中药外用治疗难愈性创面的临床研究进展
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摘要
近年来难愈性创面的发病率逐年增加,因其病程迁延不愈,给患者造成极大的痛苦,是目前亟待解决的临床难题。中药外用法治疗难愈性创面具有疗效确切、安全性高、价格低廉的优势,临床应用十分广泛。通过回顾近5年相关文献,归纳总结了散剂、膏剂、洗剂、酊剂等中药外用制剂在治疗难愈型创面的应用以及中药外用联合中药内服、负压封闭引流、皮瓣移植术、光热疗法等最新治疗方法及其疗效,总体上疗效可靠,且有发展与创新。但临床研究有待提高,相关作用机制研究需广泛开展和跟进,其剂型亦有待改进,以利于更大程度挖掘和发挥中药的优势。
The incidence rate of refractory wound has increased year by year in recent years,due to the protracted course of disease,which causes great pain to the patients and is a clinical problem that needs to be solved urgently. External treatments of Chinese medicine have been widely used in clinic,which show the definite efficacy,high safety and low cost. By reviewing the relevant literatures in recent 5 years,the application of external preparations of Chinese medicine in the treatment of refractory wound are summarized,including powder,ointment,lotion and tincture,and the latest treatment methods and efficacy are summed up,such as external application of traditional Chinese medicine combined with oral administration of Chinese medicine,vacuum sealing drainage,skin flap transplantation or photothermal therapy. These therapies show the reliable efficacy in general,with several development and innovation. However,the clinical research needs to be improved,and the related mechanism research needs to be extensively carried out and followed up. The dosage forms also need to be improved in order to more explore and exert the advantages of Chinese medicine.
The incidence rate of refractory wound has increased year by year in recent years,due to the protracted course of disease,which causes great pain to the patients and is a clinical problem that needs to be solved urgently. External treatments of Chinese medicine have been widely used in clinic,which show the definite efficacy,high safety and low cost. By reviewing the relevant literatures in recent 5 years,the application of external preparations of Chinese medicine in the treatment of refractory wound are summarized,including powder,ointment,lotion and tincture,and the latest treatment methods and efficacy are summed up,such as external application of traditional Chinese medicine combined with oral administration of Chinese medicine,vacuum sealing drainage,skin flap transplantation or photothermal therapy. These therapies show the reliable efficacy in general,with several development and innovation. However,the clinical research needs to be improved,and the related mechanism research needs to be extensively carried out and followed up. The dosage forms also need to be improved in order to more explore and exert the advantages of Chinese medicine.
引文
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[2]王芷乔,夏仲元.中药外治剂治疗难愈性创面临床研究进展[J].光明中医,2015,30(4):912-914.
[3]FU X B.Wound care study and translation application:a team's work in China[J].Int J Low Extrem Wounds,2014,13(2):84-87.
[4]王军,张英军,张庚扬,等.外用中药促进慢性难愈性创面愈合的实验研究进展[J].湖南中医杂志,2014,30(5):166-169.
[5]HEYER K,AUGUSTIN M,PROTZ K,et al.Effectiveness of advanced versus conventional wound dressings on healing of chronic wounds:systematic review and meta-analysis[J].Dermatology,2013,226(2):172-184.
[6]付小兵.糖尿病足及其相关慢性难愈合创面的处理[M].2版.北京:人民军医出版社,2013:10-19.
[7]唐乾利,郭满,吴标良.血管内皮生长因子的研究现状与进展[J].中国烧伤创疡杂志,2017,29(2):77-87.
[8]李争,陈瑜,王振国.角化生长因子及其受体在妇科肿瘤中的研究现状[J].现代肿瘤医学,2017,25(5):833-836.
[9]周映伽,沈红梅,黄杰.表皮生长因子与恶性肿瘤相关性的研究进展[J].肿瘤基础与临床,2014,27(5):452-455.
[10]张晶,姚昶,尹恒,等.生肌玉红膏促进下肢慢性创面愈合257例随机对照多中心临床研究[J].中医杂志,2013,54(1):35-38.
[11]王昱,陈倚,高凌卉,等.柏氏虎杖油膏对低位肛瘘术后创面愈合影响的临床研究[J].上海中医药杂志,2016,50(9):63-66.
[12]朱朝军,张朝晖,马静,等.生肌象皮膏治疗慢性难愈性溃疡临床疗效及初步机制[J].中国中医药信息杂志,2013,20(11):11-12.
[13]张亮,胡迪.探讨自制“红玉膏”对难愈性创面和烧烫伤治疗效果[J].辽宁中医药大学学报,2016,18(11):171-174.
[14]刘晓蓉,王昆,葛云霞,等.复方白玉散外敷治疗慢性难愈性创面30例临床研究[J].江苏中医药,2016,48(9):44-46.
[15]高建,刘静.敛疮散治疗慢性难愈性皮肤溃疡20例[J].中国中医药现代远程教育,2014,12(20):40-41.
[16]洪潆,高美秀.中药合剂外用治疗Ⅲ期与Ⅳ期褥疮40例[J].中国中医药现代远程教育,2014,12(13):22-24.
