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1.5.3 specific quality of life scale score of quality of life of patients with diabetes-specific scale [3]. WHO scale drawing of the quality of life evaluation of the design, scale CPC 27 items, including physical function in patients with diabetes, psychological, social impact and the impact of treatment on patients with 4 dimensions, each entry in the case may be light to heavy by 5 points.
1.4.2 External not collapse of traditional Chinese medicine: no swelling, and Plaster of Selecting and red, inflamed by choice or indigo Plaster golden cream. Has been collapse of: exudative little flesh wound dry and there are those red ointment for external use, the September Dan; leaking more dirty rotten smell those decoction of righting Chinese Traditional Drugs wet packing the affected area, or nine eighty-two Dan Dan Sida remove a rotten; if abscess formation or pus out of poor persons, incision, the September dip drug Dan drainage line, the use of encroachment removal of necrotic tissue therapy; of abscess or deep fascia, the muscle space infection interlinked foci, or small sores not covered by basal rot pus, blood type with the righting of Chinese medicine decoction water. Recovery period: a bad wound toe (finger) has been off, carrion done, external white paste, Shengjisan.
1.1 object of study in January 1993 ~ April 2005 received treatment in Longhua Hospital, Shanghai University of Traditional Chinese Medicine Surgery, 112 cases of diabetic foot gangrene patients.
Based staging of diabetic foot gangrene [7], from gangrene a 0 case, two 8 cases (7.1%), three in 104 cases (92.9%). Graded according to gangrene [7] standard, 104 cases of diabetic foot gangrene patients were divided into three grade Ⅰ, Ⅱ and Ⅲ level,[link widoczny dla zalogowanych], the markedly effective rate was 83.3% (30/36), 55.6% (35/63 ) and 20% (1 / 5), amputation rates were 0%, 12.7% (8 / 63) and 40% (2 / 5). The average grade Ⅰ gangrenous wound healing rate was (91.05 ± 4.09)%, significantly better than gangrene Ⅱ level (72.75 ± 4.84)% and Ⅲ level (49.60 ± 16.81)% (P 0.05).
1.5 OUTCOME MEASURES
Methods: A series of 112 diabetic patients with gangrene were investigated before and after treatment in the changes of wounds, clinical symptoms and quality of life.
Key words Clinical Study of Diabetic Gangrene righting blood
2.2 wounds treated 112 patients with diabetic foot gangrene cases were cured, 58 cases, effective in 12 patients, improved in 36 cases, 6 cases, markedly effective rate 62.5%, amputation rate of 8.9% (10/112); course of 14 ~ 272 d, average (70.06 ± 50.00) d. There were 104 cases of wounds, the median wound area 8 cm2, the average after treatment showed that the wound healing rate (77.89 ± 35.29)%, the healing rate of 0 ~ 2.5 cm2 / d, average (0.20 ± 0.41) cm2 / d, healing time was 10 ~ 640 d, average (73.91 ± 73.79) d; negative rate in patients with bacterial wound pus (no bacterial growth + wound healing) was 86.67%; fasting blood glucose average (6.19 ± 0.19) mmol / L, postprandial 2 h blood glucose average (10.04 ± 1.22) mmol / L, mean glycated hemoglobin (6.90 ± 0.34)%.
1.5.1 wound healing wound healing index evaluation, including wound healing rate, wound healing time, wound healing and pus negative rate of bacterial culture. The wound healing rate = (the original wound area - wound did not heal area) / original wound area × 100%; wound healing agents from the wound until the wound completely epithelialized time; wound healing rate = (previous wound area - the times wound area) / 1st (previous) to 2 (this) time interval.
1.4 in conventional hypoglycemic therapy, blood pressure, lipid-lowering therapy and symptomatic treatment based on Western medicine, Chinese medicine combined with the guidance of righting activating blood circulation within the government and the phases of Chinese medicine external treatment.
1.3 inclusion and exclusion criteria Inclusion criteria: (1) comply with the diagnostic criteria of diabetic foot gangrene; (2) informed consent, voluntary subjects. Exclusion criteria: (1) does not meet the diagnostic criteria and inclusion criteria were; (2) the combined effect of the existence of serious diseases such as cancer, AIDS or mental illness; (3) pregnancy or breast-feeding women, the treatment of allergy or drug allergy persons; (4) According to the researchers to determine, with the possibility of lower income groups into the group or to other complex diseases, as well as frequent changes in the work environment could easily lead to lost persons, etc.; (5) have received other treatment, may affect the of indices of the observer; (6) failing to medication, can not determine the efficacy or effect of incomplete information of judges.
