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Received:November 22, 2024 Published Online:April 20, 2025
Received:November 22, 2024 Published Online:April 20, 2025
中文摘要: 目的 探讨Buerger运动联合维生素D补充对糖尿病足溃疡愈合、足部多点皮温、踝肱指数（ABI）、糖脂代谢及神经传导的改善效果。方法 前瞻性选取2019年7月至2022年7月太原钢铁（集团）有限公司总医院收治的102例糖尿病足患者，随机分为常规组、运动组、联合组，各34例。常规组给予常规综合治疗，在此基础上，运动组给予Buerger运动，联合组给予Buerger运动联合维生素D补充。比较3组糖脂代谢指标、足部多点皮温、神经传导、溃疡面积、ABI、经皮氧分压、足背动脉平均血流速度（DAMV）、正中神经和腓神经的感觉神经传导速度（SCV）和运动神经传导速度（MCV）及安全性。结果 治疗8周后，3组空腹血糖、餐后2 h血糖、糖化血红蛋白（HbA1c）、总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、溃疡面积均降低（P＜0.05）；高密度脂蛋白胆固醇（HDL-C）、足部多点皮温、ABI、经皮氧分压、DAMV、正中神经和腓神经SCV、MCV均升高（P＜0.05）；其中联合组改善最明显（P＜0.05）。结论 Buerger运动是一种可量化执行、安全的锻炼方法，联合补充维生素D应用于糖尿病足患者，可优化糖脂代谢，改善足部缺血和神经传导情况，缓解下肢疼痛，促进溃疡愈合。
Abstract:Objective To investigate the improvement effects of Buerger exercise combined with vitamin D supplementation on the healing of diabetic foot ulcers, multi-point skin temperatures of the foot, ankle-brachial index (ABI), glucose and lipid metabolism, and nerve conduction. Methods A total of 102 diabetic foot patients treated at the General Hospital of Taiyuan Iron and Steel (Group) Co., Ltd. from July 2019 to July 2022 were prospectively selected. The patients were randomly divided into three groups (34 patients each): the conventional group, the exercise group, and the combined group. The conventional group received routine comprehensive treatment. In addition to this, the exercise group performed Buerger exercise, and the combined group received Buerger exercise combined with vitamin D supplementation. The outcomes were compared among the three groups, including glucose and lipid metabolism indicators, multi-point skin temperatures of the foot, nerve conduction, ulcer area, ABI, transcuta neous oxygen partial pressure, dorsal foot artery mean blood flow velocity (DAMV), sensory nerve conduction velocity (SCV) and motor nerve conduction velocity (MCV) of the median and peroneal nerves, and safety. Results After 8 weeks of treatment, the levels of the fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin (HbA1c), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and ulcer area decreased in all three groups (P＜0.05). High-density lipoprotein cholesterol (HDL-C), multi-point skin temperatures of the foot, ABI, transcuta neous oxygen partial pressure, DAMV, SCV and MCV of the median and peroneal nerves increased in all three groups (P＜0.05). The improvement was most pronounced in the combined group (P＜0.05). Conclusion Buerger exercise is a quantifiable and safe form of exercise. Combined supplementation of vitamin D in diabetic foot patients can optimize glucose and lipid metabolism, improve foot ischemia and nerve conduction, relieve lower limb pain, and promote ulcer healing.
keywords: Buerger exercise Vitamin D Diabetes mellitus Diabetic foot Foot ulcer Glucose and lipid metabolism
文章编号： 中图分类号：R587.2 文献标志码：A
基金项目:太原市医学重点学科高端人才培养计划(20190929)；太原钢铁(集团)有限公司科研项目(2021-21)
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