Effect Of Negative Pressure Drip Irrigation With Compound Huangbai Liquid On The Wounds Of Diabetic Foot Infection And Related Inflammatory Factors

Background:Diabetic foot is caused by diabetic patients with neuropathy and/or varying degrees of angiopathy leading to foot infection,ulcer formation and/or deep tissue destruction.Among them,diabetic foot infection is one of the main causes of amputation and death of diabetic patients.Negative pressure drip irrigation is a new kind of wound treatment method,which combines negative pressure wound treatment with liquid perfusion.Chinese herbal FufangHuangbaiYe is one of the effective methods to treat diabetic foot infection.We use FufangHuangbaiYe as drip irrigation solution to treat diabetic foot infection.We combine negative pressure suction with Chinese herbal medicine scouring theory,and give full play to Chinese herbal medicine scouring and negative pressure technology.To observe its effect on diabetic foot infectious wounds and related inflammatory factors,in order to improve the therapeutic effect of diabetic foot infectious wounds.Objective To research the clinical efficacy of negative-pressure wound therapy with instillation of FufangHuangbaiYe of diabetic foot infection wound and to observe the influence on related inflammatory factors.Methods:We chosed 120 patients with diabetic foot hospitalized in the Department of vascular diseases,Dongzhimen hospital,Beijing University of Chinese Medicine from December 2016 to March 2018.After the systematic medical treatment of all the patients,the patients were divided into 60 cases in the experimental group and 60 in the control group according to the random number table method.The experimental group was treated with negative-pressure wound therapy with instillation of FufangHuangbaiYe and the control group was treated with negative pressure wound therapy with instillation of normal saline.Serum PCT was detected by enzyme-linked immunosorbent assay.IL-6 was detected by electrochemiluminescence.CRP was detected by scattering turbidimetry.After 2 weeks and 4 weeks,we recorded the wound surface area,PCT,IL-6,CRP and local symptom score of two groups,and cultured the secretion of the wound.Variance analysis was used to compare the difference of wound area,PCT,CRP,IL-6 and wound symptom score in each group.Secretion culture result and the incidence of surgical debridement during the course of treatment were compared by chi square test.T test or rank sum test were used to compare the difference of wound area,PCT,CRP,IL-6 and wound symptom score between the 2 groups.Results:After 2 weeks of treatment,the observation indexes of both the experimental group and the control group decreased.(experimental group:wound area t=5.225,p=0.000,wound symptom score t=15.302,p=0.000,PCT t=11.714,p=0.000,CRP t=4.154,p=0.000,IL-6 t=16.745,p=0.000,positive rate of bacterial culture=31.67%,x2=100.022,p=0.000;control group:wound area t=4.046,p=0.000,wound symptom score t=11.351,p=0.000,PCT t=8.177,p=0.000,CRP t=2.282,p=0.033,IL-6 t=14.352,p=0.000,positive rate of bacterial culture=66.67%,x2=37.162,p=0.000).Comparison was conducted in two groups with effect,the results of PCT,IL-6,CRP and secretion culture were significantly different(PCT t=2.867,p=0.005,CRP r=4.110,p=0.000,IL-6 t=3.241,p=0.002,secretion culture result X2=23.122,p=0.000).But there was no statistical difference in the wound area and wound symptom score(wound area:t=1.154,p=0.251,wound symptom score:t=1.544,p=0.125).After 4 weeks of treatment,both the wound area and symptom score of the 2 groups were reduced after 2 weeks of treatment(wound area:experimental group t=9.733,p=0.000,control group t=5.309;p=0.000;wound symptom score:experimental group t=11.767,p=0.000,control group t=9.535,p=0.000).The difference between the experimental group and the control group was statistically significant(wound area:t=4.544,p=0.000,wound symptom score:t=3.321,p=0.001).The related inflammatory factors in the experimental group and the control group were reduced after 2 weeks of treatment.(experimental group:PCT t=5.917,p=0.000,CRP t=5.931,p=0.000,IL-6 t=21.291,p=0.000,control group:PCT t=7.873,p=0.000,CRP t=18.300,p=0.0000,IL-6 t=24.026,p=0.000).There was no significant difference between the experimental group and the control group(PCT =1.920,p=0.057,CRP t=1.075,p=0.290,IL-6 t=1.539,p=0.127).The positive rate of bacterial culture didn’t decline obviously in two groups(experimental group:positive rate of bacterial culture=21.67%,x2=2.055,p=0.152,control group:positive rate of bacterial culture=55%,x2=2.543,p=0.111).The difference between the experimental group and the control group was statistically significant(x2=21.624,p=0.000).Conclusion:Negative-pressure wound therapy with instillation of FufangHuangbaiYe can control diabetic foot wound infection,promote wound healing,improve clinical symptoms.The effect is better than negative pressure wound therapy with instillation of normal saline.