[1]邓智雯 颉玙 毛乔 靳璐 张习禄 雷霆.中药海绵外敷联合负压封闭引流治疗下肢静脉性溃疡的临床研究[J].陕西中医药大学学报,2023,(04):100-104.[doi:2096-1340(2023)04-0100-05]
　DENG Zhiwen JIE Yu MAO Qiao JIN Lu ZHANG Xilu LEI Ting.Clinical Study on the Treatment of Lower Limb Venous Ulcer with External Application of Medicinal Sponge and Vacuum Sealing Drainage[J].Journal of Shaanxi University of Traditional Chinese Medicine,2023,(04):100-104.[doi:2096-1340(2023)04-0100-05]
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中药海绵外敷联合负压封闭引流治疗下肢静脉性溃疡的临床研究
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《陕西中医药大学学报》[ISSN:2096-1340/CN:61-1501/R]

卷:
期数:
2023年04期
页码:
100-104
栏目:
临床研究
出版日期:
2023-07-20

文章信息/Info

Title:
Clinical Study on the Treatment of Lower Limb Venous Ulcer with External Application of Medicinal Sponge and Vacuum Sealing Drainage
文章编号:
10.13424/j.cnki.jsctcm.2023.04.018
作者:
邓智雯 颉玙 毛乔 靳璐 张习禄 雷霆
陕西中医药大学附属医院，陕西 咸阳 712000
Author(s):
DENG Zhiwen JIE Yu MAO Qiao JIN Lu ZHANG Xilu LEI Ting
Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China
关键词:
关键词：下肢静脉性溃疡; 中药敷料; 负压封闭引流; 创面愈合; 白及; 三七
Keywords:
Key words： Lower limb venous ulcer; Traditional Chinese medicine dressings; Vacuum sealing drainage; Wound healing; Baiji; Sanqi
分类号:
R654.3
DOI:
2096-1340(2023)04-0100-05
文献标志码:
A
摘要:
摘 要：目的 评价中药海绵外敷联合负压封闭引流（vacuum sealing drainage,VSD）治疗下肢静脉性溃疡的临床疗效与安全性。方法 选取我院2019年6月—2021年12月收治的下肢静脉性溃疡患者68例，采用随机抽签法分为两组，治疗组与对照组各34例。对照组采用单纯负压封闭引流，治疗组在对照组基础上采用载有微米三七的白及胶海绵外敷，1次/日，疗程均为4周。观察两组患者的临床有效率、视觉模拟评分（visual analogue scales,VAS）、创面面积、静脉临床严重程度评分（venous clinical severity score,VCSS）以评价临床疗效，并记录两组发生的不良事件。结果 治疗组的临床有效率为91.2%，对照组为64.7%，治疗组高于对照组，且两组差异有统计学意义（P<0.05）；治疗后两组患者的VAS评分、创面面积、VCSS均较治疗前明显降低（P<0.05），且治疗组较对照组改善更明显（P<0.05），治疗期间两组均未发生不良事件。结论 载有微米三七的白及胶海绵外敷联合VSD治疗下肢静脉性溃疡疗效显著，且安全性高，值得临床进一步推广应用。
Abstract:
Abstract： Objective To evaluate the clinical efficacy and safety of traditional Chinese medicine sponge external application combined with vacuum sealing drainage (VSD) in the treatment of lower limb venous ulcers.Methods A total of 68 patients with lower limb venous ulcers admitted to our hospital from June 2019 to December 2021 were selected and randomly divided into two groups,with 34 cases in the treatment group and 34 cases in the control group.The control group was treated with simple negative pressure closure drainage,while the treatment group was treated with external application of a white gelatin sponge containing microns of Panax notoginseng,once a day,for 4 weeks.Observe the clinical efficacy,visual analog scale (VAS),wound area,and venous clinical severity score (VCSS) of two groups of patients to evaluate clinical efficacy,and record adverse events that occurred in both groups.Results The clinical effective rate of the treatment group was 91.2%,while the control group was 64.7%.The treatment group was higher than the control group,and the difference between the two groups was statistically significant (P<0.05);After treatment,the VAS score,wound area,and VCSS of the two groups of patients were significantly reduced compared to before treatment (P<0.05),and the treatment group showed more significant improvement compared to the control group (P<0.05).During the treatment period,no adverse events occurred in either group.Conclusion The combination of micronized Panax notoginseng sponge and VSD has a significant therapeutic effect and high safety in the treatment of lower limb venous ulcers,which is worthy of further clinical promotion and application.

