新型湿性敷料联合内服托毒生肌散治疗慢性复杂创面临床研究
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摘要
目的:观察新型湿性敷料联合内服托毒生肌散治疗慢性复杂创面的临床疗效。方法:选取2016年1月至2018年1月在本院创面治疗中心治疗的慢性复杂创面患者185例,随机分为中西医结合组93例和西医组92例。西医组单独使用新型敷料按时换药,中西医结合组在使用新型敷料换药的同时给予托毒生肌散加减内服。两组均以1个月为1个疗程。治疗前后检测创面渗出液中转化生长因子-β1(transforming growth factor-β1,TGF-β1)和白细胞介素-1β(interleukin-1β,IL-1β)的水平,并比较两组患者治疗效果。结果:中西医结合组有效率95.24%明显高于西医组82.26%,差异有统计学意义(P<0.05);中西医结合组出现上皮化时间、创面愈合时间均比西医组短,差异有统计学意义(P<0.05);两组治疗后与治疗前比较,TGF-β1水平明显升高,IL-1β水平明显降低,差异有统计学意义(P<0.05),且组间比较差异有统计学意义(P<0.05)。结论:新型湿性敷料联合内服托毒生肌散治疗慢性复杂创面,能缩短创面愈合时间,改善调控伤口愈合的相关生长因子。
Objective:To observe the clinical curative effect of new-type wet dressing combined with Tuodu Shengji Powder(TDSJP).Methods:One hundred and eighty-five patients with chronic complex wounds treated in Wound Treatment Center in our hospital from January 2016 to January 2018 were randomly divided into the integrated traditional Chinese with 93 cases and the Western medicine group with 92 cases.The western medicine group used the new-type dressing to change dressings on time,while the integrated traditional Chinese and Western medicine group used the new-type dressing to change dressings combined with Modified TDSJP for oral administration.The ones in both groups were treated for one month as a course.The levels of transforming growth factor-β1(TGF-beta 1) and interleukin-1(IL-1β1) in wound exudates were measured before and after the treatment,and the therapeutic effects were compared between the two groups.Results:The effective rate of the integrated traditional Chinese and Western medicine group was 95.24%,which was higher than that of the Western medicine group(82.26%,P<0.05).The time of epithelialization and wound healing in the integrated traditional Chinese and Western medicine group was shorter than that in the Western medicine group(P<0.05).After the treatment,the levels of TGF-β and IL-1β in the two groups were significantly higher than those before the treatment(P<0.05).The differences were statistically significant(P<0.05).After the treatment,the levels of TGF-β1 and IL-1β in the two groups were significantly higher than those before the treatment(P<0.05),and there were significant differences between the two groups(P<0.05).Conclusion:New-type wet dressing combined with TDSJP has a remarkable clinical curative effect on chronic complex wound,can shorten the time of wound healing and improve the growth factors related to wound healing.
Objective:To observe the clinical curative effect of new-type wet dressing combined with Tuodu Shengji Powder(TDSJP).Methods:One hundred and eighty-five patients with chronic complex wounds treated in Wound Treatment Center in our hospital from January 2016 to January 2018 were randomly divided into the integrated traditional Chinese with 93 cases and the Western medicine group with 92 cases.The western medicine group used the new-type dressing to change dressings on time,while the integrated traditional Chinese and Western medicine group used the new-type dressing to change dressings combined with Modified TDSJP for oral administration.The ones in both groups were treated for one month as a course.The levels of transforming growth factor-β1(TGF-beta 1) and interleukin-1(IL-1β1) in wound exudates were measured before and after the treatment,and the therapeutic effects were compared between the two groups.Results:The effective rate of the integrated traditional Chinese and Western medicine group was 95.24%,which was higher than that of the Western medicine group(82.26%,P<0.05).The time of epithelialization and wound healing in the integrated traditional Chinese and Western medicine group was shorter than that in the Western medicine group(P<0.05).After the treatment,the levels of TGF-β and IL-1β in the two groups were significantly higher than those before the treatment(P<0.05).The differences were statistically significant(P<0.05).After the treatment,the levels of TGF-β1 and IL-1β in the two groups were significantly higher than those before the treatment(P<0.05),and there were significant differences between the two groups(P<0.05).Conclusion:New-type wet dressing combined with TDSJP has a remarkable clinical curative effect on chronic complex wound,can shorten the time of wound healing and improve the growth factors related to wound healing.
