Clinical Study Of Huoxue Tongmai Granules In The Treatment Of Diabetic Foot Ulcers (Blood Stasis Syndrome) After Tibial Transverse Transport Technique

Objective: The purpose of this study is to explore the clinical efficacy of Huoxue Tongmai Granules in the treatment of diabetic foot ulcers(blood stasis syndrome)after tibial transverse transport technique,it will provides basis and reference for the future treatment of diabetic foot ulcers with integrated traditional Chinese and western medicine.Methods:58 patients with diabetic foot ulcers treated in Rizhao Hospital of Traditional Chinese Medicine Affiliated to Shandong University of Traditional Chinese Medicine from November 2017 to September 2019 were selected.Patients who met the inclusion criteria were divided into two groups by random grouping method,30 patients in the traditional Chinese medicine group and 28 patients in the control group.Wagner classification of the patients was 2-4.All patients received active medical treatment after admission,After the patient or family members sign the medical informed consent for the operation,All patients underwent tibial transverse transport technique in the Department of Orthopaedics,Rizhao Hospital of Traditional Chinese Medicine.Tibial bone transport began on the 4th day after operation,Move 1mm outward everyday,It is completed in 4 times,All the patients are taken X-ray examination after operation.After 2 weeks,then 1mm was moved back every day.It was completed in 4 times(accordion technique).After 4 weeks,the tibial bone window was moved back to its original position.After 6-8 weeks,all the patients takes an X-ray reexamination,the external fixator was removed after healing.After operation,the traditional Chinese medicine group take Huoxue Tongmai Granules twice a day,Before operation,the pain score(Visual Analogue Score,VAS),ankle brachial index(ankle brachial index,ABI),10 g monofilament test,the foot skin temperature and ulcer area of the two groups were recorded respectively.All the clinical efficacy evaluation indexes were recorded during outpatient reexamination after operation for 3 months,and the data were statistically analyzed by statistical software.Results: 58 patients in both groups were followed up for 4～6 months with an average of(4.96±0.77)months.Among them,3 patients underwent necrotic toe amputation at the same time.There was no significant difference in sex,age,course of disease,Wagner stage and various observation indexes before treatment in two groups,the differences were not statistically significant(P>0.05),which was of comparative research value.VAS score,ankle brachial index,10 g monofilament test,skin temperature and wound healing time were compared between the two groups.VAS score: Compared with before treatment,traditional Chinese medicine and control group after operation at3 months decreased significantly(P<0.05),while compared with the control group after operation at 3 months,the traditional Chinese medicine group decreased significantly(P<0.05).Ankle brachial index:Compared with before treatment,traditional Chinese medicine and control group after operation at3 months increased significantly(P<0.05),while compared with the control group after operation at 3 months,the traditional Chinese medicine group increased significantly(P<0.05);10g monofilament test:Compared with before treatment,traditional Chinese medicine and control group after operation at3 months increased significantly(P<0.05),while compared with the control group after operation at 3 months,the traditional Chinese medicine group increased significantly(P<0.05);Skin temperature:Compared with before treatment,traditional Chinese medicine and control group after operation at3 months increased significantly(P<0.05),while compared with the control group after operation at 3 months,the traditional Chinese medicine group increased significantly(P<0.05);Wound healing time:Compared with the control group,the traditional Chinese medicine group increased obviously(P<0.05)。Conclusion: Huoxue Tongmai Granules combined with tibial transverse transport technique has better efficacy in the treatment of diabetic foot ulcers(blood stasis syndrome)than the single operation.Huoxue Tongmai Granules has the effects of promoting blood circulation,removing blood stasis and relieving pain.and it can promote microcirculation of affected limbs,improve skin sensation,increase local skin temperature of affected limbs,accelerate wound healing.it significantly improve the quality of life of patients and has important reference value in clinical research.