综合外治法治疗静脉性溃疡临床研究
|
摘要
目的:探讨综合外治法治疗静脉性溃疡的疗效及机制。方法:将60例静脉性溃疡患者随机分为2组,每组30例。其中A组采用解毒洗药溻渍后外用愈疡灵软膏换药,B组创面常规清洁消毒后湿敷庆大霉素生理盐水纱布。治疗2周后比较两组疗效、创面菌株数、创面pH值、创面经皮氧分压和血流灌注量等指标。结果:A组治愈率60.0%,显愈率83.3%;B组治愈率20.0%,显愈率43.3%,A组疗效优于B组(P<0.01)。A组创面菌株数、创面pH值,创周经皮氧分压、血流灌注量各项指标均优于B组(P<0.01)。结论:解毒洗药联合愈疡灵软膏治疗静脉性溃疡具有抑菌、酸化创面、改善创周微循环的作用,是治疗静脉性溃疡的有效方法。
Objective:To investigate the effect and mechanism of comprehensive external treatment for venous ulceration. Methods:Sixty patients with venous ulceration were divided into two groups,30 patients in each group. Group A was treated with Yuyangling ointment after washing with detoxifying lotion,and group B was treated with wet dressing gentamicin saline gauze after routine cleaning and disinfection. The total course of treatment was 2 weeks. The effect,the number of wound bacteria,the wound pH value,the percutaneous partial pressure of oxygen and blood perfusion were compared between two groups. Results:In group A,the recovery rate was 60.0%,improvement rate was 83.3%,while in group B,the above rates were 20.0% and 43.3%,indicating that group A was better than group B on the total effective rate(P<0.01). Group A was better than group B on the indexes like the number of wound strains,pH value of wounds,peri-wound transcutaneous oxygen pressure,blood perfusion(P <0.01). Conclusions:Detoxifying lotion combined Yuyangling ointment could inhibit bacteria,improve wound microcirculation,acidify wound,and this combination is an effective treatment for venous ulceration.
Objective:To investigate the effect and mechanism of comprehensive external treatment for venous ulceration. Methods:Sixty patients with venous ulceration were divided into two groups,30 patients in each group. Group A was treated with Yuyangling ointment after washing with detoxifying lotion,and group B was treated with wet dressing gentamicin saline gauze after routine cleaning and disinfection. The total course of treatment was 2 weeks. The effect,the number of wound bacteria,the wound pH value,the percutaneous partial pressure of oxygen and blood perfusion were compared between two groups. Results:In group A,the recovery rate was 60.0%,improvement rate was 83.3%,while in group B,the above rates were 20.0% and 43.3%,indicating that group A was better than group B on the total effective rate(P<0.01). Group A was better than group B on the indexes like the number of wound strains,pH value of wounds,peri-wound transcutaneous oxygen pressure,blood perfusion(P <0.01). Conclusions:Detoxifying lotion combined Yuyangling ointment could inhibit bacteria,improve wound microcirculation,acidify wound,and this combination is an effective treatment for venous ulceration.
引文
[1]MARSTON W A,ENNI W J,LANTIS J C,et al.Baseline factors affecting closure of venous leg ulcers[J].J Vasc Surq Venous Lymphat Disord,2017,5(6):829-835.
[2]国家中医药管理局.中医外科病证诊断疗效标准[M].北京:人民卫生出版社,1999:48.
[3]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:140.
[4]王凌峰,李俊良.难愈性创面与细菌的探讨[J].中华损伤与修复杂志(电子版),2012,7(4):341-345.
[5]王剑,刘德丽,李峰.近5年蒲公英抑菌抗氧化活性研究进展[J].山东中医杂志,2015,34(3):233-235.
[6]林海,龚又明,邓广海.黄柏及其炮制品水提物体内、外抑菌作用研究[J].中国药房,2012,23(31):2900-2902.
[7]戴五好,钱利武,杨士友,等.苦参、山豆根生物碱及其总碱的抑菌活性研究[J].中国实验方剂学杂志,2012,18(3):177-180.
