四妙汤加减联合银离子敷料治疗老年病毒性肝炎院外带入Ⅳ期压疮的疗效观察  

Clinical efficacy of modified Simiao Decoction combined with silver ion dressings on elderly viral hepatitis with out-of-hospital pressure ulcer of stageⅣ

作　　者：汪卫平 王子玉 刘思远 WANG Weiping;WANG Ziyu;LIU Siyuan(Department of Infectious Diseases,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102208)

机构地区：[1]首都医科大学附属北京积水潭医院感染疾病科,北京102208

出　　处：《河北中医》2024年第8期1345-1349,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察四妙汤加减联合银离子敷料治疗老年病毒性肝炎院外带入Ⅳ期压疮的临床疗效。方法将80例老年病毒性肝炎院外带入Ⅳ期压疮患者按照随机数字表法分为2组,均接受基础干预;此外,对照组40例予银离子敷料治疗,观察组40例在对照组基础上采用四妙汤加减口服治疗,2组均观察3周。比较2组的治疗效果,比较2组治疗前后压疮愈合评分表(PUSH)评分、创面面积、创面愈合时间、疼痛视觉模拟评分(VAS),于治疗3周后对创面进行细菌培养,比较2组的细菌转阴率,比较2组治疗前和治疗1周后白细胞计数(WBC)和白细胞介素6(IL-6)水平。结果观察组总有效率92.5%(37/40),对照组总有效率75.0%(30/40),观察组创面治疗效果优于对照组(P<0.05)。治疗后,观察组PUSH评分(6.30±1.07)分,对照组为(8.10±1.01)分,观察组PUSH评分低于对照组(P<0.05)。治疗1、2、3周后,2组创面面积均较本组治疗前缩小(P<0.05),且观察组创面面积均小于对照组同期(P<0.05)。观察组创面愈合时间短于对照组(P<0.05)。治疗1、2、3周后,2组疼痛VAS均较本组治疗前降低(P<0.05),且观察组疼痛VAS均低于对照组同期(P<0.05)。治疗3周后,观察组细菌转阴率为97.5%(39/40),对照组细菌转阴率为80.0%(32/40),观察组细菌转阴率高于对照组(P<0.05)。2组治疗1周后WBC及IL-6水平均较本组治疗前降低(P<0.05),且观察组治疗1周后WBC及IL-6水平均低于对照组(P<0.05)。结论四妙汤加减联合银离子敷料治疗老年病毒性肝炎院外带入Ⅳ期压疮疗效显著,可促进创面的愈合,缩短愈合时间,降低创面感染的概率,减轻局部和全身的炎症反应,减轻患者疼痛,值得临床进一步推广。Objective To observe the clinical efficacy of modified Simiao Decoction combined with silver ion dressings on elderly viral hepatitis with out-of-hospital pressure ulcer(stageⅣ).Methods A total of 80 elderly viral hepatitis with out-of-hospital pressure ulcer(stageⅣ)were randomly assigned into observation group(n=40)and control group(n=40).All patients were managed by routine intervention and silver ion dressings,and those in observation group were additionally given oral modified Simiao Decoction.Treated for 3 weeks,the aim was to compare curative effect,Pressure Ulcer Scale for Healing(PUSH)scores,wound area,wound healing time,visual analogue scale(VAS),the negative conversion rate of wound bacterial at week 3 of treatment,white blood cell(WBC)count and interleukin(IL)-6 on day 0 and at week 1 of treatment.Results The overall effective rate in the observation group was better than that in the control group(92.5%[37/40]vs 75.0%[30/40],P<0.05).The PUSH score in the observation group was significantly lower than that in the control group([6.30±1.07]points vs[8.10±1.01]points,P<0.05).At weeks1,2 and 3 of treatment,the wound area,wound healing time,and VSA scores in the both groups were significantly reduced(P<0.05),the reductions in the observation group were more pronuunced compared to the control group(P<0.05).At week 3 of treatment,the negative conversion rate ofwound bacteria in the observation group was significantly higher than that of the control group(97.5%[39/40]vs 80.0%[32/40],P<0.05).At week 1of treatment,WBC and IL-6 in the both groups were significantly decreased(P<0.05),the decrease in the observation group was more common than the control group(P<0.05).Conclusion Modified Simiao Decoction combined with silver ion dressings has significant therapeutic effects in treatment of elderly viral hepatitis with out-of-hospital pressure ulcer(stageⅣ),which can promote wound healing,shorten healing time,decrease wound infection rate,reduce inflammatory response,and relieve pain.It is worthy of further c

关 键 词：四妙汤 病毒性肝炎 院外带入压疮 老年人 外治法 

分 类 号：R248[医药卫生—中医临床基础]