关键词: 烧伤, 糖尿病, 胰岛素

Abstract: Objective To investigate the application value of topical insulin in the treatment of burn wounds in diabetic patients， and to provide a new idea for the treatment of burn wounds in diabetic patients. 
Methods One hundred and four diabetic patients with burn wounds treated in our hospital were selected and divided into two groups by random number table method, with 52 patients in each group. The control group was treated with conventional burn dressing change, and the treatment group was given 0.01 U/L normal insulin solution evenly sprayed on the wound surface on the basis of the control group, and the dressing was changed once a day until the burn wounds healed. The wound healing and infection control of the two groups were observed, and the scar growth after the wound healing at 1, 3 and 6 months after the injury, the blood perfusion value (PV) of the wound surface at the time of admission and at 14 and 28 d after the injury, the inflammatory factors ［high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1)］, pro-healing factors ［vascular epithelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), platelet derived growth factor (PDGF)］ levels and adverse effects were compared between the two groups. 
Results The wound healing rate within 28 d after injury in the treatment group was significantly higher than that in the control group (P＜0.05). Comparison of wound infection control between two groups showed that the control rate within 10 d after wound infection in the treatment group was significantly higher than that in the control group (P＜0.05). At 1 month, 3 months, and 6 months after injury,the degree of scar hyperplasia following wound healing in the treatment group was milder than that in the control group (P＜0.05). The PI values of wound surface in both groups showed an increasing trend over time, and the treatment group showed a more significant increasing trend. There was a significant difference in the interaction between groups, time points, and time points between groups (P＜0.05). The levels of serum hs-CRP, IL-6, TNF-α, and IL-1 in both groups all showed a trend of first increasing and then decreasing over time, and the trend of change in the treatment group was relatively gentle; there was a significant difference in the interaction between groups, time points and time points between groups (P＜0.05). The levels of serum VEGF, EGF, bFGF, and PDGF all showed an increasing trend over time, and the treatment group showed a more significant increasing trend; there was a significant difference in the interaction between groups, time points and time points between groups (P＜0.05). Both groups did not experience any allergic reactions or hypoglycemia.
Conclusion Topical insulin in the treatment of burn wounds in diabetic patients can promote neovascularization, improve blood circulation, inhibit the expression of inflammatory factors, effectively promote wound healing, reduce scar formation, and improve wound repair effect, with high safety. 

Key words: burns, diabetes mellitus, insulin