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Objective To investigate the effect and safety of Chinese herbal medicine Shuanghuangdan dressing combined with silver ion dressing change in improving the healing of diabetic foot wounds. Methods Totally 45 patients with diabetic foot wounds were randomly divided into three groups: Shuanghuangdan group (n=15), silver ion group(n=15) and combined treatment group (n=15). Based on the symptomatic treatment, dressing change with different dressing materials was performed. The Traditional Chinese Medicine (TCM) syndrome integral and wound healing condition were evaluated and compared between three groups. Results The combined treatment group demonstrated the smallest wound remaining after a four-week intervention, and there was a significant different between combined treatment group and Shuanghuangdan group in wound remaining(P＜0. 05). The VEGF level in the combined treatment group was higher than that in the Shuanghuangdan group and silver ion group, respectively (P＜0. 05). The TCM syndrome integral in the combined treatment group was lower than that in the Shuanghuangdan group and silver ion group, respectively (P＜0. 05). Conclusion By promoting growth of granulation tissue and blood capillary, Chinese herbal medicine dressing combined with silver ion dressing change shows a positive effect in relief of inflammation and healing of diabetic foot wounds. It is a safe and effective treatment for patients with diabetic foot wounds (目的 观察中药制剂双黄丹敷料、银离子敷料联合换药促进糖尿病足创面愈合的临床疗效, 评价其有效性和安全性。方法 选择2021年3月—9月在贵州中医药大学第一附属医院就诊的糖尿病足患者45例, 按随机数字表法分组分为双黄丹组、银离子组和双黄丹联合银离子组(联合组), 各15例。在常规对症治疗的基础上, 三组分别给予自制中药双黄丹敷料换药、银离子敷料换药和中药双黄丹联合银离子敷料换药。比较三组中医证候积分, 评估创面愈合情况。结果 治疗后, 联合治疗组创面面积最低, 与双黄丹组比较, 差异有统计学意义(P＜0. 05)。VEGF水平联合治疗组高于双黄丹组和银离子组, 中医证候积分联合治疗组低于双黄丹组和银离子组, 差异有统计学意义(P＜0. 05)。结论 中药制剂双黄丹敷料联合银离子敷料换药能明显减轻患者的炎症反应, 促进肉芽组织和新生毛细血管生长, 促进伤口创面愈合, 且创面愈合效果明显优于单纯双黄丹敷料或银离子敷料换药。)

This paper summarized the experience of wound care for a patient with diabetic foot of Wagner grade 3. Based on the clinical evaluation of illness condition and risk assessment, targeted nursing interventions on wound dressing, pain control, nutrition support and psychological care were carried out, in order to improve the recovery of diabetic foot ulcers. (本文总结1例Wagner 3级糖尿病足患者的伤口护理经验, 通过科学评估, 了解患者整体情况, 明确风险因素, 以此制定针对性的伤口换药、疼痛干预、营养支持以及心理干预方案, 帮助患者树立治疗信心, 促进患者伤口恢复。)