Diabetic gangrene is a difficult disease interdisciplinary, in the event, treatment more difficult. Foreign scholars believe that diabetic foot amputation is the end result of sexual development. In recent years, we are using Chinese and Western Medicine for the diabetic gangrene amputation rate reduced to 6.67%, showing significant advantages, compared with 38.1% ~ 75% of the domestic and abroad, 48% ~ 49% of the level of amputation rate. Therefore, combining Chinese and Western medicine combined treatment of diabetic foot is to improve the cure rate and reduce amputation rate of the key.
The specific treatment of diabetic foot many ways, we will be divided into three areas.
1, Western medicine treatment
Including the treatment of peripheral neuropathy and peripheral vascular disease treatment.
1. The treatment of peripheral neuropathy
Very good control of blood glucose can reduce and mitigate the occurrence of peripheral neuropathy and development. However, Pirart that has happened, there is no reversal of the role of peripheral neuropathy, should be early prevention and treatment of peripheral nerve lesions and the protection of its functions.
At present the clinical improvement of neurological function of the drug are mainly aldose reductase inhibitors, myo-inositol, neurotrophic agents and nerve growth factor.
2. Peripheral Vascular Disease Treatment
Mainly to improve limb blood circulation and blood hypercoagulability. The effective treatment of diabetic foot a lot of chemical drugs, the clinical effects of commonly used and better drugs include expansion of the blood vessels of drugs such as prostaglandins, anti-platelet drugs such as cilostazol, anticoagulant drugs such as low molecular weight heparin and warfarin, and so on, fiber snake venom protein, dissolved substances such as various kind of product.
3. Surgical treatment of
Including various types of vascular bypass surgery and transluminal angioplasty. Conditional upon the implementation of clinically proven surgical intervention in patients with surgical treatment of peripheral vascular disease is still the preferred method.
① endovascular interventional therapy: Because of its trauma, surgery and rapid recovery features, combined with all kinds of balloon, stent development and application of rapid development in recent years, the clinical application of a gradual increase in a way replaces the part of the bypass surgery. It is suitable for the more limited occlusion of segmental vessels or vascular stenosis cases.
② a variety of vascular bypass surgery: the use of autologous or artificial blood vessel stenosis or occlusion of blood vessels at both ends of the establishment of additional flow channels to ease the ischemic limb. This approach from the 20th century began to use since the early 50s, more than 50 years of history, has accumulated many successful experiences, is a relatively mature surgical method. However, in order to obtain the best treatment to guarantee the effective pursuit of the patency rate is our purpose.
Second, Chinese medicine treatment
A large number of case report showed that: The Chinese medical treatment can effectively alleviate the patient's clinical symptoms and reduce amputation rates and morbidity and improve the lives of patients with diabetic foot and quality of life. According to TCM laws, we will be divided into three kinds of diabetic foot syndrome types.
1. Humid Yun-toxin
Limb pain, day night light weight, local swelling, purple skin, dark, steeped spreading ulceration rotting, flesh-colored do not fresh; body heat, dry mouth, red tongue, yellow greasy moss, pulse a few strings. Expelling heat Lishi detoxification. Side with four Miao Yong An Tang addition and subtraction.
2. Hanning Blocking Collateral Type
Limb warmth stand the cold, numbness, Suanzhang pain, pain go intensified, taking a rest pain reduction, skin pale, cold touch of the hair, dorsalis pedis pulse moving the decline; tongue pale, moss Baini, pulse Shen fine. Expelling Onyang Tongluo, Fang Yang and soup with the addition and subtraction.
3. Qi and Yin Deficiency type
Duration of the course of time, the skin dry, Haomao off, toe (referring to) A thickening of deformation, muscle atrophy, necrotic tissue eventually becoming detached surface after the sores heal, granulation dull red or pale instead of fresh; burnout fatigue, emaciation, dry mouth want drink, mamillata, less moss, pulse weak breakdown. Expelling Prostisol. Side-step decoction with care.
Third, local treatment
Local diabetic foot wounds, ulcers and gangrene treatment of diabetic foot treatment is an important means, but also the key to the preservation of limbs. Advantages of local treatment has been reflected in traditional Chinese medicine outside the governance. Practice has proved that for thousands of years, Chinese medicine has a unique external drug efficacy, proper use and selection of drugs for external use traditional Chinese medicine has contributed to save the limb effect.
The partial treatment of diabetic foot can be divided into three stages:
1. Basic stages of treatment
This phase must run through the multi-drug therapy, such as controlling high blood sugar, anti-infection, and then clear the large blood vessels, improve microcirculation and correct other complications, and supportive therapy. However, localized not only to maintain drainage gangrene smooth things, it should not deal with.
2. To the decay phase of
Patients generally improved, glucose and infection under control, improved microcirculation, complications to be corrected, on this basis, focusing on to rot, increase the depth of drainage, surgical debridement, the gradual removal of necrotic tissue.
3. Myogenic stage
Marked improvement in patients with systemic, local secretions significantly reduced, the gradual removal of necrotic tissue, treatment focuses on the use of a variety of myogenic means to promote local granulation neonatal gangrene, so that wound healing.
Diabetic foot ulcers is a complex of refractory disease, the occurrence of disease development and the healing process, the true, stasis, wet, heat, phlegm, drugs and other pathological factors interact and are constantly changing, in the course of treatment should seize the main card, and timely adjusted according to local and systemic changes in governance of the governing law and medicine, and should be a reasonable application of nutritional support, traditional Chinese medicine TCM can only be levied in full effect.
