水动力清创系统联合去腐生新膏治疗下肢慢性难愈性溃疡气虚血瘀证临床疗效观察  

Clinical effect observation of hydrodynamic debridement system combined with Qufu Shengxin Ointment on refractory ulcer of lower limbs with qi deficiency and blood stasis

作　　者：李逸梅 龚旭初[1] 方勇[1] 乔楠[1] 吴金娜[1] 陈海东[1] LI Yi-mei;GONG Xu-chu;FANG Yong;QIAO Nan;WU Jin-na;CHEN Hai-dong(Nantong Hospital of Traditional Chinese Medicine,Nantong 226001,China)

机构地区：[1]南通市中医院,南通226001

出　　处：《中华中医药杂志》2023年第2期906-910,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：南通市卫健委青年基金(A类)项目(No.QA2020012);南京中医药大学自然科学基金(No.XZR2021084);第七批全国名老中医师承项目(No.国中医药人教函[2022]76号);国家中医药管理局重点专科项目(No.国中医药办医政函[2019]210号);第四批全国中医临床优秀人才研修项目(No.国中医药人教发[2017]24号)。

摘　　要：目的:观察应用水动力清创系统联合去腐生新膏治疗下肢慢性难愈性溃疡气虚血瘀证的临床疗效。方法:选取74例下肢难愈性溃疡患者,按照随机数表法分为观察组(25例)、对照1组(25例)、对照2组(24例)。3组入院后均采用水动力清创系统清理创面,观察组清创后予外用去腐生新膏,对照1组外用重组人碱性成纤维生长因子凝胶,对照2组外用湿润烧伤膏,初期每日换药,首次肉芽长出后隔日一换,直至痊愈。观察并分析3组创面局部症状总积分、愈合性指标(新鲜肉芽出现时间、溃疡愈合时间、疤痕平整率、溃疡感染率、皮肤不良反应率、溃疡面积、溃疡深度)及溃疡危险因素检测指标[踝肱指数(ABI)、下肢经皮氧分压(tcpO2)、震动感觉阈值(VPT)]。结果:治疗后,各组局部症状总积分、溃疡面积、溃疡深度、ABI、tcpO2、VPT均较治疗前显著改善(P<0.01);观察组治疗后局部症状积分、溃疡面积、溃疡深度、新鲜肉芽出现时间、溃疡愈合时间、疤痕平整率、tcpO2、VPT改善情况均显著优于两个对照组(P<0.01,P<0.05)。结论:水动力清创系统联合去腐生新膏治疗下肢难愈性溃疡具有更好的临床效果,能显著改善溃疡局部症状,缩短溃疡愈合时间,缓解溃疡愈合危险因素,安全有效,值得推广应用。Objective:To observe the clinical effect of hydrodynamic debridement system (HDS) combined with Qufu Shengxin Ointment on chronic refractory ulcer of lower limbs with qi de?ciency and blood stasis.Methods:Seventy-four patients with refractory of ulcer of lower limbs were selected and divided into three groups according to the random number table method,observation group (25 cases),control 1 group (25 cases),control 2 group (24 cases).All the 3 groups were treated with HDS to clean the wound.After debridement,observation group was treated with Qufu Shengxin Ointment,control 1 group with recombinant human basic?broblast growth factor gel (FJF) and control 2 group with moisture exposed burn ointment (MEBO).The wound local symptom score,healing indexes (?rst granulation appearance time,ulcer healing time,scar leveling rate,ulcer infection rate,skin adverse reaction rate,ulcer area,ulcer depth),ankle brachial index (ABI),transcutaneous pressure of onimetry(tcpO2) and vibration perception threshold (VPT) were observed and analyzed in 3 groups.Results:After the treatment,local symptom score,ulcer area,ulcer depth,ABI,tcpO2and VPT were improved compared with before the treatment in all groups(P<0.01).The improvement of local symptom score,ulcer area,ulcer depth,?rst granulation appearance time,ulcer healing time,scar leveling rate,tcpO2and VTP in observation group was better than those in control groups (P<0.01,P<0.05).Conclusion:HDS combined with Qufu Shengxin Ointment in the treatment of refractory lower ulcer has better clinical effect,can signi?cantly improve ulcer local symptoms,shorten ulcer healing time,alleviate ulcer healing risk factors,safe and effective,worthy of promotion and application.

关 键 词：水动力清创系统 去腐生新膏 下肢难愈性溃疡 轻粉 外治疗法 气虚血瘀 

分 类 号：R632.1[医药卫生—外科学]