Clinical effect of Puhua Decoction in treatment of diabetic foot
XIAO Yang1 KE Ting1 LI Ting2 QI Haiyan1 WANG Gaolei1 HANG Cheng1 HUANG Qian1 XU Jianqin1▲
1.The Second Department of Endocrinology, Mie′s Internal Medicine, Shaanxi Traditional Chinese Medicine Hospital， Shaanxi Province, Xi′an 710003, China;
2.the First Department of Spleen and Stomach, Shaanxi Traditional Chinese Medicine Hospital, Shaanxi Province, Xi′an 710003, China
Abstract：Objective To investigate the clinical effect of external application of Puhua Decoction in treatment of diabetic foot. Methods From September 2017 to December 2018, 60 patients in the Second Department of Endocrinology, Mie′s Internal Medicine, Shaanxi Traditional Chinese Medicine Hospital were selected as study subjects. They were divided into the treatment group and the control group according to the random number table method, with 30 cases in each group. The control group was treated with conventional Western medicine, and surgical debridement and dressing change. While, in the treatment group, Puhua Decoction was applied externally for debridement and dressing change on the basis of traditional Western medicine dressing. The course of treatment was eight weeks. The condition of foot wound, traditional Chinese medicine symptom score, clinical effect, ankle-brachial index (ABI) and toe-to-brachial index (TBI) of both lower limbs, white blood cell count, neutrophil ratio, hypersensitive C-reactive protein, fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin and serum advanced glycation end products(AGEs) level were compared between two groups. Results After treatment, the scores of foot wound in both groups were lower than those before treatment (all P < 0.01). However, there was no statistically significant difference in the scores of foot wound between the two groups (P > 0.05). After treatment, the traditional Chinese medicine symptom scores in both groups were lower than those before treatment, and the treatment group were lower than the control group (all P < 0.05). There was no statistically significant difference in clinical efficacy between the two groups (P > 0.05). After treatment, there was no statistically significant difference in ABI, TBI between the two groups (P > 0.05). After treatment, the white blood cells, neutrophils ratio, hypersensitive C-reactive protein, fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the two groups were all lower than those before treatment (all P < 0.01), and the white blood cells and fasting blood glucose in the treatment group were lower than those in the control group (all P < 0.05). After treatment, serum AGEs levels of both groups were lower than those before treatment (all P < 0.01), but there was no statistically significant difference in serum AGEs levels between the two groups (P > 0.05). Conclusion External application of Puhua Decoction can improve diabetic foot wound and the clinical traditional Chinese medicine symptom of “heat and blood stasis” to a certain extent, significantly reduce white blood cells and fasting blood glucose levels, and can also reduce serum AGEs levels to a certain extent, protect vascular endothelium, and reduce sugar foot amputation and the risk of infection. So as to provide guidance value for clinical treatment of diabetic foot topical medication. However, due to the limited number of patients actually included in this article, the sample size is too small, and the sample size still needs to be further expanded to continue relevant clinical trial observations.
2020, Vol. 17 
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