引文
[1] 沈亮,阙华发.生肌中药内服外用治疗大鼠慢性难愈性创面的疗效[J].中西医结合学报,2009,7(12):1150-1152.
[2] 傅秀珍.湿性敷料与中药制剂联合使用治疗11例Ⅲ期压疮护理体会[J].辽宁中医药大学学报,2012,14(8):121-123.
[3] 倪栋梅.湿性敷料在肛瘘及肛周脓肿术后伤口换药的疗效观察[J].全科护理,2016,14(24):2531-2533.
[4] 国家中医药管理局.中医病证诊断疗效标准[M].北京:中国中医药出版社,1994:76.
[5] 张锡纯.医学衷中参西录[M].北京:人民卫生出版社,2009:525.
[6] 颜永刚,雷国莲,刘静.中药桃仁的研究概况[J].时珍国医国药,2011,22(9):2263.
[7] 陈炳铜.302种中药对绿脓杆菌抗菌作用的研究[J].广东中医,1960,5(8):39.
[8] 徐荣辉.丹参对家兔皮肤切口愈合影响的组织化学观察[J].中草药,1982,13(12):15.
[9] 朱莉.湿性敷料对糖尿病足溃疡渗出液中TGF-β1和IL-1β的动态影响及疗效观察[D].长沙:中南大学护理学院,2013.
[10] 张得时,何淑敏,韩小雪.湿性敷料结合窄谱光子治疗慢性难愈创面的效果观察[J].现代临床护理,2014,13(4):28-30.
[11] 黄漫容,成守珍,郑美春,等.湿性愈合敷料治疗成人慢性脐炎的效果观察[J].齐齐哈尔医学院学报,2010,31(1):114-115.
[12] 朱竞,毛细云,王建民.促进肛瘘术后创面愈合的药物治疗研究进展[J].中医药临床杂志,2010,22(2):179-180.
[13] 张玉,冯璐,张艳.糖尿病足溃疡敷料应用进展[J].中国美容医学,2011,20(4):580.
[14] 占婷婷,程孝平,徐海霞.提毒生肌散联合湿性敷料在肉芽组织增殖期中的疗效观察[J].齐鲁护理杂志,2015,21(14):121-123.
[2] 傅秀珍.湿性敷料与中药制剂联合使用治疗11例Ⅲ期压疮护理体会[J].辽宁中医药大学学报,2012,14(8):121-123.
[3] 倪栋梅.湿性敷料在肛瘘及肛周脓肿术后伤口换药的疗效观察[J].全科护理,2016,14(24):2531-2533.
[4] 国家中医药管理局.中医病证诊断疗效标准[M].北京:中国中医药出版社,1994:76.
[5] 张锡纯.医学衷中参西录[M].北京:人民卫生出版社,2009:525.
[6] 颜永刚,雷国莲,刘静.中药桃仁的研究概况[J].时珍国医国药,2011,22(9):2263.
[7] 陈炳铜.302种中药对绿脓杆菌抗菌作用的研究[J].广东中医,1960,5(8):39.
[8] 徐荣辉.丹参对家兔皮肤切口愈合影响的组织化学观察[J].中草药,1982,13(12):15.
[9] 朱莉.湿性敷料对糖尿病足溃疡渗出液中TGF-β1和IL-1β的动态影响及疗效观察[D].长沙:中南大学护理学院,2013.
[10] 张得时,何淑敏,韩小雪.湿性敷料结合窄谱光子治疗慢性难愈创面的效果观察[J].现代临床护理,2014,13(4):28-30.
[11] 黄漫容,成守珍,郑美春,等.湿性愈合敷料治疗成人慢性脐炎的效果观察[J].齐齐哈尔医学院学报,2010,31(1):114-115.
[12] 朱竞,毛细云,王建民.促进肛瘘术后创面愈合的药物治疗研究进展[J].中医药临床杂志,2010,22(2):179-180.
[13] 张玉,冯璐,张艳.糖尿病足溃疡敷料应用进展[J].中国美容医学,2011,20(4):580.
[14] 占婷婷,程孝平,徐海霞.提毒生肌散联合湿性敷料在肉芽组织增殖期中的疗效观察[J].齐鲁护理杂志,2015,21(14):121-123.