负压封闭引流技术结合拔毒生肌散在糖尿病足溃疡患者中的应用

樊波波; 马海涛; 蔡高坡; 代雪娜; 王汉杰; 周涛

doi:10.16766/j.cnki.issn.1674-4152.004285

负压封闭引流技术结合拔毒生肌散在糖尿病足溃疡患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004285

河南中医药大学第一附属医院周围血管科，河南郑州 450000

基金项目:

河南省中医药科学研究专项课题 2022JDZX053

详细信息

通讯作者:
周涛，E-mail：zhoutao6801@126.com

中图分类号: R587.2
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出版历程
- 收稿日期: 2025-06-11
- 网络出版日期: 2026-03-13

The application of negative vacuum stealing drainage technology combined with Badu Shengji Powder in diabetic foot ulcer patients

Department of Peripheral Vascular Surgery, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探讨负压封闭引流(VSD)技术结合拔毒生肌散对糖尿病足溃疡(DFU)患者创面愈合及血清C反应蛋白(CRP)、白介素-18(IL-18)、糖原合酶激酶3β(GSK-3β)水平的影响。方法选择2023年1月—2025年5月河南中医药大学第一附属医院周围血管科收治的118例DFU患者，采用随机数字表法分为观察组及对照组，各59例。对照组行VSD技术治疗，观察组行VSD技术结合拔毒生肌散治疗，分析二者结合对患者创面愈合、CRP、IL-18、GSK-3β等指标的影响。结果治疗后观察组创面面积、创面深度、肉芽生长、创面渗出评分分别为(1.14±0.15)分、(1.23±0.15)分、(1.15±0.16)分、(1.21±0.15)分，均明显低于对照组[(1.62±0.17)分、(1.64±0.19)分、(1.72±0.19)分、(1.68±0.17)分，F=14.156、11.278、114.287、13.564，P＜0.001]；治疗后观察组CRP、白细胞计数(WBC)、IL-18、GSK-3β、转化生长因子(TGF-β1)、内皮抑素(ES)水平均低于对照组(P＜0.001)，血管内径、血流速度、阻力系数、血管内皮生长因子(VEGF)、碱性成纤维生长因子(bFGF)均高于对照组(P＜0.001)。结论 VSD技术结合拔毒生肌散可有效促进DFU创面愈合，调节IL-18、GSK-3β等指标，改善足背血流动力学和促进血管新生。
- 糖尿病足溃疡 /
- 负压封闭引流技术 /
- 拔毒生肌散 /
- C反应蛋白 /
- 白介素-18 /
- 糖原合酶激酶3β
Abstract: Objective To investigate the effects of negative vacuum sealing drainage (VSD) technology combined with Badu Shengji Powder on wound healing, serum C-reactive protein (CRP), interleukin-18 (IL-18), and glycogen synthase kinase 3β (GSK-3β) levels in patients with diabetic foot ulcer (DFU). Methods A total of 118 DFU patients admitted to the department of peripheral vascular, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, from January 2023 to May 2025, were separated into the observation group (n=59, VSD technology + Badu Shengji Powder) and the control group (n=59, VSD technology). The effects of the combination on wound healing, CRP, IL-18, GSK-3β, and other indices were analyzed. Results Wound area, wound depth, granulation growth and wound exudation scores of both groups significantly decreased after treatment, and the above scores in the observation group [(1.14±0.15) points, (1.23±0.15) points, (1.15±0.16) points and (1.21±0.15) points] were significantly lower than the other group [(1.62±0.17) points, (1.64±0.19) points, (1.72±0.19) points and (1.68±0.17) points, F=14.156, 11.278, 114.287, 13.564, all P < 0.001]; After treatment, CRP, white blood cell count (WBC), IL-18, GSK-3β, transforming growth factor (TGF-β1) and endostatin (ES) in the observation group were significantly lower than those in the control group (P < 0.001), while vascular diameter, blood flow velocity, resistance coefficient, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) significantly higher (P < 0.001). Conclusion VSD technology combined with Badu Shengji Powder can effectively promote DFU wound healing, regulate IL-18, GSK-3β, and other indicators, improve the hemodynamics of the back of the foot, and promote angiogenesis.
- Diabetic foot ulcer /
- Vacuum sealing drainage technology /
- Badu Shengji Powder /
- C-reactive protein /
- Interleukin-18 /
- Glycogen synthase kinase 3β

