1, cure method of diabetic foot
The first link: sugar control
It is very important for diabetic foot patients to strictly control blood sugar. Even for type 2 diabetes, it is best to switch to insulin treatment. If the blood sugar is not well controlled, intensive insulin therapy can be used. Insulin is usually injected subcutaneously four times a day (short-acting insulin is injected before breakfast, lunch and dinner, and medium-acting insulin is injected before going to bed). If necessary, insulin can be continuously injected by intravenous injection or using an insulin pump. At the same time, closely monitor blood sugar, fasting blood sugar is controlled below 7 mmol/L, and postprandial blood sugar is controlled at around 8 mmol/L.
The second ring: promoting blood circulation
Intravenous application of vasodilator: anisodamine (654-2) 20 ~ 40mg dissolved in 250ml physiological saline is intravenously dripped 1 time a day for 10 day or 2 weeks, or oral administration of 654-2 tablets 20 ~ 30mg three times a day can relieve microvascular spasm, activate microvascular autonomic movement and reduce exudation. Prostaglandin E(PGE 1): 20 micrograms of oral liquid plus normal saline 100 ml slow intravenous drip or 20 ml normal saline intravenous injection, 10 ~ 14 days is a course of treatment. Other similar drugs include PGI2 and Baoxin. Oral western medicine for promoting blood circulation also includes Peda (cilostazol): 50 ~ 100mg/ day; Pentoxifylline (Pan Tong): 400 ~ 800 mg/day; Enteric-coated aspirin 100 ~ 300mg 1 time daily; Persephone 50 ~ 100 mg, three times a day, etc.
2. Traditional Chinese medicine for improving microcirculation: add 80-400 mg of ligustrazine to 250-500ml of normal saline, once a day, and slowly drip no more than 40 drops per minute for 2-3 weeks, and then take Chuanxiong tablets; 20 ~ 30 ml of Danshen injection or 8 ~ 16 ml of compound Danshen injection and 250 ml of normal saline were given intravenously, once a day, and the course of treatment was 2 weeks. 20 ~ 40ml of safflower needle can also be added into 250ml of normal saline for intravenous drip; Agkistrodon halys antithrombotic enzyme 0. 25~0。 Intravenous drip of 5 units of 250 ml normal saline for 2 weeks can reduce blood viscosity and plasma fibrinogen, inhibit platelet adhesion and aggregation, thus promoting blood circulation and removing blood stasis; Mailuoning needle 10 ~ 20ml plus normal saline for 2 weeks. There are other drugs, such as Kangluosu and Xuesaitong.
3, autologous blood ultraviolet irradiation.
4。 Hyperbaric oxygen: 0. Inhaling pure oxygen under the mask at the pressure of 15Mpa for 1 ~ 2 hours every day for 10 ~ 20 days can promote infection control and accelerate wound healing.
The third ring: anti-inflammatory
Mild infection: Commonly used effective antibiotics include: oral anti-inflammatory drugs such as amoxicillin/clavulanate potassium, bifloxacin, cefalexin, etc. Intravenous infusion of anti-inflammatory drugs such as cefazolin, ampicillin/sulbactam and clindamycin. It usually takes 2 ~ 4 weeks.
Severe infection: Severe infection may lead to amputation and endanger the life of patients. Early surgical treatment of infected lesions, removal of rotten tissue, incision and drainage of plantar cavity. At the same time, it is best to use antibiotics according to the culture results. However, before the culture results come out, we should consider that Gram-positive cocci, negative bacilli, anaerobic bacteria and other infections are easy to coexist in rotten feet, and choose broad-spectrum antibiotics, supplemented by metronidazole to fight anaerobic bacteria. According to the recovery of ulcer and the general situation, the application time should be more than 4 weeks.
Life-threatening infection: ampicillin/sulbactam can be combined with aztreonam; Piperacillin/tazobactam and vancomycin; Vancomycin, ceftazidime and metronidazole; Imipenem and cilastatin; Fluoroquinolones, vancomycin and metronidazole, etc.
The fourth ring: dressing change
The principle of dressing change can be summarized as follows:
One elimination: anti-inflammatory and disinfection. Topical application of iodine, alcohol disinfection, spraying antibiotics, etc.
The second volume reduction: reduce the pressure, try to eliminate local edema, drain secretions, and if necessary, surgically cut the abscess and drain it. At the same time, the dressing should not be wrapped too tightly, which will affect the blood supply.