Objective: To evaluate the effects of the therapy mainly for strengthening healthy energy to promote blood circulation in treating diabetic patients with gangrene.
1.2 Diagnostic Criteria diagnosis of diabetic foot according to the Chinese Association of Integrative Medicine Peripheral Vascular Disease Committee of the standards set in 2002 [2]. (1) over 40 years of age; (2) history of diabetes or elevated fasting blood glucose, urine sugar positive determination; (3) the performance of chronic limb ischemia, such as numbness, cold (or heat intolerance ), intermittent claudication, bleeding, nutritional disorders, limb or skin redness reduction burning sensation, or even ulcers or gangrene, limb disease, the lower limbs as the most important; (4) various physical examination demonstrated changes in artery occlusion, lower limb see distal arterial disease; (5) may be associated with hypertension,[link widoczny dla zalogowanych], coronary heart disease, hyperlipidemia, renal artery disease,[link widoczny dla zalogowanych], cerebrovascular disease and complications such as retinal artery disease; (6) to exclude thromboangiitis obliterans, arteritis, Raynaud's disease and cold injury in ischemic vascular disease and other diseases.
1.4.1 Chinese medical treatment method in acute phase, treatment with heat and dampness, promoting blood circulation and contact, side by Simiao An Tang Simiao Pill, with intravenous infusion Qingkailing and context such as traditional Chinese medicine preparation Injection. Remission, treatment with Qi and blood circulation, Torrey myogenic, side with Bu Yang Huan Wu Tang Yang Rong decoction of ginseng, astragalus with intravenous infusion, such as traditional Chinese medicine Danshen injection preparations. If the course of the local was dry gangrene, and business administration to blood circulation, clearing away heat and detoxifying, side steps with care soup or soup of Simiao An addition and subtraction, and with the intravenous infusion of Qingkailing Lianbizhi injection or traditional Chinese medicine preparation, etc. .
1.5.2 syndrome measurement or classification of quantization integral choice in patients with diabetic foot gangrene of 28 common clinical symptoms and signs, such as the number of gangrene, gangrene depth, ulcer surface color, new granulation tissue, skin color, skin temperature, muscle atrophy, numbness, pain, arterial pulse, dry mouth, Shenpi fatigue, poor appetite, shortness of breath, pale, spontaneous perspiration, dizziness, backache, urine, etc., according to its frequency, duration of symptoms of the nature, scope and symptoms of the amount of such symptoms by severity. Press does not appear, light, medium, heavy and severe divided into five, were recorded as 1,2,3,4,5 points, the symptoms and signs that the sum of scores assigned by the disease syndrome to quantify the overall card points .


Diabetic foot gangrene is common and serious complications of diabetes, amputation rate and a higher disability, serious harm to the patient's physical and mental health. To righting activating blood-based combination therapy, can enhance the effectiveness and reduce the high amputation rate [1], significantly improves local and systemic symptoms and improve quality of life. In this study, the main righting Huoxue 112 patients with diabetic foot gangrene, the TCM to quantify the efficiency and quality of life, amputation rate of the combination of the traditional indicators of efficacy evaluation, comprehensive evaluation of its clinical efficacy.
2 results
1.4.3 Western routine western medicine for the treatment of righting the basis of activating blood circulation therapy. Application of insulin to control blood sugar, the fasting blood glucose control in the 4.4 ~ 6.1 mmol / L, while actively controlling blood pressure and blood lipids, use of antibiotics in severe infections, correcting water, electrolyte disorders and acid-base balance disorders and anemia, hypoproteinemia and so on.