参考文献/References:

［1］甘红艳,杨玉金,郑春艳,等.复方黄柏液联合艾灸治疗下肢静脉性溃疡的效果观察［J］.循证护理,2022,8 (17):2375-2378.
［2］彭玮,张洪雷,张嗣兰.白油膏联合黄马酊外敷治疗下肢静脉性溃疡临床研究［J］.中国药业,2022,31 (19):88-90.
［3］李飞,南方,党芸,等.充气加压治疗对下肢静脉性溃疡患者伤口愈合效果的Meta分析［J］.中华护理杂志,2021,56(6):929-934.
［4］蒋劲松,虞聪.下肢静脉性溃疡的诊治策略［J］.中国血管外科杂志(电子版),2021,13(2):107-110.
［5］Leclercq A,Labeille B,Perrot JL,et al.Skin graft secured by VAC (vacuumassisted closure) therapy in chronic leg ulcers:a controlled randomized study［J］.Annales De Dermatologie et De Venereologie,2016,143(1):3-8.
［6］常光其,陈翠菊,陈忠,等.慢性下肢静脉疾病诊断与治疗中国专家共识［J］.中国血管外科杂志(电子版),2014,6(3):143-151.
［7］葸根,陆雄,董志毅.下肢静脉曲张术后联合应用抗凝药物预防深静脉血栓形成临床观察［J］.陕西医学杂志,2017,46(12):1694-1695.
［8］Green J,Jester R,McKinley R,et al.The impact of chronic venous leg ulcers:a systematic review［J］.Journal of Wound Care,2014,23(12):601-612.
［9］范丽君,王缙,赵金妹.中医古籍中臁疮病名考证［J］.亚太传统医药,2018,14(12):85-86.
［10］包易如,朱朝军,张朝晖.张朝晖运用黄芪当归药对治疗疮疡疾病经验［J］.辽宁中医杂志,2022,49 (10):32-34.
［11］王亚蒙,魏纹瑶,马立人.生肌玉红膏治疗60例慢性难愈性创面的临床观察［J］.中医临床研究,2020,12 (15):62-64.
［12］柴政.一效膏促进慢性皮肤溃疡创面修复的研究［D］.沈阳:辽宁中医药大学,2016.
［13］柳言平.愈疡灵软膏治疗下肢静脉性溃疡的临床研究［D］.济南:山东中医药大学,2008.
［14］李龙剑,张艳,彭丽华,等.外用中药治疗皮肤创伤的研究进展［J］.中国现代应用药学,2015,32 (10):1285-1288.
［15］王婕然,姜晓文,于文会,等.中药外用治疗皮肤创伤修复研究进展［J］.动物医学进展,2018,39(8):97-101.
［16］蔡燕玲,黎罕文,杨晓明.三七的药理研究进展［J］.陕西中医学院学报,2001，24(5):57-58.
［17］李淑慧,李晓辉,楚延.三七总皂苷抗炎作用机制的实验研究［J］.中草药,2000,31(9):39-41.
［18］方鹏飞,常丽霞,宋渊.三七总皂苷临床应用研究进展［J］.中医药学报,2016,44(3):120-123.
［19］陆春美,崔秀明.屏边三七总皂苷的活血化瘀及镇痛作用评价研究［J］.中医药学报,2022,50(9):32-35.
［20］王坤堂.白及多糖基水凝胶的制备、性能研究及在创面修复中的应用［D］.天津:天津中医药大学,2022.
［21］罗江蓉,岑瑛.负压封闭引流装置促进创面愈合的机制及在我国的临床应用进展［J］.四川医学,2013,34 (10):1667-1669.
［22］梁嘉樑,纪海,王明怀,等.生肌膏联合封闭负压引流技术治疗足部创面16例［J］.陕西中医药大学学报,2017,40(6):68-71.
［23］纪海,黄军锋.负压引流联合黄连解毒汤对四肢创面修复中的应用价值［J］.现代中医药,2020,40 (1):97-99，103.
［24］陆永攀,刘明,丁亮,等.负压封闭引流技术促进创面愈合机制的研究进展［J］.中国中西医结合外科杂志,2018,24(1):121-124.
［25］雷霆,司明明,周军,等.明胶/白芨胶微米三七海绵材料对创面愈合影响的实验研究［J］.临床医学研究与实践,2016,1(11):1-5，8.
［26］雷霆,孙东旭,周军,等.基于Wnt/β-catenin信号通路的三七/白及胶海绵促进糖尿病足溃疡模型大鼠创面愈合的作用机制研究［J］.中国药房,2019,30(4):483-487.
［27］雷霆,余金文,周军,等.明胶/白芨胶-三七多孔材料对糖尿病溃疡大鼠创面修复及β-catenin、GSK-3β、RSPO-3表达的影响［J］.现代中西医结合杂志,2019,28(19):2057-2062.
［28］雷霆,屈建,周军,等.白及胶/微米三七膏对大鼠糖尿病足溃疡炎症微环境的分子机制研究［J］.西部医学,2020,32(3):339-343，349.
［29］颉玙,张康,张金梅,等.白及胶/微米三七膏含药血清对脂多糖诱导的巨噬细胞核因子-κB信号通路的影响［J］.中国中西医结合外科杂志,2022,28(1):12-16.

备注/Memo

备注/Memo:
基金项目：陕西省自然科学基础研究计划项目(2021JM-474)；咸阳市科技计划项目(2018k02-95)
更新日期/Last Update: 2023-07-29