Modified Simiao Yong'an Decoction combined with conventional western medicine on lower limb hemodynamics in patients with low-risk diabetes foot / 国际中医中药杂志

ABSTRACT

Objective:To explore the effect of modified Simiao Yong'an Decoction combined with conventional western medicine on lower limb hemodynamics in patients with low-risk diabetes foot (DF).Methods:This retrospective cohort study included 70 patients with infectious diabetic foot, between January 2015 and May 2019, and they were divided into control group and study group, with 35 in each group. The control group was treated with conventional western medicine, while the study group was treated with modified Simiao Yong'an Decoction on the basis of the control group. Both groups were treated for 4 weeks and followed up for 1 year. The levels of basic fibroblast growth factor (bFGF) and VEGF were detected by ELISA, the levels of blood viscosity, fibrinogen and HbAlc were detected by automatic hemorheological analyzer, the dorsal artery of foot was detected by color Doppler ultrasound, the diameter and blood flow velocity of dorsal artery of foot were recorded, and the conduction velocity of sural nerve and common peroneal nerve were detected by electromyography for recurrence rate calculation. And the clinical response rates were evaluated.Results:The total clinical response rate was 94.3% (33/35) in the study group and 77.1% (27/35) in the control group, and there was significant difference between the two groups ( χ2=4.20, P=0.040). After treatment, the bFGF [(177.15±7.96)ng/L vs. (158.87±7.21)ng/L, t=10.00], VEGF[(53.77±4.15)ng/L vs. (45.44±4.92)ng/L, t=7.66] levels in the study group were significantly higher than those in the control group ( P<0.01). After treatment, the whole blood viscosity [(3.84±0.86)mPa?s vs. (4.56±0.99)mPa?s, t=3.25], fibrinogen [(3.59±0.78) g/L vs.(4.23±0.97)g/L, t=3.04]and HbAlc[(9.61±1.31)% vs. (10.85±1.82)%, t=3.27] levels in the study group were significantly lower than those in the control group ( P<0.01). After treatment, the sural nerve conduction velocity [(39.42±5.11)m/s vs. (34.22±4.52)m/s, t=4.51], common peroneal nerve conduction velocity [(40.94±4.22)m/s vs. (35.52±3.72)m/s, t=5.70], blood vessel diameter [(2.21±0.60)mm vs. (1.92±0.52)mm, t=2.16], while the blood flow velocity [(55.89±5.84)cm/s vs. (52.95±5.85)cm/s, t=2.10] in the study group were significantly higher than those in the control group ( P<0.05). During the follow-up, the recurrence rate was 21.21% (7/33) in the study group and 29.63% (8/27) in the control group. with out statistical significance between the two groups ( χ2=0.20, P=0.653). Conclusion:Modified Simiao Yong'an Decoction combined with conventional western medicine can improve lower limb blood circulation and nerve conduction velocity of low-risk DF patients, promote rehabilitation and reduce recurrence.