[溃疡与糖尿病足:现代及替代治疗策略]

[Ulcers and diabetic foot : Modern and alternative treatment strategies].

作者信息

Tanasov Andrei, Nwabudike Lawrence Chukwudi, Tiplica George-Sorin

机构信息

Colentina Klinik, Dermatologie 2, "Carol Davila" Universität für Medizin und Pharmazie, Bukarest, Rumänien.

N. Paulescu Nationales Diabetes Institut, Bukarest, Rumänien.

出版信息

Dermatologie (Heidelb). 2025 Jan;76(1):3-8. doi: 10.1007/s00105-024-05442-4. Epub 2024 Dec 17.

Abstract

Treatment of diabetic foot is challenging due to the complex pathophysiological mechanisms, various clinical manifestations, severe complications with considerable impairment of quality of life, and the need for special, individualized treatment strategies. Particularly in the case of diabetic foot ulcers, conventional therapies are not always effective, so new treatment strategies are needed. This review aims to present alternative therapies with current efficacy data for diabetic foot ulcers that may be suitable for treatment-refractory ulcers. Platelet-rich plasma and stem cells have regenerative and anti-inflammatory effects and show good results in the treatment of diabetic ulcers, while ozone therapy improves local circulation and antioxidant levels. Wearable devices could become crucial for the long-term monitoring of patients with diabetic foot as they allow early identification of ulcers or infections. There are also literature reports of alternative treatments (e.g., maggot debridement, honey dressings, acupuncture) that have been used successfully for treatment-refractory ulcers, demonstrating how diverse the management of the diabetic foot can be.

摘要

由于糖尿病足的病理生理机制复杂、临床表现多样、严重并发症会显著损害生活质量,且需要特殊的个体化治疗策略,因此糖尿病足的治疗具有挑战性。特别是在糖尿病足溃疡的情况下,传统疗法并不总是有效,所以需要新的治疗策略。本综述旨在介绍可能适用于治疗难治性溃疡的糖尿病足溃疡替代疗法及其当前疗效数据。富含血小板血浆和干细胞具有再生和抗炎作用,在糖尿病溃疡治疗中显示出良好效果,而臭氧疗法可改善局部循环和抗氧化水平。可穿戴设备对于糖尿病足患者的长期监测可能至关重要,因为它们能够早期识别溃疡或感染。也有文献报道了替代治疗方法(如蛆虫清创、蜂蜜敷料、针灸)已成功用于治疗难治性溃疡,这表明糖尿病足的治疗方法可以多么多样化。

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