Clinical Study Of Diabetes Foot Treated By Transverse Tibial Bone Transport Method Combined Withxiaoke Antang Prescription

Background:Diabetic foot(DF)is one of the serious complications of diabetes,a slight trauma can easily lead to skin ulcers,when concurrent infection,the ulcer may prolonged do not heal,development to gangrene of foot.has a high disability and mortality.The key to treatment is reconstruction of distal foot blood supply,There used to many ways to reconstruction of distal foot blood supply.but the effect is not perfect,so how to cure the diabetes foot is a difficult problem.In recent year,transverse tibial bone transport method have solved this problem.the results of clinical observation is encouraging.because of application of the technology in short time,and the sample size is small,need a long time,complications are greater,a largerscaled clinical use still needs to be based on a largerscaled sample and study.At the same time,there are still many areas need to be corrected in terms of surgical methods.Xiaoke Antang prescription is an experiential prescription of Professor Lin Shou Ning for the treatment of diabetes and diabetes complications and shows good effect in clinic practice.Objective:The purpose of this study is further observation effect of transverse tibial bone transport method on diabetic foot.and combine transverse tibial bone transport method and Xiaoke Antang prescription for treatment diabetic foot,Using traditional Chinese medicine as intervention,To observe whether the combination of the two method can improve the treatment effect.Searching for a better new method of integrated traditional Chinese and Western medicine treatment.Methods: A retrospective study patients with diabetic foot treated by transverse tibial bone transport method from January to January in our hospital.All cases included were in accordance with diagnostic criteria for diabetes,diabetic foot,Wagner classification of diabetic foot,qi and yin deficiency in diabetic foot.According to whether the patients take Chinese medicine after operation,Divide them into traditional Chinese medicine group and control group,and there were patients in each group.The traditional Chinese medicine prescription taken by the Chinese medicine group is Xiaoke Antang prescription.All patients were excluded from surgical contraindications,complete examination before surgery,blood pressure and blood sugar control stability,actively debridement,and antiinfective therapy,Then adoption of transverse tibial bone transport method,Postoperative control group was given antiinfection therapy,improve circulation therapy,change of dressing,timely and accurately bone transport,and periodic review of X-ray.On the basis of the treatment of the control group,Chinese medicine group add Xiaoke Antang prescription for oral administration.one times a day,continuous use for weeks.Observation of foot ulcer healing in two groups,record healing time of foot ulcer after operation in two groups,VAS pain score before and months after operation,gram nylon wire trial,ABI,foot temperature,blood flow of arteriae tibialis posterior and dorsalis pedis artery.record postoperative complications(nail path infection,skin ischemic necrosis,bone window malunion).And evaluation by TCM Symptom Score,recorded the scores of TCM symptoms before and weeks after operation.Lastly,statistics and comparative analysis the collected data.Results: All patients were followed up for at least months.One patient in the traditional Chinese medicine group developed into fullfoot gangrene after admission,amputation blow ankle joint,the rest of patients foot ulcer were healing.There was significant difference in average healing time between the two groups(P<0.05).There was statistical significance before and after operation in VAS pain score,gram nylon wire trial,ABI,foot temperature,blood flow of arteriae tibialis posterior and dorsalis pedis artery(P<0.05).There was statistical significance after operation in gram nylon wire trial,blood flow of arteriae tibialis posterior and dorsalis pedis artery between the two groups.There was no statistical significance after operation in VAS pain score,ABI,foot temperature between the two groups(P>0.05).The complications of the two groups were as follows,there were one case of poor wound healing,one cases of nail infection,and none of poor healing of bone window in Chinese medicine group;there were six cases of poor wound healing,six cases of nail infection,and two cases of poor healing of bone window in control group.There were has advantages in complications of Chinese medicine group.On the scoring of TCM symptoms,There were significant differences in TCM symptom scores between the two groups before and weeks after operation(P<0.05).and significant difference in the scores of TCM symptoms between the two groups at weeks after operation.Conclusion: The general effect of combine transverse tibial bone transport method and Xiaoke Antang prescription for treatment of diabetic foot is very pleasing,Combining of these two methods could shorten treatment times.and have more advantages in recovery of blood circulation and reduction of complications.At the same time,it also has great advantages in the curative effect of traditional Chinese medicine syndromes,It is an effective method of treating diabetic foot with the combination of integrated traditional Chinese and Western medicine treatment.