湿性愈合理论下阳和汤湿敷对溃疡期下肢静脉曲张术后创面愈合的影响  

The influence of wet compress of Yanghe Decoction on wound healing in ulcerative-stage lower limb varicose veins under wet healing theory

作　　者：谢利成 黄海燕 范立彬 尉理梁 洪进 XIE Licheng;HUANG Haiyan;FAN Libin;WEI Liliang;HONG Jin(Department of Vascular Hernia Surgery,Affiliated Hospital of Shaoxing University of Arts and Sciences,Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴文理学院附属医院血管疝外科,浙江绍兴312000

出　　处：《中华全科医学》2025年第4期592-595,612,共5页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2024ZL1147)。

摘　　要：目的探讨湿性愈合理论下阳和汤湿敷在溃疡期下肢静脉曲张患者术后促创面愈合中的应用效果,为此类患者术后促进创面愈合提供更充分的理论依据。方法选取2022年9月-2024年8月于绍兴文理学院附属医院治疗的溃疡期下肢静脉曲张患者96例,根据随机数字表法分为观察组和基线组,各48例。基线组术后实施常规治疗,观察组在基线组基础上实施湿性愈合理论下阳和汤湿敷。评估2组疗效、中医证候积分、溃疡面积,统计术后创面愈合时间、并发症发生率,检测血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、转化生长因子β1(TGF-β1)。结果观察组疗效优于基线组(P<0.05)。观察组治疗后各项中医证候主症评分及总积分低于基线组(P<0.05);观察组治疗后溃疡面积、溃疡深度均小于基线组(P<0.05);观察组创面愈合时间[(28.33±4.08)d]短于基线组[(30.25±4.14)d,t=2.289,P<0.05];观察组治疗后血清VEGF、TGF-β1水平高于基线组,血清HIF-1α水平低于基线组(P<0.05);观察组并发症发生率[6.25%(3/48)]低于基线组[20.83%(10/48),χ^(2)=4.360,P=0.037]。结论湿性愈合理论下阳和汤湿敷应用于溃疡期下肢静脉曲张术后患者能有效提高治疗效果,减轻患者症状,促进术后创面愈合,调节VEGF、TGF-β1、HIF-1α水平,减少并发症。Objective This study aims to evaluate the application of Yanghe Decoction wet dressing based on wet healing theory,promoting wound healing in postoperative patients with lower extremity varicose veins at the ulcer stage.Methods A total of 96 patients with ulcerated lower extremity varicose veins,admitted to the Affiliated Hospital of Shaoxing University from September 2022 to August 2024,were selected and divided into an observation group and a baseline group based on a random number table method,with 48 patients in each group.The baseline group received postoperative treatment,while the observation group received Yanghe Decoction wet dressing based on the wet healing theory in addition to the baseline treatment.The treatment efficacy,traditional Chinese medicine(TCM)syndrome scores,ulcer area,postoperative wound healing time,and complication rates were evaluated in both groups.Vascular endothelial growth factor(VEGF),hypoxia-inducible factor-1α(HIF-1α),and transforming growth factor-β1(TGF-β1)were also measured.Results The observation group demonstrated significantly better therapeutic efficacy compared to the baseline group(P<0.05).After treatment,the scores for the main symptoms of TCM syndromes and the total score in the observation group were lower than those in the baseline group(P<0.05).The ulcer area and ulcer depth in the observation group after treatment were smaller than those in the baseline group(P<0.05).The wound healing time in the observation group[(28.33±4.08)days]was shorter than that in the baseline group[(30.25±4.14)days,t=2.289,P<0.05].After treatment,the levels of VEGF and TGF-β1 in the observation group were higher than those in the baseline group,while the level of HIF-1αwas lower(P<0.05).The incidence of complications in the observation group was 6.25%(3/48),which was lower than in the baseline group(20.83%,10/48,χ^(2)=4.360,P=0.037).Conclusion Under the theory of wet healing,the application of Yanghe Decoction wet compress can effectively improve treatment effect,reduce symptoms

关 键 词：湿性愈合理论 阳和汤 湿敷 溃疡期 下肢静脉曲张 创面愈合 

分 类 号：R543.6[医药卫生—心血管疾病]