目的 探討己酮可可堿聯(lián)合胰激肽原酶治療糖尿病足的臨床療效。方法 選擇2018年5月—2022年2月在漯河市中心醫(yī)院治療的86例糖尿病足患者為研究對(duì)象，根據(jù)住院號(hào)的奇偶性分為治療組和對(duì)照組，每組各43例。對(duì)照組患者肌肉注射注射用胰激肽原酶，40 U/次，1.5 mL滅菌注射用水溶解，1次/d；在此基礎(chǔ)上，治療組患者靜脈滴注注射用己酮可可堿，0.4 g加入250 mL生理鹽水，1次/d。兩組患者連續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者糖尿病自護(hù)行為量表（SDSCA）、自我感受負(fù)擔(dān)量表（SPBS）評(píng)分和食物多樣化評(píng)分（DDS），血清胰島素樣生長(zhǎng)因子-1（IGF-1）、同型半胱氨酸（Hcy）、瘦素、轉(zhuǎn)化生長(zhǎng)因子-β（TGF-β）和白細(xì)胞介素-13（IL-13）水平，足部潰瘍面積和深度，足背動(dòng)脈血管內(nèi)徑、血流流速、搏動(dòng)指數(shù)（PI）、阻力指數(shù)（RI）。結(jié)果 治療后，對(duì)照組有效率為81.40%，明顯低于治療組（97.67%，P<0.05）。治療后，兩組SDSCA評(píng)分明顯升高，而SPBS評(píng)分和DDS評(píng)分明顯下降（P<0.05）；兩組患者血清IGF-1和TGF-β水平明顯升高，而Hcy、瘦素和IL-13水平均明顯降低（P<0.05）；兩組足部潰瘍面積、潰瘍深度均明顯減?。?i>P<0.05）；兩組患者足背動(dòng)脈血管內(nèi)徑、血流流速、PI、RI均明顯增加（P<0.05）；上述指標(biāo)以治療組改善更為明顯（P<0.05）。結(jié)論 注射用己酮可可堿聯(lián)合注射用胰激肽原酶治療糖尿病足可有效促進(jìn)潰瘍愈合，減輕患者疼痛，提高自我管理能力。

Objective To investigate the clinical efficacy of pentoxifylline combined with pancreatic kininogenase in treatment of diabetes foot. Methods Patients (86 cases) with diabetes foot in Luohe Central Hospital from May 2018 to February 2022 were divided into control and treatment group according to parity of inpatient number, and each group had 43 cases. Patients in the control group were intramuscular injection administered with Pancreatic Kininogenase for injection, 40 units added into 1.5 mL sterilized water for injection, once daily. Patients in the treatment group were iv administered with Pentoxifylline for injection on the basis of the control group, 0.4 g added into 250 mL normal saline, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the scores of SDSCA, SPBS and DDS, the levels of IGF-1, TGF-β, Hcy, leptin and IL-13, foot ulcer area and depth, internal diameter, blood flow velocity, PI and RI of dorsalis pedis artery in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 81.40%, which was significantly lower than that of the treatment group (97.67%, P < 0.05). After treatment, SDSCA score was significantly increased, while SPBS score and DDS score were significantly decreased, the levels of serum IGF-1 and TGF-β were significantly increased, while the levels of Hcy, leptin and IL-13 were significantly decreased, the area and depth of foot ulcer were significantly decreased, and the diameter, blood flow velocity, PI and RI of dorsalis pedis artery were significantly increased in two groups, and these indexes were most significantly improved in the treatment group (P < 0.05). Conclusion Pentoxifylline for injection combined with Pancreatic Kininogenase for injection in treatment of diabetes foot can effectively promote ulcer healing, reduce pain and improve the ability of self-management.

R977

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（LHGJ20200896）