复方黄柏液联合湿性愈合敷料治疗老年深Ⅱ度烧伤难愈性创面的临床观察  

Clinical Observation of Compound Cortex Phellodendri Liquid Combined with Wet Healing Dressing in the Treatment of Refractory DeepⅡDegree Burn Wounds in the Elderly

作　　者：肖长栓 刘娅平 王昊 暴海洋 杨景哲[1] 陈红雨 XIAO Changshuan;LIU Yaping;WANG Hao;BAO Haiyang;YANG Jingzhe;CHEN Hongyu(Department of Burn and Plastic Surgery,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China;Department of Obstetrics and Gynecology,Jinan Lixia District Second People's Hospital,Jinan 250000,Shandong,China)

机构地区：[1]承德医学院附属医院烧伤整形科,河北承德067000 [2]济南市历下区第二人民医院妇产科,山东济南250000

出　　处：《中国美容医学》2024年第9期16-21,共6页Chinese Journal of Aesthetic Medicine

基　　金：承德市科学技术研究与发展计划项目(编号:202109A051)。

摘　　要：目的:探讨复方黄柏液联合湿性愈合敷料对老年深Ⅱ度烧伤难愈性创面的治疗效果。方法:选取2018年3月-2023年3月于承德医学院附属医院烧伤整形科治疗的120例老年深Ⅱ度烧伤难愈性创面患者为研究对象,按随机数字表法分为对照组、高剂量治疗组、低剂量联合组和高剂量联合组4组,每组30例。对照组予1%TBSA创面外用碘伏溶液35 ml及干燥无菌敷料包扎,高剂量治疗组予1%TBSA创面外用复方黄柏液涂剂35 ml及干燥无菌敷料包扎,低剂量联合组予1%TBSA创面外用复方黄柏液涂剂17.5 ml及用湿性愈合敷料包扎,高剂量联合组予1%TBSA创面外用复方黄柏液涂剂35 ml及用湿性愈合敷料包扎,四组均每天换药1次,持续治疗21 d。观测四组患者治疗14 d后创面病理学变化,评价治疗21 d后临床疗效,于7、14、21 d后计算治疗创面愈合率,测定创面组织中血管内皮生长因子(VEGF)、成纤维细胞生长因子-7(FGF-7)、肿瘤坏死因子-α(TNF-α)、半胱胺酸天冬氨酸水解酶-3(Caspase-3)水平、核转录因子-κBp65(NF-κBp65)表达情况及创面组织细胞凋亡率。结果:治疗后,四组创面愈合率、创面VEGF、FGF-7、TNF-α、NF-κBp65水平、创面细胞凋亡率及Caspase-3水平比较,高剂量联合组最优,之后依次是高剂量治疗组、低剂量联合组、对照组,差异均有统计学意义(P<0.05)。结论:复方黄柏液涂剂外用对老年深Ⅱ度烧伤创面临床治疗与使用剂量呈正相关,与湿性愈合敷料联合后临床疗效更佳,可促进生长因子合成释放,改善炎症反应及抑制细胞凋亡促进创面愈合,值得临床推广。Objective To investigate the therapeutic effects of Compound Cortex Phellodendri Liquid combined with wet healing dressing on refractory deep II degree burn wounds in the elderly.Methods A total of 120 elderly patients with refractory deep II degree burn wounds who were treated in the Department of Burn and Plastic Surgery at the Affiliated Hospital of Chengde Medical University from March 2018 to March 2023 were selected as the study subjects.They were divided into the control group,the high-dose treatment group,low-dose combination group and high-dose combination group,with 30 patients in each group.The control group was treated with 35 ml of 1%TBSA topical iodophor solution and dry sterile dressing.The high-dose treatment group was treated with 35 ml of 1%TBSA topical Compound Cortex Phellodendri Liquid and dry sterile dressing.The low-dose combination group was treated with 17.5 ml of 1%TBSA topical Compound Cortex Phellodendri Liquid and wet healing dressing.The high-dose combination group was treated with 35 ml of 1%TBSA topical Compound Cortex Phellodendri Liquid and wet healing dressing.Each group changed their dressing once a day,for 21 days.Pathological changes of wound surface after 14 d of treatment were observed.Clinical efficacy after 21 d of treatment was evaluated.7 d,14 d and 21 d later,wound healing rates were calculated.The levels of vascular endothelial growth factor(VEGF),fibroblast growth factor-7(FGF-7),tumor necrosis factor-α(TNF-α)and caspase-3 in wound tissues,the expression of nuclear factor-κBp65(NF-κBp65)and wound cell apoptosis rate were measured.Results After treatment,the wound healing rate,the levels of VEGF,FGF-7,TNF-α,and NF-κBp65,the apoptosis rate of wound cells,and the level of Caspase-3 in the four groups were compared,and the high-dose combined group was the best,followed by the high-dose combined group,the low-dose combined group,and the control group,and the differences were statistically significant(P<0.05).Conclusion Clinical efficacy of Compound Cortex Phellodend

关 键 词：复方黄柏液 湿性愈合敷料 老年 深Ⅱ度烧伤 难愈性创面 临床疗效 血管内皮生长因子 成纤维细胞生长因子-7 肿瘤坏死因子-α 半胱胺酸天冬氨酸水解酶-3 核转录因子-κBp65 细胞凋亡率 

分 类 号：R644[医药卫生—外科学]