| Background:Diabetes mellitus is a kind of common and frequently encountereddisease. There are over one point seven hundred million sufferer in theworld. Diabetic foot is one of the chronic complication of the diabetesmellitus and it is the major reason that cause amputation anddisability. So the sequence of the diabetic foot is very serious. Itrequires a large treatment expenditure. In the United States, fifty percent non-traumatic patients's amputation reason is that the diabeticfoot infection is not controlled very well. Therefore, how to controldiabetic foot infection availably has become a indispensable promblein clinical treatment. Kejuxi decoction(DaHuang, Wu Mei, WuBeiZi) is aempirical formula of professor Cai Bing Qin who is a expert of the vascularsurgery in our hospital. This decoction is used to treat the diabetic footinfection. It has a good curative effect during the past few decades. Itcan decurtate the length of the diabetic foot infection patients stay. Italso can reduce the amputation rate of the diabetic foot patients. In thisstudy, the therapeutic efficacy of Kejuxi decoction treating the diabeticfoot infection is compared to the therapeutic efficacy of matched group.It is in order to evaluate the ascendancy of Kejuxi decoction inmanagement of diabetic foot infection local wound objectively.Bacteriostatic experiment is to observe the bacteriostatic effect ofKejuxi decoction in vitro on pathogen of the diabetic foot. It can providea modern medical basis to popularize clinically.Methods:1. Patients who were accorded with selecting standard were divided intotwo groups accorded with the time sequence and the serial number in the envelope which were done already before. One is western medicinetreatment group called control group, the other is Kejuxi decoctiontreatment group called treatment group. Both two group were treatedwith the same basic treatment. On local processing, matched grouptreated the ulcer with hydrogen peroxide and physiological saline.Treatment group used the Kejuxi decoction to wash the affectedlimb. Observe the symptom changes of the affected limb to see whetherthere was a prominent difference between these two groups.2. Bacteriostatic experiment were adopted with the disk diffusion method.The aerobic, anaerobic and fungal bacteria ofen clinically seen wereisolated and Kejuxi decoction, metronidazole, gentamycin, miconazoleand normal saline treated respectively.Results:1. In the clinical observation study, the general efficiency rate ofcontrol group is 50％, and the general efficiency rate of the treatmentgroup is 88.89％. Compare with two groups, P＜0.01, there is a prominentstatistics different between them.2. There is a obvious improvement of treatment group on major symptomsuch as flare, ache, temperature of the skin, secretion atpost-treatment. Compare with control group, P＜0.05, there is astatistics different.3. Kejuxi decoction was highly sensitive to staphylococcus aureus,staphylococcus epidermidis, pseudomonasaeruginosa, E. coli,enterococcus and Klebsiella pneumoniae of the aerobic bacteria.Gentamycin was highly sensitive to staphylococcus aureus andenterococcus, but the sensitivity was less than Kejuxidecoction(P＜0.05). Gentamycin was moderately sensitive to Klebsiellapneumoniae. It is resistant to staphylococcus epidermidis, pseudomonasaeruginosa ansd E. coli.4. Kejuxi decoction was highly sensitive to bacteroides fragilis,Fusobacterium varium of the anaerobic bacteriostatic. It wasmoderately sensitive to clostridium perfringens. Metronidazole washighly sensitive to fusobacterium varium, but the sensitivity was lessthan Kejuxi decoction(P＜0.05). Metronidazole was moderately sensitiveto bacteroides fragilis and it had no bacteriostasic activity to clostridium perfringens.5. Kejuxi decoction was highly sensitive to candida albicans andtrichophyton rubrum of the fungal bacteriostatic. Miconazole washighly sensitive to trichophyton rubrum, and the sensitivity wassimilar with Kejuxi decoction(P＞0.05). Miconazole was moderatelysensitive to candida albicans.Conclusion:Kejuxi decoction can fairly improve the clinlcal symptom of thediabetic foot infection. It can control the infection effectively and ithas a fairly effect on promoting the ulcer to scar over. The curativeeffect of the treatment group is better than control group. Atexperimental concentration, Kejuxi decoction proves in vitrobacteriostatic effect on the aerobic, anaerobic and fungal bacteriostaticthat were isolated from diabetic foot ulcer. The result of thisexperimental study can provide a academic basis to treat the diabetic footinfection clinically.
|
PDF Full Text Request