Ozone fumigation combined with ozone autotransfusion therapy creates a new idea of diabetic foot treatment.
Clinical manifestations and typing of diabetic foot
(A) General manifestations
1.The patient’s skin is itchy and dry without sweating, the extremities are cold, swollen or dry, the skin color is dark and pigmented, and the fine hair is lost.
2, extremity tingling, burning pain, numbness, dullness or loss of sensation. Feet feel like cotton wool, duck walking, intermittent limping, rest pain. Difficulty in squatting and standing up, often walking with a cane.
3. Malnutrition of the extremities, poor muscle atrophy and tension, easy damage to joint ligaments.
4, common metatarsal head subsidence, metatarsophalangeal joint bending to form bowed feet, mallet toe, chicken claw toe, Charcot’s joint (charcot). Pathological fractures may occur as a result of bone destruction.
5. Weak or absent arterial pulsations at the extremities, and blood murmurs can be heard at the narrowed vessels. The deep and superficial reflexes are dull or absent.
6. The skin of the extremity is prone to dryness or blisters, hemorrhages, erosions, ulcers, gangrene or necrosis.
(B) Local manifestations and typing of gangrene
According to the nature and clinical manifestations of gangrene of the extremity can be divided into three clinical types: wet gangrene, dry gangrene and mixed gangrene.
1, wet gangrene: mostly occurs in the extremity of the arterial and venous blood flow is simultaneously blocked, circulatory and microcirculatory disorders and neurological disorders. Skin damage, infection and sepsis. Lesions vary in severity, superficial ulceration or severe gangrene. Local redness, swelling, heat, pain, dysfunction and, in severe cases, general malaise or toxemia, bacteraemia and other manifestations are often present.
2, dry gangrene: mostly occurs in the limb arteries and small arteries atherosclerosis, narrowing of the lumen or arterial thrombosis, so that blood flow is gradually or abruptly interrupted. However, venous blood return is still open and tissue fluid is reduced leading to varying degrees of local ischemic gangrene.
3, mixed gangrene: more often seen in a part of the limb arterial or venous obstruction, poor blood flow combined with infection. Wet gangrene and dry gangrene occur simultaneously in the same limb site. Generally heavy, gangrenous area, often involving large parts of the limb or whole foot gangrene.
Treatment.
Principles and Methods of Traditional Combined Internal Medicine Treatment
During the course of the three treatment phases, treatment principles and methods need to be applied according to the patient’s specific situation.
(1) Control of hyperglycemia: Using the three main techniques of diet moderation, oral hypoglycemic agents or insulin injections, blood glucose is lowered to near normal levels, which facilitates gangrene healing.
(2) Anti-infection: Use effective antibacterial agents to control infection. Penicillin, gentamicin, and vanguardin are commonly used intravenously by drip or intramuscular injection until the infection is controlled.
(3) Dilatation, anticoagulation and thrombolysis, activating blood circulation and improving microcirculation. Commonly used drugs include 654-2, Chuanxiongzin, viper antithrombin, and vincristine, etc. Intravenous drip in batches. Generally, every 2l days is a course of treatment. To improve circulation, promote the formation of collateral circulation and reduce blood viscosity. Open microcirculatory channels, improve microcirculatory disorders, and promote granulation and early healing of gangrene.
(iii) Actively prevent arteriosclerosis, limb ischemia, neuropathy, infection and predisposing factors.
(iv) Improve circulation in the extremities, exercise appropriately, prohibit smoking, and take long-term drugs to improve microcirculation, activate blood circulation, soften blood vessels, reduce blood viscosity, and improve nerve function.
(V) Active prevention of risk factors
1, maintain foot hygiene, shoes and socks should fit, clean, well ventilated, preferably wearing soft-soled cloth shoes, cotton woven socks, and prohibit barefoot walking.
2.Educate the patient to seek medical treatment for corns, calluses and tinea pedis in a timely manner, and not to treat them on their own to prevent infection and septicemia leading to gangrene.
3.Pay attention to heat preservation. Foot washing water should not exceed the patient’s body surface temperature, prohibit hot water bags, electric blankets, physical therapy, fireplace heating to prevent burns.
4, caution with the moon car massager to prevent skin friction blistering infection leading to severe gangrene.
5, patients should not be strenuous exercise, avoid excessive weight bearing on both feet, and prevent trauma.
6, often check the foot for dangerous causes
Other treatment: Chinese medicine treatment methods; surgical treatment ( 1. arterial reconstruction 2. interventional radiotherapy 3. amputation);
At present, our department adopts German ozone technology, which is effectively optimized on the basis of comprehensive medical treatment and opens up new ideas than the traditional local drug exchange and drug to improve microcirculation, etc., and has obtained good clinical results and social benefits, and the treatment principles are introduced as follows.
(1) immune dysregulation is an important factor in the generation of arterial spasm and atherosclerosis in diabetic patients, medical ozone can stimulate the body to produce IL-10 and TGF-B1, thus adjusting the patient’s own immune status and reducing the generation of atherosclerosis or arterial spasm in patients.
(2) The main reason for diabetic foot is that the relative or absolute secretion of insulin is insufficient, resulting in hyperglycemia and pseudo hypoglycemia due to insufficient utilization of sugar by tissues. Medical ozone has the same effect as insulin, which can accelerate glucose metabolism in the body, promote sugar conversion, lower the patient’s blood glucose concentration, and prevent the patient from burning fat.
(3) The production of diabetic foot ulcers has an important relationship with arterial spasm and arterial embolism in patients. Medical ozone can also change the way platelets aggregate in the blood, generate peroxide and change the development of thrombus where there is a thrombus, and increase the elasticity of blood vessels.
(4) Pseudo-hypoxemia in diabetic patients increases vascular permeability and extravasation of body fluids, resulting in poor local healing or susceptibility to infection. Medical ozone has the function of regulating vascular permeability, promoting wound healing and reducing the incidence of infection.
(5) Diabetic patients with skin ulcers difficult to heal is an important reason is that the patient’s body resistance is reduced, local wound infection, medical ozone local application has strong bactericidal ability, can clean the wound; systemic application can reduce the patient’s blood glucose concentration, improve immune capacity, reduce the chance of local infection.
(6) Medical ozone can promote the local reticuloendothelial proliferation of lesions, accelerate the healing of local wounds, and ozone pain relief effect is obvious, but no side effects and addiction.
The method still belongs to the scope of comprehensive medical treatment, when the disease progresses to an irreversible stage, surgical intervention is required, so prevention is far more important than treatment, to control the disease in the bud, so you are still waiting to see what happens?