[1]周绍荣,沈宇弘,李卓,等.三妙散配合紫珠软膏对糖尿病足溃疡创面损伤、血管新生状态及血清磷脂酰肌醇3激酶、趋化因子受体4的影响[J].陕西中医,2025,46(10):1336-1340.[doi:DOI:10.3969/j.issn.1000-7369.2025.10.007]
　ZHOU Shaorong,SHEN Yuhong,LI Zhuo,et al.The effects of Sanmiao powder combined with Zizhu ointment on ulcer wound injury,angiogenesis status and serum PI3K and CXCR4 in diabetic foot[J].,2025,46(10):1336-1340.[doi:DOI:10.3969/j.issn.1000-7369.2025.10.007]
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三妙散配合紫珠软膏对糖尿病足溃疡创面损伤、血管新生状态及血清磷脂酰肌醇3激酶、趋化因子受体4的影响

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年10期
页码:
1336-1340
栏目:
临床研究
出版日期:
2025-10-05

文章信息/Info

Title:
The effects of Sanmiao powder combined with Zizhu ointment on ulcer wound injury,angiogenesis status and serum PI3K and CXCR4 in diabetic foot
作者:
周绍荣1; 沈宇弘2; 李卓1; 黄何尘1; 王元成1; 张盈盈3
（1.上海中医药大学附属曙光医院传统外科，上海 200021；2.上海中医药大学教学处，上海 201203；3.上海中医药大学附属曙光医院手术室，上海 200021）
Author(s):
ZHOU Shaorong1; SHEN Yuhong2; LI Zhuo1; HUANG Hechen1; WANG Yuancheng1; ZHANG Yingying3
(1.Department of Traditional Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;2.Department of Teaching,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;3.Operating Room,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
关键词:
糖尿病足溃疡; 中医多时相疗法; 血管新生; 神经传导速度; 血液循环; 磷脂酰肌醇3激酶
Keywords:
Diabetic foot ulcer; Multi-temporal therapy of traditional Chinese medicine; Angiogenesis; Nerve conduction velocity; Blood circulation; Phosphatidylinositol 3-kinase
分类号:
R 587.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.10.007
文献标志码:
A
摘要:
目的：观察三妙散配合紫珠软膏对Wagner 3～4级糖尿病足溃疡创面损伤、血管新生状态及血清磷脂酰肌醇3激酶（PI3K）、趋化因子受体4（CXCR4）的影响。方法：选择170例糖尿病足溃疡难愈患者，采用随机数字表法分为常规组85例（脱落3例，最终纳入82例），给予西医常规治疗；中医多时相疗法组85例（脱落4例，最终纳入81例），常规组干预同时进行三妙散配合紫珠软膏干预。疗程结束后比较常规组、中医多时相疗法组临床疗效，治疗前、后观察两组患者中医证候评分；治疗6、12周计算溃疡面积减少率；检测患者踝肱指数、创面氧分压；检测组织中白细胞介素1β（IL-1β)、肿瘤坏死因子-α（TNF-α）水平；检测血清CXCR4、神经生长因子（NGF）、血管内皮生长因子（VEGF）、PI3K水平。结果：中医多时相疗法组患者总有效率为96.30%，较常规组总有效率81.71%高（P＜0.05）；中医多时相疗法组患者中医证候评分较常规组低（P＜0.05）；治疗6、12周中医多时相疗法组溃疡面积减少率高于常规组（P＜0.05），中医多时相疗法组踝肱指数、创面氧分压较常规组高（P<0.05）；中医多时相疗法组创面组织中IL-1β、TNF-α水平低于常规组（P＜0.05），血清CXCR4、NGF、PI3K、VEGF水平较常规组高（P＜0.05）。结论：三妙散配合紫珠软膏治疗Wagner 3～4级糖尿病足溃疡患者，可抑制创面炎症损伤，改善血管新生状态、神经传导速度，调节局部血液循环，缓解病情，提升疗效。
Abstract:
Objective:To observe the effects of Sanmiao powder combined with Zizhu ointment on the wound injury,angiogenesis status,and serum phosphatidylinositol 3-kinase (PI3K) and chemokine receptor 4 (CXCR4) of Wagner grade 3-4 diabetic foot ulcers.Methods:170 patients with refractory diabetic foot ulcer were randomly divided into two groups by number table.In the routine group,85 cases (3 cases fell out,82 cases were finally included) were given conventional western medicine treatment.There were 85 cases in the traditional Chinese medicine multi-temporal therapy group (4 cases fell off and 81 cases were eventually included),and the conventional group received the traditional Chinese medicine multi-temporal therapy intervention at the same time.After the course of treatment,the clinical efficacy of the conventional group and the traditional Chinese medicine multi-temporal therapy group were compared.Before and after treatment,the patients were evaluated for foot redness,wound pus,thick pus,smelly pus,strong heat and thirst,irritability,constipation and red urine and pain.The ulcer area reduction rate was calculated after 6 and 12 weeks of treatment.Fibular nerve conduction velocity,tibial nerve conduction velocity,ankle-brachial index and wound oxygen partial pressure were measured.The levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected.The levels of serum CXCR4,nerve growth factor (NGF),vascular endothelial growth factor (VEGF) and PI3K were detected.Results:The total effective rate was 96.30% in the TCM multi-temporal therapy group and 81.71% in the conventional group.The total effective rate in the TCM multi-temporal therapy group was higher than that in the conventional group (P<0.05).The scores of red and swollen feet,wound pus,thick pus,smelly pus,strong heat and thirst,irritability,constipation and deutzia and pain in the TCM multi-temporal treatment group were lower than those in the conventional group (P<0.05).After 6 weeks and 12 weeks of treatment,the ulcer area reduction rate in the TCM multi-temporal therapy group was higher than that in the conventional group (P<0.05),the fibular and tibial nerve conduction velocity of the affected limb in the TCM multi-temporal therapy group was higher than that in the conventional group (P<0.05),and the ankle-brachial index and wound oxygen partial pressure in the TCM multi-temporal therapy group were higher than that in the conventional group (P<0.05).The levels of IL-1β and TNF-α in TCM multi-temporal therapy group were lower than those in conventional group (P<0.05).The levels of serum CXCR4,NGF,PI3K and VEGF in TCM multi-temporal therapy group were higher than those in conventional group (P<0.05).Conclusion:The treatment of patients with Wagner grade 3-4 diabetic foot ulcers with Sanmiao powder combined with Zizhu ointment can inhibit the inflammatory damage of the wound surface,improve the state of angiogenesis and nerve conduction velocity,regulate local blood circulation,alleviate the condition and enhance the therapeutic effect.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82274528）；上海市“科技创新行动计划”医学创新研究专项课题（22Y11922600）
更新日期/Last Update: 2025-10-10