摘要
目的：探讨活血、回阳、祛腐外治生肌三法对糖尿病足伴慢性骨髓炎的治疗优势。方法：局部辨证，应用活血、回阳、祛腐外治生肌三法代表药物紫色疽疮膏、朱红膏、回阳生肌膏，短期（2-3周）抗菌素，有限手术，共治疗糖尿病足伴慢性骨髓炎93例。结果：仅局部应用中药29.00%（27/93），有限手术61.29%（57/93），膝上截肢6.45%（6/93），死亡3.22%（3/93），初次治疗后疮面愈合77.40%（72/93）；全身应用抗菌素61.29%（57/93），未应用抗菌素38.7%（36/93），常见抗菌素敏感性较高的是亚胺培南（78.1%）、哌拉西林/他唑巴坦（70.6%）、莫西沙星（64.2%）、氨曲南（60.2%）、利奈唑脘（59.1%）、左旋氧氟沙星（56.7%）等。结论：局部辨证外用中药，配合有限手术，短期内应用抗菌素，可以作为糖尿病伴慢性骨髓炎有效的治疗方法，体现了中医药治疗优势。
Objective：To investigate the healing advantages of three methods of generating muscles （activating blood, restoring Yang and dispelling decay） for treating diabetic foot accompanying chronic osteomyelitis. Methods：According to the local syndrome differentiation, 93 cases of diabetic foot accompanying chronic osteomyelitis were classified into three groups treated with the three methods of generating muscles, 2-3 weeks antibiotics and limited surgery, as the purple sore ointment, the ZhuHong ointment and the Yang-restoring and muscle-generating ointment being on behalf of the blood-activating, Yang-restoring and decay-removing methods respectively. Results：The topi-cal application of Chinese medicine was 29.0%（27/93）, the limited surgery executed 61.3%（57/93）, the knee ampu-tation 6.5%（6/93）, the death 3.2%（3/93） and the wound healing after initial treatment 77.4%（72/93）;the cases treat-ed with antibiotics in the whole body was 61.3%（57/93） and with no antibiotics was 38.7%（36/93）, and the common antibiotics with higher sensitivity were imipenem （78.1%）, piperacillin/tazobactam （70.6%）, moxifloxacin （64.2%）, aztreonam（60.2%）, linezolid abdominal（59.1%） and levofloxacin（56.7%）. Conclusion：Combined the limited surgery and short-term use of antibiotics, the Chinese medicine topically applied through the local syndrome differentiation is effective in curing diabetic patients with chronic osteomyelitis, which reflects the therapeutic advantages of Chi-nese medicine.
出处
《西部中医药》
2015年第2期88-91,共4页
Western Journal of Traditional Chinese Medicine
基金
北京市中医管理局中医外治法专项(编号WZF2012-13)
关键词
骨髓炎
糖尿病足
生肌三法
osteomyelitis
diabetic foot
three methods of generating muscles