[8]刘明,张玥,刘春梅.等.愈疡灵软膏治疗下肢静脉性溃疡临床研究[J].山东中医药大学学报,2003,27(6):419-421.
[9]SHUKLA V K,SHUKLA D,TIWARY S K,et al.Evaluation of p H measurement as a method of wound assessment[J].J Wound Care,2007,16(7):291-294.
[10]SCHNEIDERLA,KORBER A,GRABBE S,et al.Influence of p H on wound-healing:a new perspective for wound-therapy[J].Arch Dermatol Res,2005,298(9):413-420.
[11]PERCIVAL S L,MCCARTY S,HUNT J A,et al.The effects of p H on wound healong,biofilms,and antimicrobial efficacy[J].Wound Repair Regeneration,2014,22(2):174-186.
[12]LEVEEN H,FALK G,BOREK B,et al.Chemical acidification of wounds adjuvant to healing and unfavorable action of alkalinity and ammonia[J].Ann Surg,1973,178(6):745-753.
[13]刘明,陈会苓.疮周辨证与疮周用药[J].中医外治杂志,2006,15(1):52-53.
[14]张敏莉,张柏根.下肢慢性静脉功能不全的原因与病理[J].中国中西医结合外科杂志,2009,15(4):347-349.
[15]王雁南,张玥,颜光宇.中药复方脉络通洗剂外洗治疗血瘀型闭塞性动脉硬化症的局部微循环疗效评价[J].世界中西医结合杂志,2016,11(7):979-982.
[16]王雁南,陈柏楠,许永楷,等.解毒洗药溻渍治疗对下肢静脉性溃疡疮周微循环的影响[J].中国中西医结合外科杂志,2015,21(5):443-446.
[2]国家中医药管理局.中医外科病证诊断疗效标准[M].北京:人民卫生出版社,1999:48.
[3]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:140.
[4]王凌峰,李俊良.难愈性创面与细菌的探讨[J].中华损伤与修复杂志(电子版),2012,7(4):341-345.
[5]王剑,刘德丽,李峰.近5年蒲公英抑菌抗氧化活性研究进展[J].山东中医杂志,2015,34(3):233-235.
[6]林海,龚又明,邓广海.黄柏及其炮制品水提物体内、外抑菌作用研究[J].中国药房,2012,23(31):2900-2902.
[7]戴五好,钱利武,杨士友,等.苦参、山豆根生物碱及其总碱的抑菌活性研究[J].中国实验方剂学杂志,2012,18(3):177-180.
[8]刘明,张玥,刘春梅.等.愈疡灵软膏治疗下肢静脉性溃疡临床研究[J].山东中医药大学学报,2003,27(6):419-421.
[9]SHUKLA V K,SHUKLA D,TIWARY S K,et al.Evaluation of p H measurement as a method of wound assessment[J].J Wound Care,2007,16(7):291-294.
[10]SCHNEIDERLA,KORBER A,GRABBE S,et al.Influence of p H on wound-healing:a new perspective for wound-therapy[J].Arch Dermatol Res,2005,298(9):413-420.
[11]PERCIVAL S L,MCCARTY S,HUNT J A,et al.The effects of p H on wound healong,biofilms,and antimicrobial efficacy[J].Wound Repair Regeneration,2014,22(2):174-186.
[12]LEVEEN H,FALK G,BOREK B,et al.Chemical acidification of wounds adjuvant to healing and unfavorable action of alkalinity and ammonia[J].Ann Surg,1973,178(6):745-753.
[13]刘明,陈会苓.疮周辨证与疮周用药[J].中医外治杂志,2006,15(1):52-53.
[14]张敏莉,张柏根.下肢慢性静脉功能不全的原因与病理[J].中国中西医结合外科杂志,2009,15(4):347-349.
[15]王雁南,张玥,颜光宇.中药复方脉络通洗剂外洗治疗血瘀型闭塞性动脉硬化症的局部微循环疗效评价[J].世界中西医结合杂志,2016,11(7):979-982.
[16]王雁南,陈柏楠,许永楷,等.解毒洗药溻渍治疗对下肢静脉性溃疡疮周微循环的影响[J].中国中西医结合外科杂志,2015,21(5):443-446.