[17]崔邦胜,陈棉智,郭锋,等.消渴洗剂治疗肢体慢性难愈性溃疡创面疗效观察[J].新中医,2016,48(12):79-80.
[18]史岚峰.复方虎杖敛疮液治疗慢性难愈性溃疡及压疮160例的护理[J].河北中医,2012,34(4):609-610.
[19]龙梅.蒙药三黄洗剂对促进肛肠术后创面愈合的120例临床观察[J].中国民族医药杂志,2014,20(10):22-22.
[20]罗永娟,梁丽仪.红花酒精外敷治疗糖尿病性皮肤溃疡的效果[J].内蒙古中医药,2015(2):86-87.
[21]路书敏,王金荣.自制红花酒剂治疗Ⅰ、Ⅱ期压疮的护理体会[J].河北中医,2013,35(7):1084,1100.
[22]张小舟,宋其合,涂红梅,等.湿润伤口灵联合VSD治疗难愈性伤口临床效果[J].创伤与急危重病医学,2016,4(1):28-32.
[23]吴景枫,朱锦匙,冯路瑶.负压封闭引流术联合枝黄止痛洗剂治疗糖尿病足溃疡疗效观察[J].中医药导报,2015,21(16):73-75.
[24]王健.中医辨证治疗肛瘘术后难愈性创面的应用意义评述[J].光明中医,2017,32(4):466-468.
[25]吴争光.中医辨证方法治疗肛瘘术后难愈性创面的疗效评价[J].中医临床研究,2016,8(25):89-90.
[26]李良增.中医辨证方法治疗肛瘘术后难愈性创面的疗效观察[J].北方药学,2014,11(8):65-66.
[27]赵常举.中医辨证方法治疗肛瘘术后难愈性创面的临床疗效评估[J].临床医药文献杂志,2014,1(12):2085,2087.
[28]霍春芬,霍慧兰,朱红霞.中药换药法治愈难愈性溃疡126例[J].中国美容医学杂志,2012,21(12):285-286.
[29]陈莉,王艳云,吴燕民,等.中西结合治疗下肢难愈性静脉溃疡效果观察[J].中国医学工程,2015,23(6):162-163.
[30]刘振峰,加亨,洪汉刚,等.中药外敷技术结合皮瓣移植治疗足踝部难愈性创面的临床研究[J].中成药,2015,37(5):1148-1150.
[31]王智峰,谢筱青,李素娟.逢春散加光热疗法治疗难愈性创面60例观察[J].浙江中医杂志,2013,48(1):11.
[32]GAIRE B P,SUBEDI L.A review on the pharmacological and toxicological aspects of Datura stramonium L[J].J Integr Med,2013,11(2):73-79.
[33]王军,张英军,张庚扬,等.外用中药促进慢性难愈性创面愈合的实验研究进展[J].湖南中医杂志,2014,30(5):166-169.
[34]MOHAMMADI A,MOHAMMAD-ALIZADEH-CHARANDABI S,MIRGHAFOURVAND M,et al.Effects of cinnamon on perineal pain and healing of episiotomy:a randomized placebo-controlled trial[J].J Integr Med,2014,12(4):359-366.
[35]LIU H,LIN S,XIAO D,et al.Evaluation of the wound healing potential of Resina Draconis(Dracaena cochinchinensis)in animal models[J].Evid Based Complement Alternat Med,2013.doi:10.1155/2013/709865.
[36]HSIAO C Y,HUNG C Y,TSAI T H,et al.A study of the wound healing mechanism of a traditional Chinese medicine,Angelica sinensis,using a proteomic approach[J].Evid Based Complement Alternat Med,2012.doi:10.1155/2012/467531.
[37]PAWAR R S,TOPPO F A,MANDLOI A S,et al.Exploring the role of curcumin containing ethanolic extract obtained from Curcuma longa(rhizomes)against retardation of wound healing process by aspirin[J].Indian J Pharmacol,2015,47(2):160-166.
[38]LEE K,LEE B,LEE M H,et al.Effect of Ampelopsis Radix on wound healing in scalded rats[J].BMC Complem Altern M,2015,15(1):213.
[39]ZHANG X N,MA Z J,WANG Y,et al.Angelica Dahurica ethanolic extract improves impaired wound healing by activating angiogenesis in diabetes[J].PLo S One,2017,12(5):e0177862.
[40]YANG W T,KE C Y,WU W T,et al.Effects of Angelica dahurica and Rheum officinale extracts on excisional wound healing in rats[J].Evid Based Complement Alternat Med,2017(2017):1583031.
[41]王云飞,阙华发,高丹,等.四君子加川牛膝方对大鼠下肢难愈性创面愈合的影响[J].上海中医药大学学报,2013,27(3):95-98.
[42]王云飞,李淑娟,杨伟朋,等.四君子加川牛膝方对大鼠下肢难愈性创面组织成纤维细胞及相关细胞因子的影响[J].上海中医药大学学报,2017,31(2):80-84.
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