the optimal method of ES application remains undetermined; therefore, high-quality and large-scale studies are essential.
糖尿病溃疡是一种慢性伤口，治疗难度极大，会导致严重的身心痛苦并增加医疗成本。其多因素病因需要长期的跨学科协作和多种辅助治疗措施。虽然众多研究表明电刺激（ES）对糖尿病溃疡愈合有积极影响，但这些研究结果的稳健性和一致性需要进一步评估，以优化临床应用。我们检索了包括PubMed、Cochrane图书馆、Embase、科学网和中国知网（CNKI）在内的数据库。仅纳入了比较ES治疗与安慰剂或传统治疗的随机临床试验（RCT）。提取的信息包括客观愈合指标和用于评估效应大小的数据。十项涉及451名患者的RCT符合纳入标准。与对照或安慰剂相比，ES提高了溃疡愈合率（MD 20.37，95%CI：16.89 - 23.85，p <0.001），并增加了愈合溃疡的数量（RR 1.45，95%CI：1.18 - 1.78，p <0.001），这两个结果均具有统计学意义。观察到的益处可能归因于ES对糖尿病溃疡患者下肢血管和神经功能的积极作用。低频、中等强度交流电以及低强度或高压直流电均已证明在促进溃疡愈合方面有效。结果表明ES可能是治疗糖尿病溃疡的一种有前景的方法。然而，ES的最佳应用方法仍未确定；因此，高质量的大规模研究至关重要。
