红光照射联合去腐生新膏治疗气虚血瘀型臁疮的临床效果  

Clinical observation on effect of red light irradiation combined with Qufu Shengxin ointment to treat qi deficiency and blood stasis type ecthyma disease

作　　者：陈海东[1] 陈德轩[2] 方勇 杨旭[1] 李逸梅[1] 龚旭初 CHEN Hai-dong;CHEN De-xuan;FANG Yong(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Nantong(226001),China.)

机构地区：[1]南京中医药大学南通附属医院,江苏南通226001 [2]南京中医药大学附属江苏省中医院,江苏南京210029

出　　处：《中国中西医结合外科杂志》2024年第1期71-75,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：南京中医药大学自然科学基金(XZR2021084);南通市卫健委青年基金(A类)(QA2020012);第七批全国名老中医师承项目(国中医药人教函〔2022〕76号);国家中医药管理局重点专科项目(国中医药办医政函〔2019〕210号);南通市“十四五”科教强卫工程临床医学中心及青年医学重点人才项目(通卫科教〔2021〕15号)。

摘　　要：目的:观察应用红光照射治疗联合去腐生新膏外用治疗气虚血瘀型臁疮的临床疗效。方法:选取64例臁疮患者,中医证属气虚血瘀型,采用随机数字表法分为试验组和对照组,每组32例。两组入院后均行清创治疗,清创后两组均采用红光照射治疗,其中试验组配合外用去腐生新膏,对照组配合外用重组人碱性成纤维生长因子凝胶。比较治疗后两组患肢临床疗效(疼痛、肿胀、溃疡面积、溃疡深度、创面愈合率、愈合时间)、创面愈合相关因素[创面细菌阳性率、患肢经皮氧分压(tcpO_(2))、皮肤不良反应率]、血清炎症及相关细胞因子[C反应蛋白(CRP)、白细胞介素(IL-6)、血管内皮生长因子(VEGF)]。结果:治疗后两组临床疗效指标(疼痛、肿胀、溃疡面积、溃疡深度、创面愈合率、愈合时间)及tcpO_(2)、CRP、IL-6、VEGF指标均较前改善。试验组治疗7 d后疼痛、肿胀缓解情况均优于对照组(P <0.05);治疗14 d后肿胀、CRP较对照组改善(P <0.05),溃疡面积、溃疡深度、tcpO_(2)、IL-6、VEGF较对照组明显改善(P <0.01)。治疗后,两组创面细菌培养阳性率及皮肤不良反应率无明显差异(P>0.05)。结论:红光照射联合去腐生新膏治疗气虚血瘀型臁疮临床疗效显著,其能改善创面炎症,促进血管新生、改善微循环,且不增加创面不良反应发生率。Objective To observe the clinical effect of red light irradiation combined with Qufu Shengxin ointment in the treatment of qi deficiency and blood stasis type ecthyma.Methods 64 patients with ecthyma,whose TCM syndrome was blood stasis type,were divided into experimental group and control group with 32 cases each by random number table method.After admission,debridement treatment was given to both groups.After debridement,red light irradiation was given to both groups.The experimental group was combined with Qufu Shengxin ointment and the control group with topical recombinant human basic fibroblast growth factor gel.Clinical effect(pain,swelling,ulcer area,and ulcer depth,wound healing rate and healing time),factors related to wound healing(positive rate of wound bacteria,transcutaneous oxygen partial pressure tcpO_(2),skin adverse reaction rate),serum inflammation and related cytokines[C-reactive protein(CRP),interleukin(IL-6),vascular endothelial growth factor(VEGF)]were analyzed at observation sites 2.Results After treatment,the clinical therapeutic index and tcpO_(2),CRP,IL-6 and VEGF indexes of two groups were improved.Compared with the two groups,the relief of pain and swelling in experimental group was better than that in control group after 7 days of treatment(P<0.05).After 14 days of treatment,swelling and CRP were improved compared with control group(P<0.05),ulcer area,ulcer depth,tcpO_(2),IL-6 and VEGF were significantly improved compared with control group(P<0.01).After treatment,there were no significant differences in the positive rate of bacterial clearance and skin defects between the two groups(P>0.05).Conclusion Red light irradiation combined with Qufu Shengxin ointment to treat qi deficiency and blood stasis type ecthyma has significant clinical effect,which can relieve the clinical symptoms of affected limb,improve wound inflammation,promote angiogenesis,improve microcirculation and do not increase wound side effects.

关 键 词：红光照射 去腐生新膏 气虚血瘀型臁疮 溃疡 

分 类 号：R654.4[医药卫生—外科学] R268[医药卫生—临床医学]