目的 探讨己酮可可碱联合胰激肽原酶治疗糖尿病足的临床疗效。方法 选择2018年5月—2022年2月在漯河市中心医院治疗的86例糖尿病足患者为研究对象，根据住院号的奇偶性分为治疗组和对照组，每组各43例。对照组患者肌肉注射注射用胰激肽原酶，40 U/次，1.5 mL灭菌注射用水溶解，1次/d；在此基础上，治疗组患者静脉滴注注射用己酮可可碱，0.4 g加入250 mL生理盐水，1次/d。两组患者连续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者糖尿病自护行为量表（SDSCA）、自我感受负担量表（SPBS）评分和食物多样化评分（DDS），血清胰岛素样生长因子-1（IGF-1）、同型半胱氨酸（Hcy）、瘦素、转化生长因子-β（TGF-β）和白细胞介素-13（IL-13）水平，足部溃疡面积和深度，足背动脉血管内径、血流流速、搏动指数（PI）、阻力指数（RI）。结果 治疗后，对照组有效率为81.40%，明显低于治疗组（97.67%，P<0.05）。治疗后，两组SDSCA评分明显升高，而SPBS评分和DDS评分明显下降（P<0.05）；两组患者血清IGF-1和TGF-β水平明显升高，而Hcy、瘦素和IL-13水平均明显降低（P<0.05）；两组足部溃疡面积、溃疡深度均明显减小（P<0.05）；两组患者足背动脉血管内径、血流流速、PI、RI均明显增加（P<0.05）；上述指标以治疗组改善更为明显（P<0.05）。结论 注射用己酮可可碱联合注射用胰激肽原酶治疗糖尿病足可有效促进溃疡愈合，减轻患者疼痛，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

河南省医学科技攻关计划联合共建项目（LHGJ20200896）