| Objective: to observe the effect of skin regeneration therapy(Moist exposed burn therapy/Moist exposed burn therapy,MEBT/MEBO)on promoting wound healing of diabetic foot Wagner in grade 3,and to preliminarily explore the intervention mechanism of MEBT/MEBO on age-RAGE signaling pathway during wound healing of diabetic foot Wagner in grade 3,so as to provide theoretical basis for clinical treatment of diabetic foot ulcer with MEBT/MEBO.Method: Using the random number table method,Wagner class 3 diabetic patients aged 50~70 years were enrolled and randomly divided into treatment group(36 cases)and control group(30 cases).Patients in both groups received basic treatment,including symptomatic and supportive treatment such as blood pressure control,blood lipid control,vasodilation,nutritional nerve,and nutritional support.In the treatment group,MEBT/MEBO was used for wound treatment,while in the control group,Pei Fu Was used for wound treatment,and dressing was changed 1-2 times per day.Wounds and symptoms(including exudate,carrion,granulation,epithelial volume,wound area and depth,surrounding skin color,swelling,and pain)were recorded before,two weeks,and four weeks of treatment,respectively,and compared according to the symptom scale.ELASA method was used to determine the expression levels of AGEs and RAGE in the supernatant of the homogenate before,two weeks and four weeks of treatment.All experimental data were processed with SPSS22.0 statistical analysis software,and P<0.05 was considered statistically significant.Results: A total of 66 patients with Wagner level 3 of diabetic foot were included in this study,which were divided into treatment group(MEBO group)with 36 cases and control group(Pei Fu Group)with 30 cases.Before treatment,there were no statistically significant differences in general conditions(age,postpranational blood glucose,brachial ankle index,wound area)and symptom scores between the two groups(P > 0.05),indicating comparability.After two weeks of treatment,carrion and granulation score of MEBO group decreased significantly compared with that of the Pei Fu group,and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the scores of exudate,carrion,granulation,epithelial volume,wound surface,and wound cycle in the MEBO group were significantly lower than those in the Pei group,with statistically significant differences(P<0.05).After 2 weeks and 4 weeks of treatment,the expression level of AGEs in wound tissues of both groups decreased.Compared with the Treatment group,the expression level of AGEs in the MEBO group decreased significantly,with statistically significant difference(P < 0.05).RAGE expression levels in the MEBO group decreased significantly two weeks and four weeks after treatment,and there were statistically significant differences between the two groups compared with the Pei group(P < 0.05).After four weeks of treatment,rank sum test results showed that 2 patients in the treatment group were cured,23 were significantly effective,9 were effective,and 2 were ineffective,with an effective rate of 94.4% and a significant efficiency of 63.89%.The effective rate was 83.33% and the effective rate was 20%.P=0.000(P < 0.05)the difference was statistically significant.The results of the two groups were compared,and the efficacy of the MEBO group was better than that of the Pei Fu group.Conclusions:(1)MEBT/MEBO can promote the wound repair of grade 3Wagner in diabetic foot by improving the wound pus,rot,granulation,epithelial volume and surrounding conditions,and has an accurate clinical effect.(2)MEBT/MEBO significantly reduced the expression levels of AGEs and RAGE on the wound surface,which may be related to the regulation of age-RAGE signaling pathway. |
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