Keywords: strengthening body resistance; activating blood; diabetic foot; gangrene; clinical research
2.1 General Information January 1993 ~ April 2005 received treatment in Longhua Hospital, Shanghai University of Traditional Chinese Medicine Surgery diabetic foot gangrene patients, a total of 112 cases. 65 patients were male, female 47 cases; aged 44 to 87 years, mean (72.61 ± 7.56) years; the longest duration of diabetes 40 years, the average (13.80 ± 11.41) years; first diagnosed with diabetes in 7 patients (6.25%); gangrene of diabetic foot disease 2 d ~ 3 years, the median duration of 60 d; wound area 0.06 ~ 300 cm2, the median wound area of 8 cm2; wound number 1 to 7, with a median number of a wound; which diminished dorsalis pedis artery pulse 81 cases (72.32%), disappeared in 26 cases (23.21%), normal in 5 cases (4.46%). Were 112 patients with type 2 diabetes, of which 70 cases with hypertension (62.50%), hyperlipidemia in 55 cases (49.11%). The average fasting blood glucose before treatment (9.23 ± 0.45) mmol / L, postprandial 2 h blood glucose average (17.55 ± 1.23) mmol / L, mean glycated hemoglobin (9.59 ± 0.35)%, both conventional lowering blood sugar, blood pressure and blood fat and other western medical treatment, the fasting blood glucose control in the 4.4 ~ 6.1mmol / L, blood pressure control at 140/90 mmHg, triglycerides control at 1.8 mmol / L below, total cholesterol control in the 3.2 ~ 7.0 mmol / L. Wound pus bacterial culture, the higher the bacterial infection Staphylococcus aureus (44.44%), Escherichia coli (16.67%), Pseudomonas aeruginosa (12.22%), Proteus mirabilis (11.11%), Gram Gram positive bacteria (11.11%), mixed growth of bacteria in 19 cases (16.96%).
Conclusion: Strengthening healthy energy to promote blood circulation is effective in treating diabetic patients with gangrene.
1 Materials and Methods
Results: Fiftyeight cases were cured, 12 cases showed response, 36 cases improved, and 6 cases failure of treatment. The total obvious effect rate was 62.5% (70/112) and the amputation rate was 8.9% (10/112). The 104 diabetic cases of threestage gangrene were classified into grade Ⅰ, Ⅱ and Ⅲ. The total effect rates of the diabetic cases of grade Ⅰ, Ⅱ and Ⅲ were 83.3% (30/36) , 55.6% (35/63) and 20% (1 / 5), and the amputation rates were 0%, 12.7% (8 / 63), and 40% (2 / 5) respectively. After the treatment, the clinical symptoms ,[link widoczny dla zalogowanych], gangrene number, gangrene area and gangrene depth were obviously improved (P <0.05), and the quality of life was obviously improved (P <0.01), especially in physical condition, emotional wellbeing and therapeutic effects on patients (P <0.05 ).
1.6 efficacy criteria developed under the Ministry of Health issued the \of Lung Cancer Standards \invalid (including deterioration). (1) healing: wound completely healed, clinical symptoms disappeared; (2) markedly: the wound more than 75% narrowing, the clinical symptom score decreased ≥ 2 / 3; (3) Effective: wounds more than 25% narrowing, decreased the clinical symptom score ≥ 1 / 3; (4) invalid (including deterioration): wounds less than 25% narrowing, and even expand, the clinical symptom score decreased <1 / 3.
Treatment of righting activating blood of 112 cases of diabetic foot gangrene


<div style=\Abstract Evaluation of righting blood treatment method based on the clinical efficacy of diabetic foot gangrene. Methods: 112 patients with diabetic foot gangrene patients with wound healing, common syndrome scores and quantify the quality of life evaluation method based righting the treatment of blood on the clinical efficacy of diabetic foot gangrene. Results: 112 patients were cured 58 cases,[link widoczny dla zalogowanych], effective in 12 patients, improved in 36 cases, 6 cases, markedly effective rate 62.5% (70/112), amputation rate of 8.9% (10/112). 104 patients with diabetic foot gangrene gangrene based classification is divided into three patients with grade Ⅰ, Ⅱ and Ⅲ level, the markedly effective rate was 83.3% (30/36), 55.6% (35/63) and 20% (1 / 5), amputation rates were 0%, 12.7% (8 / 63), 40% (2 / 5). After treatment, the majority of the number of clinical symptoms and gangrene, depth, scope, ulcer surface color, granulation tissue, new epithelial tissue and other than those before treatment were significantly improved (P <0.05). Quality of life score after treatment than before treatment significantly improved (P <0.01), especially in patients with diabetes on the physical, psychological and other aspects of the treatment of patients (P <0.05). Conclusion: righting activating blood-based diabetic foot can be treated effectively.
1.7 software package SPSS 11.5 Statistical Methods for statistical analysis of data. According to the study of different objects were selected t test, χ2 test and ANOVA analysis.
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