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表 1 2组DFU患者临床资料比较

Table 1. Comparision of clinical data between the two groups of DFU patients

组别	例数	年龄(x±s，岁)	性别(男性/女性，例)	糖尿病病程(x±s，年)	DFU病程(x±s，月)	Wagner分级(例)			溃疡面积(x±s，cm²)
组别	例数	年龄(x±s，岁)	性别(男性/女性，例)	糖尿病病程(x±s，年)	DFU病程(x±s，月)	2级	3级	4级	溃疡面积(x±s，cm²)
观察组	59	54.36±7.11	33/26	11.54±2.19	4.35±0.46	34	12	13	15.23±2.64
对照组	59	52.37±5.94	34/25	11.34±2.88	4.39±0.58	36	11	12	15.14±2.31
统计量		1.650^a	0.035^b	0.425^a	0.415^a	0.128^c			0.197^a
P值		0.102	0.853	0.672	0.679	0.720			0.844
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 2组DFU患者治疗前后创面愈合情况比较(x±s，分)

Table 2. Comparison of wound healing between the two groups of DFU patients before and after intervention (x±s, points)

组别	例数	创面面积		创面深度		肉芽生长		创面渗出
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	59	2.56±0.27	1.14±0.15^b	3.45±0.37	1.23±0.15^b	2.88±0.29	1.15±0.16^b	2.76±0.31	1.21±0.15^b
对照组	59	2.51±0.28	1.62±0.17^b	3.47±0.39	1.64±0.19^b	2.86±0.31	1.72±0.19^b	2.74±0.33	1.68±0.17^b
统计量		0.987^a	14.156^c	0.286^a	11.278^c	0.362^a	114.287^c	0.339^a	13.564^c
P值		0.326	＜0.001	0.776	＜0.001	0.718	＜0.001	0.735	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 3 2组DFU患者治疗前后炎症指标比较(x±s)

Table 3. Comparison of inflammatory indexes between the two groups of DFU patients before and after treatment (x±s)

组别	例数	CRP(mg/L)		WBC(×10⁹/L)		IL-18(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	59	43.15±5.26	26.45±3.17^b	9.55±1.23	6.23±0.75^b	113.26±15.41	67.54±8.19^b
对照组	59	43.21±5.18	34.16±4.59^b	9.47±1.14	7.19±0.84^b	117.46±12.58	85.66±9.14^b
统计量		0.062^a	8.254^c	0.366^a	4.178^c	1.622^a	9.264^c
P值		0.950	＜0.001	0.715	＜0.001	0.108	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组DFU患者治疗前后GSK-3β、TGF-β1水平比较(x±s，μg/L)

Table 4. Comparison of GSK-3β and TGF-β1 levels between the two groups of DFU patients before and after treatment (x±s, μg/L)

组别	例数	GSK-3β		TGF-β1
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	59	35.26±4.11	15.23±2.74^b	36.14±4.55	20.33±3.14^b
对照组	59	35.14±4.22	19.62±2.51^b	36.25±3.72	25.17±2.69^b
统计量		0.156^a	8.471^c	0.144^a	7.613^c
P值		0.876	＜0.001	0.886	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 2组DFU患者治疗前后足背血流动力学指标比较(x±s)

Table 5. Comparison of dorsal foot hemodynamics indexes between the two groups of DFU patients before and after treatment (x±s)

组别	例数	血管内径(mm)		血流速度(cm/s)		阻力系数
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	59	1.71±0.19	2.03±0.24^b	48.44±6.12	57.11±6.31^b	0.62±0.07	0.78±0.09^b
对照组	59	1.73±0.18	1.88±0.19^b	48.34±6.17	52.41±6.17^b	0.63±0.08	0.71±0.08^b
统计量		0.587^a	4.153^c	0.088^a	5.034^c	0.723^a	5.178^c
P值		0.558	＜0.001	0.930	＜0.001	0.471	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 6 2组DFU患者治疗前后溃疡创面血管新生指标比较(x±s)

Table 6. Comparison of ulcer wound angiogenesis indexes between the two groups of DFU patients before and after treatment (x±s)

组别	例数	VEGF(pg/mL)		bFGF(ng/L)		ES(ng/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	59	51.26±6.14	91.33±10.25^b	43.26±6.15	77.59±8.14^b	61.25±7.11	31.25±4.16^b
对照组	59	52.33±6.57	80.17±9.45^b	44.27±5.19	68.44±8.23^b	61.34±7.88	42.55±4.79^b
统计量		0.914^a	5.871^c	0.964^a	5.321^c	0.065^a	10.647^c
P值		0.363	＜0.001	0.337	＜0.001	0.948	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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