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马勃孢子粉治疗糖尿病足溃疡的疗效及安全性研究
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Abstract:
目的：探索马勃孢子粉治疗糖尿病足溃疡的效果及安全性。方法：按照纳排标准纳入81例糖尿病足溃疡患者，对照组(41例)行常规治疗，研究组(40例)行常规治疗 + 马勃孢子粉治疗。收集两组患者基本资料，比较两组的临床疗效、创面面积、细菌培养阳性率炎症指标及创面渗出液指标，并进行安全性评价。结果：治疗后，与对照组相比，研究组治疗总有效率显著提高；创面面积显著缩小；细菌培养阳性率显著降低；炎症指标(CRP、ESR、IL-6和TNF-α)水平显著降低；创面渗出液指标TIMP-1和VEGF水平均明显升高，而MMP9水平明显降低。结论：马勃孢子粉治疗糖尿病足溃疡疗效显著，安全性好，值得临床推广使用。
Objective: To explore the efficacy and safety of puffball spore powder in the treatment of diabetes foot ulcers. Methods: According to the inclusion and exclusion criteria, 81 patients with diabetes foot ulcers were included. The control group (41 cases) received basic treatment, and the research group (40 cases) received basic treatment + puffball spore powder treatment. The basic data of the two groups were collected, and the clinical efficacy, wound area, positive rate of bacterial culture, inflammatory index, and wound exudate index of the two groups were compared, and the safety was evaluated. Results: After treatment, compared with the control group, the total effective rate of the study group was significantly improved; the area of the wound decreased significantly; the positive rate of bacterial culture obviously decreased; the levels of inflammatory markers (CRP, ESR, IL-6, and TNF-α) were markedly reduced; the levels of TIMP-1 and VEGF in wound exudate were significantly up-regulated, while the level of MMP9 was significantly down-regulated. Conclusion: The efficacy and safety of puffball spore powder in the treatment of diabetes foot ulcers are significant, and it is worthy of clinical application.
| [1] | Zhang, Y., Lazzarini, P.A., McPhail, S.M., van Netten, J.J., Armstrong, D.G. and Pacella, R.E. (2020) Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016. Diabetes Care, 43, 964-974. https://doi.org/10.2337/dc19-1614 |
| [2] | Armstrong, D.G., Tan, T., Boulton, A.J.M. and Bus, S.A. (2023) Diabetic Foot Ulcers. JAMA, 330, 62-75. https://doi.org/10.1001/jama.2023.10578 |
| [3] | Sa, B.C., Bermudez, N.M., Shimon, S.V. and Kirsner, R.S. (2024) Diabetic Foot Ulcers: A Review of Debridement Techniques. Surgical Technology Online, 44, 31-35. https://doi.org/10.52198/23.sti.43.wh1718 |
| [4] | Rehman, Z.U., Khan, J. and Noordin, S. (2023) Diabetic Foot Ulcers: Contemporary Assessment and Management. Journal of the Pakistan Medical Association, 73, 1480-1488. https://doi.org/10.47391/jpma.6634 |
| [5] | Everett, E. and Mathioudakis, N. (2018) Update on Management of Diabetic Foot Ulcers. Annals of the New York Academy of Sciences, 1411, 153-165. https://doi.org/10.1111/nyas.13569 |
| [6] | Liu, F., Li, Y., Guo, X., Liu, R., Zhang, H. and Li, Z. (2022) Advances in Traditional Chinese Medicine as Adjuvant Therapy for Diabetic Foot. World Journal of Diabetes, 13, 851-860. https://doi.org/10.4239/wjd.v13.i10.851 |
| [7] | Yang, Y., Zhou, Y. and Ge, M. (2023) The Effect of Externally Applied Traditional Chinese Medicine in Diabetic Foot: A Systematic Review and Meta-Analysis of 34 RCTs. The Foot, 56, Article ID: 102045. https://doi.org/10.1016/j.foot.2023.102045 |
| [8] | 陈军, 叶亮, 贺唐唐, 等. 紫色马勃的应用历史、研究概述与展望[J]. 南京中医药大学学报, 2023, 39(5): 495-500. |
| [9] | 叶勇. 马勃孢子粉发酵液抗真菌药效物质基础及其抗菌作用的研究[D]: [博士学位论文]. 合肥: 合肥工业大学, 2022. |
