足浴对早期糖尿病足的控制

足浴对早期糖尿病足的控制

将糖尿病足定义为与下肢远端异常和不同程度的周围血管病变相关的足部(踝关节或踝关节以下)感染、溃疡和(或)深层组织破坏。其临床表现为足部的溃

疡与坏疽,临床上控制好血糖是预防糖尿病足的关键,在此基础上进行积极地护理干预,有利于促进病变好转,降低患者致残率。近年来,我科运用中医辨证论治的理论自制中药熏洗剂进行辨证施护,对控制早期糖尿病足患者的局部病情临床效果比较理想,现报告如下。

The diabetic foot is defined and distal end of lower limb

abnormalities and various degree of peripheral vascular disease

associated with foot (ankle or foot below the ankle) infection, ulcer and

(or) deep tissue damage. The clinical manifestations of ulcer and

gangrene of the foot, the clinical control of blood glucose level is the

key to prevent diabetic foot, on the basis of active nursing intervention,

is conducive to the promotion of the lesions improved, reduce the

disability. In recent years, adopting the method of traditional Chinese

medicine syndrome differentiation theory of self-made Chinese

medicine lotion syndrome nursing, ideal for controlling the clinical

effect of early local condition of patients with diabetic foot, report as

follows now.

1临床资料与方法

1 clinical data and methods

一般资料:选自我院2007年5月~2011年5月间收治的住院病人56例,符

合《糖尿病足诊断疗效标准》[1],采用Wagner分级法[2],56例病人均为糖尿病足0级和1级,病人有糖尿病病史,主要症状有四肢远端感觉、运动障碍,表现为肢体麻木、挛急疼痛,肌肉无力等;主要体征有震动觉、压力觉、痛觉、温度觉的减退以及跟腱反射的减弱或消失等;辅助物理学检查、神经电生理检查有异常改变,QST和NCS中至少两项异常。将56例病人随机分成观察组和对照组,两组资料比较,差异无显着性,具有可比性。

General information: 56 cases of inpatients in our hospital from 2007 May ~2011 years were treated between May, accord with "standard" clinical diagnosis of diabetic foot [1], using the Wagner classification [2], 56 patients were diabetic foot 0 level and 1 level, the patient with a history of diabetes, are the main symptoms of limbs far end feeling, movement disorders, manifested as limb numbness, spasm and pain, muscle weakness and so on; main signs are vibration perception, sensation, pain, temperature sensation of pressure loss and Achilles tendon reflex abate or disappear; auxiliary physics examination, electrophysiological abnormalities, QST and NCS in at least two abnormal. Methods 56 cases were randomly divided into observation group and control group, compared two groups of data, no significant difference, comparable.

2方法

The 2 method

1常规治疗:两组均根据医嘱使用胰岛素和口服降糖药,有效控制血糖和血压,

开展健康教育,指导合理饮食,选择合适的鞋袜,预防意外损伤,适度进行散步、太极拳等运动。

1 conventional treatment: two groups according to the doctor's use of insulin and oral hypoglycemic drugs, effective control of blood glucose and blood pressure, health education, reasonable diet, appropriate footwear, prevention of accidental injury, moderate walking, Tai Chi exercise.

2在常规治疗的基础上观察组运用中药熏洗剂泡足,对照组用温水泡足。两组均以14天为一疗程,共2个疗程。

2 on the basis of routine treatment, the observation group used traditional Chinese medicine foot bath lotion, the control group with warm water bubble foot. The two groups were 14 days for a course of treatment, a total of 2 courses.

3中药熏洗剂泡足:根据患者的临床表现,在临床中医的指导下进行辨证分型,制定个体化的中药熏洗剂泡足方案,按疗程使用。

3 traditional Chinese medicine foot bath lotion: according to the clinical manifestations of patients, syndrome differentiations in clinical medicine under the guidance of traditional Chinese medicine, develop individualized lotion foot soaking solution, according to the course of use.

1阴虚血瘀证:肢体麻木,腿足挛急,酸胀疼痛或小腿抽筋,夜间为甚,或灼热疼痛,五心烦热,失眠多梦,皮肤干燥,头晕耳鸣,口干不欲饮,便秘,舌质暗红,苔花少津,脉细数。中药方剂组成:当归25g,地黄20g,川芎20g,赤芍30g,川牛膝25g,透