Sanqing: surgical debridement. Try to remove necrotic tissue, diaphragm and dead bone. Clean up local pus and other secretions, expose fresh granulation tissue, and use bioactive dressing containing decomposing enzyme to promote autolysis of necrotic tissue.
Delayed excision and suture: after a period of treatment, the skin temperature of the bad foot drops, the edema subsides, and the wound surface is dry. The dressing containing epidermal growth factor can be used to continue dressing change, or 654-2 and insulin can be sprayed locally to remove dry scabs and irregular bony processes, and the skin can be sutured or a flap can be transplanted.
The Fifth Ring: Compassion and Support
1, fever, fever can be cooled by ice pack and alcohol bath; Use antipyretics (hormone or indomethacin suppository, etc.). ) when necessary.
2, correct ketosis, water, electrolyte disorder, timely potassium, rehydration, keep the balance of water and electrolyte.
3. In order to improve heart function, drugs and diuretics that dilate coronary arteries can be used appropriately.
4, prevention and treatment of other organ infections, especially lung and urinary tract infections.
5. Supplementary nutrition: for example, mecobalamin, neurotropin, vitamin B, etc. It is used for nourishing nerves, intramuscular injection or oral administration, and can supplement plasma and human albumin for people with anemia, hypoproteinemia and malnutrition.
2. Dietotherapy for diabetic foot
First, blood-activating tea eggs
Salvia miltiorrhiza 12g, safflower 12g, peach kernel 10g, tea 4g and 4 eggs are taken. Boil the first three herbs in water for 30 minutes, then leave the fire to cool, and then add eggs and tea to cook together. After the egg is cooked, break the shell and soak it in the liquid medicine until the egg white is purple. Eat 1 egg every day.
Second, the seven fast horses of God
Take 2 pig's trotters, 45g of Radix Astragali preparata, 20g of Radix Codonopsis, 4g of Chinese angelica 15g, 4g of cinnamon, seasoning salt, sugar, yellow rice wine, aniseed, soy sauce, pepper, etc. Put pig's trotters, medicines and seasonings into a pot, add appropriate amount of water and cook on high fire 1 hour. Take out pig's trotters, skim off the floating oil in the pot, then put the pig's trotters in the pot, continue to cook with low heat until the meat is rotten, take them out to cool, remove the bones, cut into pieces and put them on a plate.
Third, angelica crucian carp
Take crucian carp 1(500g), angelica 10g, 5g of safflower, and seasonings such as salt, monosodium glutamate, chopped green onion, ginger and yellow wine. After the crucian carp is washed, other raw materials are put into the fish belly, wrapped with lotus leaves and baked in the oven. This diet is extremely beneficial to enhance the resistance and rehabilitation of patients with diabetic foot.
3. How to effectively reduce blood sugar
1, increase activity
Patients with type 2 diabetes usually get better blood sugar control by strengthening exercise. Even simple exercise, such as walking for 20 minutes every day, can effectively improve insulin resistance and lose weight as long as it persists. Studies have confirmed that diabetic patients can really reduce the dosage of hypoglycemic drugs or even get rid of drug treatment completely after reasonable exercise.
2. "Coarse" grains should not be intensively cultivated.
It is very important to control the fineness of grain grinding. Taking bread as an example, the GI of white bread is 70, but that of bread mixed with 75%~80% barley grains is 34. It is suggested to replace flour and rice with coarse grains.
3. Use a small plate.
Choosing small tableware can reduce food intake, reduce appetite and calorie intake, and maintain a reasonable weight.
Step 4 change breakfast to "thick"
Because porridge is heated for a long time, starch is easily converted into dextrin and then easily decomposed into glucose. At the same time, porridge is in a semi-liquid state, and the emptying time of the stomach after meals is relatively short, so eating porridge is easier to raise postprandial blood sugar than eating staple food. Therefore, it is best not to just drink porridge for breakfast, but to eat "thick" food and stick to the staple food.
5, the appetite must be counted.
Obese people who lose 5% of their weight can reduce the incidence of diabetes by 70%. Calculate your daily intake and see how much you should eat less.
6. increase the intake of vitamin C.
Increasing the content of antioxidants such as vitamin C in diet can prevent the destruction of arterial wall, reduce plaque accumulation and heart disease, and thus effectively reduce the occurrence of diabetic complications. Increasing the proportion of fruits and vegetables in the diet can provide the best source of antioxidants.
