Clinical Analysis Of The Application Of Physical Therapy In The Treatment Of Diabetic Foot Ulcers

The definition of diabetic foot(DF) by WHO is lower limbs infection, ulcer and(or)deep disorganization in diabetes mellitus(DM) induced by the combination of neuropathic changes and distal blood vessel changes in different degrees. DF is also called diabetic extremital gangrene, which is a common and serious complications of Diabetes, and it is the main cause leading to deficiency and lethal. Physical therapy, as a simple, economical,safe and trusty adjunctive therapy, is widely used in DF.ObjectiveTo observe the change of biochemical indicators, lower limb vascular ultrasound after the application of physical therapy including far-infrared ray, semiconductor laser and pressure cycle, to analyze the clinical effects of the physical therapy in the treatment of diabetic foot ulcer(DFU).Methods80 cases of inpatients who were diagnosed with DF according the diabetes diagnosis by WHO diabetes experts commission in 1999 from June 2010 to June 2013 were selected for the study. 60 patients from June 2010 to January 2012 were divided into conventional therapy group, 20 patients who were received treatment after March 2012 were divided into physical therapy group. Conventional therapy group was given normal treatment including anti-infection, blood glucose control. Physical therapy group was treated with normal methods and physical therapy including far-infrared radiation, semiconductor laser irradiation and pressure cycle once a day for three weeks. The biochemical indicators,doppler examination of lower blood vessel, ulcer area changed before and after the treatment were measured and compared. Quantitative data was denoted by(x±s), the differences between groups were analyzed by t test. Categorical data was denoted by positive cases, rate, the effectiveness was compared using chi-square test. P<0.05 was considered as statistically difference.Results1. Compared with before treatment, the blood sugar, blood lipid, CRP level were all decreased in different degrees in conventional therapy group and physical therapy group after treatment, and the level of CRP in physical therapy group was significantly lower than that conventional therapy group(P<0.05).2. In 80 cases, 56 cases of DFU had obvious lower artery pathological changes,including endarterium incrassation, atherosclerotic plaque, blood vessel cavity straitness,blood flow rate slower. After treatment, the peak flow rate of femoral artery, popliteal artery,dorsalis pedis artery was significantly better than before treatment(P<0.05), and average flow rate was also improved in different degrees. The peak flow rate and average flow rate of femoral artery, dorsalis pedis artery after treatment in physical therapy group was significant better than that in conventional therapy group(P<0.05).3. Comparing the ulcer area of two groups, 10 cases had marked effect, 7 cases had effect, 3 cases without effect, the effective rate of the physical therapy group was85.0%. 23 cases had marked effect, 9 cases had effect, 28 cases without effect, the effective rate of the conventional therapy group was 53.3%. The effective rates between two groups were statistically significant(χ2=6.34, P<0.05).Conclusions1. Conventional treatment, conventional treatment combined with physical therapy in the treatment of DFU can both obtain certain clinical effect.2. On the basis of conventional treatment including blood sugar control, anti-infection,combining physical therapy can further improve local blood circulation, promote ulcer healing, reduce inflammation of ulcer surface, and it has advantage of simple operation,lower cost, is worthy of popularization and application.