Therapeutic effects of hyperbaric oxygen combined with cilostazol on the patients with diabetic foot and its impact on the level of serum insulin-like growth factor-1

Objective To investigate clinical efficacy of hyperbaric oxygen (HBO) combined with cilostazole in the treatment of the patients with diabetic foot and its impact on the level of serum insulin-like growth factor-1 (IGF-1). Methods One hundred patients with diabetic foot who were admitted into the Department of Endocrinology of the Shanxi Integrated Hospital of Traditional Chinese and Western Medicine from August 2016 to February 2018, were recruited as research subjects. The patients were randomly divided into the observation group (or the HBO + cilostazol group) and the control group (or the simple cilostazol group), each consisting of 50 patients. After 3 courses of treatment, the clinical efficacy, hemorheological parameters, peripheral nerve conduction velocity and the expression level of serum IGF-1 were compared between the 2 groups. Results After 3 courses of treatment, the total efficacy rate of the observation group (82.0%) was obviously higher than that of the control group (60.0%), and statistical significance could be seen when comparisons were made between them (P<0.01). The plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, fibrinogen, erythrocyte aggregation index and erythrocyte specific volume of the observation group were significantly lower than those of the control group, with statistical significance (P<0.05). The median nerve conduction velocity, ulnar nerve conduction velocity and peroneal nerve conduction velocity of the 2 groups all significantly increased, and the levels of the observation group were significantly higher than those of the control group, also with statistical significance (P<0.05 or P<0.01). The levels of serum IGF-1 in both groups significantly elevated, as compared with those before treatment, and the serum IGF-1 level in the observation group [(98.38 ± 20.83) mg/L] after treatment was significantly higher than that in the control group [(64.48 ± 22.92) mg/L], also with statistical significance (P<0.05 or P<0.01). Conclusion HBO combined with cilostazol could effectively reduce blood viscosity, improve blood circulation, increase peripheral nerve conduction velocity and regulate the expression level of serum IGF-1 in patients with DF. Therefore, it would have good prognosis for further improvement of diabetic microangiopathy. Key words: Hyperbaric oxygen; Cilostazole; Diabetic foot; Insulin-like growth factor 1