7. Increase the intake of sugar-free liquid.
Dehydration can also lead to an increase in blood sugar, and people should consume about 2 ~ 3 liters of sugar-free liquid every day. When blood sugar rises, drinking water can dilute blood sugar and avoid excessive food intake. Patients with heart disease or renal complications need to limit their fluid intake appropriately, and should consult a doctor or dietitian for details.
8. Drink green tea every day
Compared with other drinks, green tea has higher polyphenol content because it has not been fermented. Polyphenols have strong antioxidant properties and hypoglycemic effects, and they can also control the release of blood sugar.
9. Don't touch junk food.
If you often go to McDonald's and KFC, diabetes will also patronize you. Scientists in Minnesota conducted a 15-year follow-up survey of 3000 people aged 8-30. The results show that people who eat junk food twice a week not only gain about 4.5 kilograms, but also triple their insulin resistance, which is a high risk factor for diabetes. Even if your weight is normal, trans fats and refined carbohydrates in junk food will increase the risk of diabetes.
10, bring lunch to work
Avoid eating lunch in restaurants or fast food restaurants, because it can easily make people lose control of their appetite. The food in fast food restaurants is heavy, with too many calories and fat. The study found that there is a correlation between frequent eating out and weight gain. In the process of preparing your own lunch, you will carefully control the raw materials and weight of the ingredients. If you find it a little troublesome to prepare your own lunch every day, you can start by preparing it twice a week.
1 1. Cook in a hurry and add less water.
The hardness, thickness and particle size of food will affect the GI of food. Grains do not need to be cooked at high temperature for a long time, because the longer the processing time, the higher the temperature, the more water, the better the gelatinization and the higher the GI of food.
12, self-relaxation and emotional adjustment
Relaxation exercises such as deep breathing and relaxing music to relax muscles are helpful to relieve stress and make hypoglycemia treatment more effective. Learn to adjust emotions and enhance self-efficacy, so as to overcome the bad mentality such as fear and negativity after illness, which is also helpful to control blood sugar.
A handful of nuts before meals.
Eating fatty foods before meals, such as almonds, walnuts and other nuts, can not only increase satiety, but also make you eat less at dinner. Unsaturated fatty acids in nuts also help to improve the insulin level of diabetic patients and slow down food digestion, thus helping to control postprandial blood sugar.
14, standing gum
Chewing sugar-free chewing gum can control people's appetite for snacks, but not too much, because some brands of sugar-free chewing gum contain sweeteners, which will make the stomach feel uncomfortable at higher doses. Chewing gum will also leave a fresh breath in the mouth, and people don't want to eat smelly snacks to destroy it.
15, Tai Chi Chuan
Traditional exercise methods, such as playing Tai Ji Chuan and practicing Qigong, can help people adjust their breathing, improve blood circulation and play an indispensable role in regulating their bodies. An Australian study also found that practicing Tai Ji Chuan in patients with type 2 diabetes can also slow down the decline of physical function caused by diabetes, especially for obese patients.
16, have some vinegar
Acidic substances produced after food fermentation can reduce the GI of the whole diet. Adding vinegar or lemon juice to non-staple food is a simple and easy method.
17, self-massage
By massaging feet and other body parts, on the one hand, it can prevent complications, on the other hand, it can regulate the pancreas, liver and endocrine system, which is helpful to stimulate the human body to produce more insulin cells. This kind of "reflex therapy" has achieved remarkable results after long-term persistence.
18, postprandial blood glucose measurement
Monitoring blood sugar within 2~3 hours after meals is helpful for sugar lovers to control their blood sugar level more smoothly and prevent hyperglycemia and hypoglycemia. On this basis, make a more reasonable diet and exercise plan.
19, sleep time is particular.
Researchers at Yale University found that people who sleep less than six hours a day have twice the risk of developing diabetes. People who sleep more than 8 hours a day have a threefold increase in the risk of developing diabetes. Too much or too little sleep will interfere with hormones related to blood sugar.
20. Stay away from the bad habit of raising blood sugar.
Overeating and hunger will make the blood sugar level in the body rise sharply, especially the "sweet addiction" and "fried food control" that girls often have, or the appetite liberation after vicious dieting. Secondly, emotional instability, bad temper and frequent anger may also lead to high blood sugar after meals. Of course, lack of exercise, sitting on the sofa watching TV after meals, surfing the Internet for a long time and playing games are not conducive to the stability of blood sugar. Studies have shown that people with high fasting blood sugar have a risk of diabetes 3-9 times higher than normal people, and those with high postprandial blood sugar have a risk of diabetes 4- 10 times higher.