| [10] | Zeng, Q., Singh, R., Ye, Y., Cheng, S., Fan, C. and Zeng, Q. (2021) Calvatia lilacina Extracts Exert Anti-Breast-Cancer Bioactivity through the Apoptosis Induction Dependent on Mitochondrial Reactive Oxygen Species and Caspase Activation. Nutrition and Cancer, 74, 1058-1070. https://doi.org/10.1080/01635581.2021.1936576 |
| [11] | 丁晓桐, 王裔惟, 闵文, 等. 马勃孢子粉醇提物对小鼠全层皮肤缺损性创面的治疗作用考察[J]. 中国实验方剂学杂志, 2022, 28(8): 149-58. |
| [12] | 陈大伟, 冉兴无. 2017《中国糖尿病足诊治指南》解读[J]. 中国医师杂志, 2017, 49(12): 1405-1408. |
| [13] | 中华中医药学会外科分会. 糖尿病足溃疡的中医循证临床实践指南[J]. 糖尿病天地: 临床, 2016, 10(1): 42-45. |
| [14] | 中华中医药学会糖尿病分会. 糖尿病足中医诊疗标准[J]. 世界中西医结合杂志, 2011, 6(7): 618-625. |
| [15] | Huang, H., Xin, R., Li, X., Zhang, X., Chen, Z., Zhu, Q., et al. (2023) Physical Therapy in Diabetic Foot Ulcer: Research Progress and Clinical Application. International Wound Journal, 20, 3417-3434. https://doi.org/10.1111/iwj.14196 |
| [16] | Mariadoss, A.V.A., Sivakumar, A.S., Lee, C. and Kim, S.J. (2022) Diabetes Mellitus and Diabetic Foot Ulcer: Etiology, Biochemical and Molecular Based Treatment Strategies via Gene and Nanotherapy. Biomedicine & Pharmacotherapy, 151, Article ID: 113134. https://doi.org/10.1016/j.biopha.2022.113134 |
| [17] | 宋孝汝, 王丽. 中医护理干预联合紫朱软膏外敷治疗早期糖尿病足溃疡患者创面愈合和生活质量的影响[J]. 新疆中医药, 2023, 41(6): 80-82. |
| [18] | 黎文艳, 何春红, 张静云. 中药熏洗治疗糖尿病足临床观察[J]. 光明中医, 2023, 38(23): 4618-4620. |
| [19] | Cicha-Jeleń, M., Muszynska, B., Kala, K. and Sulkowska-Ziaja, K. (2024) Medicinal Potential of the Giant Puffball Mushroom Calvatia Gigantea (agaricomycetes): A Review. International Journal of Medicinal Mushrooms, 26, 13-25. https://doi.org/10.1615/intjmedmushrooms.2024054161 |
| [20] | 孙浩. “煨脓长肉”法指导马勃孢子粉换药治疗慢性难愈性创面的临床观察[D]: [硕士学位论文]. 南京: 南京中医药大学, 2021. |
| [21] | He, T., Sun, P., Liu, B., Wan, S., Fang, P., Chen, J., et al. (2022) Puffball Spores Improve Wound Healing in a Diabetic Rat Model. Frontiers in Endocrinology, 13, Article 942549. https://doi.org/10.3389/fendo.2022.942549 |
| [22] | 郑美洁, 李贤, 高哲, 等. 血小板/淋巴细胞比值和C-反应蛋白与糖尿病足溃疡严重程度及预后的关系[J]. 中国临床研究, 2022, 35(7): 938-942, 947. |
| [23] | 段皓, 刘国亭, 孙宏武, 等. 红细胞沉降率、C反应蛋白、糖尿病周围神经病变与糖尿病足溃疡严重程度的相关性研究[J]. 足踝外科电子杂志, 2021, 8(1): 22-26. |
| [24] | Jang, D., Lee, A., Shin, H., Song, H., Park, J., Kang, T., et al. (2021) The Role of Tumor Necrosis Factor Alpha (TNF-α) in Autoimmune Disease and Current TNF-α Inhibitors in Therapeutics. International Journal of Molecular Sciences, 22, Article 2719. https://doi.org/10.3390/ijms22052719 |
| [25] | Xu, Y., Fu, X. and Chen, F. (2023) Epalrestat Is Effective in Treating Diabetic Foot Infection and Can Lower Serum Inflammatory Factors in Patients. American Journal of Translational Research, 15, 6208-6216. |
| [26] | Li, G., Zou, X., Zhu, Y., Zhang, J., Zhou, L., Wang, D., et al. (2017) Expression and Influence of Matrix Metalloproteinase-9/tissue Inhibitor of Metalloproteinase-1 and Vascular Endothelial Growth Factor in Diabetic Foot Ulcers. The International Journal of Lower Extremity Wounds, 16, 6-13. https://doi.org/10.1177/1534734617696728 |
| [27] | Kartika, R.W., Alwi, I., Suyatna, F.D., Yunir, E., Waspadji, S., Immanuel, S., et al. (2021) The Role of VEGF, PDGF and IL-6 on Diabetic Foot Ulcer after Platelet Rich Fibrin + Hyaluronic Therapy. Heliyon, 7, e07934. https://doi.org/10.1016/j.heliyon.2021.e07934 |
| [28] | Chang, M. and Nguyen, T.T. (2021) Strategy for Treatment of Infected Diabetic Foot Ulcers. Accounts of Chemical Research, 54, 1080-1093. https://doi.org/10.1021/acs.accounts.0c00864 |
