综合疗法治疗难治性皮肤溃疡的临床研究
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摘要
目的探索难治性皮肤溃疡治疗方法 ,为临床治疗此类疾病提供经验与方法。方法将120例我院门诊或住院收治的难治性皮肤溃疡患者随机分为微创清理创口配合激光及中药湿敷(联合治疗)组,微创清理创口配合激光(清创激光)组,微创清理创口配合硼酸湿敷(清创湿敷)组,每组40例,分别记录各组治疗前,治疗2、6周,随访8、12周"臁疮"评分、疗效指数、愈显率、皮肤病生活质量(DLQI)评分及不良反应和复查情况,对比各组的治疗效果。结果联合治疗组与清创激光组、清创湿敷组比较,治疗2、6周,随访8、12周,渗出、面积、疼痛,明显低于其他两组(P <0.05);清创激光组和清创湿敷组治疗2、6周,随访8、12周渗出、面积、疼痛无明显差异(P> 0.05)。联合治疗组治疗2、6周,随访8、12周,疗效均明显高于清创激光组和清创湿敷组(P均<0.05)。治疗2、6周,随访8、12周,联合治疗组DLQI评分显著低于清创激光组和清创湿敷组(P均<0.05)。三组患者不良反应及复查指标无明显差异(P均> 0.05)。结论西医清创配合激光及中医药、民族医药治疗难治性皮肤溃疡临床有优势,安全可靠,值得推广。
Objective To study the treatment of refractory skin ulcer,and to provide experience and methods for clinical treatment of such diseases.Methods 120 patients with refractory skin ulcer were randomly divided into three groups:minimally invasive debridement combined with laser and traditional Chinese medicine wet compress(combined treatment group),minimally invasive debridement combined with laser(debridement laser group),minimally invasive debridement combined with boric acid wet compress(debridement wet compress group),40 cases of each group.The"dejection"score,efficacy index,more obvious rate,dermatosis quality of life(DLQI)score and adverse reactions and re-examination data were recorded before treatment,treatment for 2,6 weeks,and follow-up for 8,12 weeks,and compared the treatment effect between groups.Results Compared with the laser group and the debridement wet compress group,the exudation,lesion area and pain level of the combined treatment group were significantly lower than that of the laser group and the debridement wet compress group(P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,while there were no significant differences between the laser group and the debridement wet compress group.The curative effect of the combined treatment group was significantly higher than that of the debridement laser group and the debridement wet compress group(all P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,and also the DLQI score of combined treatment group was significantly lower than that of debridement laser group and debridement wet compress group(all P<0.05).There were no significant differences in adverse reactions and re-examination indexes among the three groups(all P>0.05).Conclusion Modern Western medicine debridement combined with laser,traditional Chinese medicine,and ethnic medicine has advantages in the treatment of refractory skin ulcer,and is safe and reliable,which is worthy of clinical promotion.
Objective To study the treatment of refractory skin ulcer,and to provide experience and methods for clinical treatment of such diseases.Methods 120 patients with refractory skin ulcer were randomly divided into three groups:minimally invasive debridement combined with laser and traditional Chinese medicine wet compress(combined treatment group),minimally invasive debridement combined with laser(debridement laser group),minimally invasive debridement combined with boric acid wet compress(debridement wet compress group),40 cases of each group.The"dejection"score,efficacy index,more obvious rate,dermatosis quality of life(DLQI)score and adverse reactions and re-examination data were recorded before treatment,treatment for 2,6 weeks,and follow-up for 8,12 weeks,and compared the treatment effect between groups.Results Compared with the laser group and the debridement wet compress group,the exudation,lesion area and pain level of the combined treatment group were significantly lower than that of the laser group and the debridement wet compress group(P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,while there were no significant differences between the laser group and the debridement wet compress group.The curative effect of the combined treatment group was significantly higher than that of the debridement laser group and the debridement wet compress group(all P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,and also the DLQI score of combined treatment group was significantly lower than that of debridement laser group and debridement wet compress group(all P<0.05).There were no significant differences in adverse reactions and re-examination indexes among the three groups(all P>0.05).Conclusion Modern Western medicine debridement combined with laser,traditional Chinese medicine,and ethnic medicine has advantages in the treatment of refractory skin ulcer,and is safe and reliable,which is worthy of clinical promotion.
引文
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[6]王浩,李小毅,欧阳容兰,等.植皮后弹性绷带加压包扎在修复难治性创面中的应用[J].临床军医杂志,2011,39(1):145-146.
[7]张玉冬,刘明,刘政,等.候玉芬诊治下肢慢性溃疡的经验[J].世界中西医结合杂志,2014,9(10):1035-1037.
[8]苑海刚,薛凤,赵钢.蓬子菜水溶液对大鼠皮肤溃疡疮面修复影响的实验研究[J].中医药学报,2016,44(2):40-42.
[2]李亮,朱晓铭,唐晓勇,等.360例下肢静脉性溃疡个体化治疗的临床分析[J].中国普外基础与临床杂志,2016,23(5):590-591.
[3]张彤,汪五清,杜凌波,等.积雪苷治疗下肢难愈性皮肤溃疡的疗效观察[J].世界临床药物,2013,34(6):336-338.
[4]Sherif Sultan,Wael Tawfick,Edel P Kavanagh and Niamh Hynes.Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers[M].IntechOpen,2016.
[5]贾连城,盛巡,孙明杰,等.回阳生肌膏治疗慢性难治性皮肤溃疡疗效观察及作用机制探讨[J].中国中医药信息杂志,2009,16(10):10-12.
[6]王浩,李小毅,欧阳容兰,等.植皮后弹性绷带加压包扎在修复难治性创面中的应用[J].临床军医杂志,2011,39(1):145-146.
[7]张玉冬,刘明,刘政,等.候玉芬诊治下肢慢性溃疡的经验[J].世界中西医结合杂志,2014,9(10):1035-1037.
[8]苑海刚,薛凤,赵钢.蓬子菜水溶液对大鼠皮肤溃疡疮面修复影响的实验研究[J].中医药学报,2016,44(2):40-42.