Clinical experience in treating diabetic gangrene with combination of TCM and Western Medicine

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In recent years, the prevalence of diabetes increased gradually, all kinds of chronic complications increase, while the diabetic gangrene is

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In recent years, the prevalence of diabetes increased gradually, all kinds of chronic complications increase, while the diabetic gangrene is a common and serious complication of limb and spread of microvessels and neuropathy. According to [1] reports, the incidence of diabetes accounted for about 0.9%1.7%. The clinical features of distal limb pain, infection, ulcers, gangrene. Once the disease occurs, the rapid development, serious illness, treatment intractable, amputation rate is about 40 times of non diabetic patients [2]. One of the important causes of disability and death in diabetic patients. At present, the use of integrated traditional Chinese and Western medicine treatment, the amputation rate of the disease from the past 38.1% - 75.8% to 4.2%, the cure rate of 87.5%[3], fully embodies the advantages of the combination of traditional Chinese and Western medicine treatment of the disease.

This disease belongs to Chinese medicine "Xiaoke, mortification". As early as in the Song Dynasty "health treasures" in there "diabetes patients of knee foot hair inside, death does not save the record. Is generally believed that the pathogenesis of this disease is deficiency of Qi and Yin, blood stasis and blood heat, acral dystrophy caused by. The heat blood stasis Qi and yin deficiency diabetes, induced acral dystrophy as standard. Based on this, the author summed up some of the past clinical results, to control blood sugar as a prerequisite for treatment, anti infection, clearing heat and detoxifying, promoting blood circulation to remove blood stasis, and received a good effect, is introduced as follows:

therapeutic method

1 actively control diabetes

1.1 strict control diet

1.2 intensive insulin therapy to control blood glucose

2 internal treatment

2.1 positive anti infection, choose sensitive antibiotics intravenous drip

2.2 anticoagulation, improving microcirculation, promoting blood circulation and removing blood stasis. Intravenous Xiaoshuanling, anisodamine, ligustrazine, oral pancreatic kallikrein tablets.

3 external treatment

After routine disinfection with hydrogen peroxide and saline wash the wound, after cleaning the wound with Compound Danshen injection, antibiotic sensitive liquid infiltration, then apply puffball powder, exposed the wound, the daily change time.

Typical case

Wang, male, 43 years old, workers. In March 5, 1996 with "polydipsia polyuria weight loss in 9 years, double foot skin ulcers in February was admitted to the hospital. Physical examination: double limb dorsalis pedis artery pulsation weakened, visible right foot back 2 * 3 cm 2, heel 3 * 8 cm 2, Zumu left toe 1 * 2 cm 2, heel 3 * 15 cm 2 skin ulceration, visible purulent secretions, wound edge skin color dark red. After admission to the strict diet control, intensive insulin therapy to control blood glucose, intravenous penicillin, Xiaoshuanling, anisodamine, ligustrazine, oral pancreatic kallikrein, simultaneously with penicillin powder according to the wound, wound secretion culture results to amikacin wet compress for 1 months, the wound granulation is reduced. Tissue growth, but the edge of tissue color dark red, so combined with compound salvia miltiorrhiza injection, wound infiltration after topical exposure puffball powder, dressing, once a day, a week after the wound healing.

Experience

Treatment of diabetic gangrene is very difficult, for many years of severe limb gangrene, often by surgical high amputation, cause lifelong disability. In recent years, our country has made some progress in the conservative treatment of internal medicine. In recent years, some domestic and foreign literatures have reported that the combination of traditional Chinese and Western medicine has a bright future. In this case, patients began to take medicine treatment, although the internal and external, but local tissue blood circulation is poor, slow healing, and the wound combined with Salvia miltiorrhiza, puffball powder, drug directly to patients, so only 1 weeks will wound healing, reflected by the advantages of Chinese medicine treatment. Salvia miltiorrhiza, bitter taste, slightly cold, blood stasis, cooling blood and removing pain, nourishing and soothing [4]. "Japan Hua Zi Materia Medica" records "sadashi repose...... Pus pain, muscle long meat "is the new role of Quyu health. Puffball, spicy, Qingfei Liyan, detoxification hemostatic [5]. The earliest recorded in "Mingyi bielu" main "inside the horse itch", "herbal preparation" to "records" Qingfei heat, scattered blood cough, sore throat treatment...... Topical application the sores". Consistent with modern pharmacological studies and ancient herbal pharmacological effect shows that this product for Staphylococcus aureus, Pseudomonas aeruginosa, Proteus and Streptococcus pneumoniae has certain inhibitory effect. No high temperature disinfection, direct external wound, not sticky when wet. The first reported that Yang Liuhong got satisfactory curative effects in treatment of 2 cases of [6], and the combined treatment of this disease in Dan. There is no domestic reports. The author thinks that the combination of hand anti-inflammatory pain, improve microcirculation, correct the hypercoagulable state, increase local tissue blood supply, improve skin nutrition, promote the synergy of wound tissue repair; a convenient, economical and practical, suitable for application in the primary hospital, the curative effect is satisfactory. In the course of clinical practice there are still some problems such as small to expect to solve, pus cavity, puffball powder is packing for dry gangrene is ineffective and so on. Due to the relatively low incidence of the disease, the case is limited, we need to continue to study in the course of clinical practice in the future continue to sum up the study, to be verified in order to look forward to a better effect.

Reference

1. Diabetes in Chinese Kuang AK. Changsha: Hunan science and Technology Press, 1986:220.

2 Huang Gongyi, et al. Practical diabetes. Beijing: People's Medical Publishing House, 1992:317.

3. China Westlife, diabetic cases. Harbin: Heilongjiang science and Technology Press, 1993:300.

4 Ling. In Ikki, pharmacy. Shanghai: Shanghai science and Technology Press, 1984:154-155.

5. To Ren Hai and compound Danshen Injection on curative effect of treating diabetic skin ulcer and gangrene observation. Journal of Chinese 1996 combination of TCM and Western medicine; 16 (3): 180

6 willow Hong, et al. Puffball powder to cure diabetes cause gangrene in 2 cases. Jilin medicine 1991; 5:10.

 

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