迈之灵用于混合痔手术的疗效分析

目的分析迈之灵治疗混合痔的疗效及对创面愈合的影响。方法将150例混合痔患者完全随机分为观察组和对照组,各75例。对照组术前术后给了常规治疗,观察组在对照组治疗基础上,术前1d开始口服迈之灵300mg／次,2次／d,连续服用10d。观察2组术后水肿、出血、疼痛症状消失时间和创面愈合时间。结果观察组术后水肿、出血、疼痛症状消失时间和创面愈合时间短于对照组[（5．0±2．1）d比（8．8±3．6）d,（5．6±4．4）d比（12．2±4．7）d,（5．8±2．3）d比（11．2±4．5）d,（19．3±1．7）d比（23．5±1．5）d,均P〈0．05],术后并发症评分明显低于对照组,2组比较差异均有统计学意义（均P〈0．05）;观察组术后治疗总有效率为94．7％（71／75）,对照组术后治疗总有效率为80．0％（60／75）,2组比较差异有统计学意义（P〈0．05）。结论口服迈之灵可减少混合痔患者术后疼痛、水肿等并发症的发生,有效缩短混合痔术后水肿、出血、疼痛症状消失时间和创面愈合时间。     

地奥司明片减轻肛门直肠手术后水肿、疼痛和促进创面愈合的临床观察

目的：观察地奥司明片减轻肛门直肠手术后水肿、疼痛和促进创面愈合的临床效果。方法：将我院2011年3—9月260例行肛门直肠手术患者随机分为治疗组（136例）和对照组（124例）。治疗组术后第l天开始服用地奥司明片,每次2片（每片0．45g）,每日2次,连服7d;对照组术后不口服地奥司明片及其他止痛、消炎药物。对2组患者术后创面局部水肿和疼痛情况及创面愈合时间进行比较。并观察不良反应。结果：治疗组术后48、72h和7d的水肿和疼痛评分及总评分较对照组显著改善（P〈0．01）;治疗组术后平均创面愈合时间显著短于对照组（P〈0．01）。2组患者均未见不良反应发生。结论：地奥司明片能有效减轻患者肛门直肠手术后水肿和疼痛症状,促进创面愈合,且安全性较好。     

阿奇霉素、龙血竭结合激光治疗宫颈重度糜烂的临床疗效

目的 探讨阿奇霉素、龙血竭结合激光治疗宫颈重度糜烂的临床疗效、创面愈合时间及不良反应.方法 对平湖市第一人民医院2007年9月～2009年8月220例宫颈重度糜烂患者随机分成治疗组115例,对照组105例.治疗组激光术前予阿奇霉素0.25g,每天2次口服,术毕及术后3、5、7天对创面喷敷龙血竭胶囊药粉.对照组单纯激光治疗.结果 治疗组较对照组痊愈率高,创面愈合时间短,术后不良反应少,均有统计学意义（P＜0.05）.结论 阿奇霉素、龙血竭结合激光治疗宫颈重度糜烂疗效好、愈合快、缩短阴道排液及出血时间,减少阴道出血量.     

龙血竭联合光热照射治疗宫颈糜烂疗效观察

目的探讨龙血竭联合光热照射治疗宫颈糜烂的临床疗效。方法477例宫颈糜烂患者按数字表法随机分为治疗组277例和对照组200例,对照组采用单纯光热照射治疗,治疗组口服龙血竭片,4片／次,3次／d,联合光热照射治疗,采用χ^2检验比较两组治疗效果。结果治疗组痊愈261例（94．3％）,好转11例（3．9％）,无效5例（1．8％）,总有效率98．2％,与对照组的150例（75．0％）、36例（18．0％）、14例（7．0％）、92．9％比较,差异有统计学意义（χ^2=36．4,P〈0．01）;治疗组术后阴道排液时间明显短于对照组（t=12．5,P〈0．01）。结论龙血竭联合光热照射治疗宫颈糜烂疗效好,治愈率高。     

地奥司明片用于痔疮患者术后40例

目的观察地奥司明片用于痔疮患者术后的疗效。方法选择手术治疗的痔疮患者80例,随机分为观察组和对照组。两组均采用外剥内扎术式进行手术,术后予以常规抗炎、局部坐浴和对症治疗。观察组在此治疗基础上予以加用地奥司明片0．9g,每天2次,连用7d。结果观察组术后第2,4天临床疗效总评分均明显低于对照组（P〈0．01）,术后第7天两组患者的临床疗效总评分比较无明显统计学差异（P〉0．05）;观察组术后创面愈合时间明显短于对照组（P〈0．05）;两组患者治疗期间无严重的药物不良反应。结论地奥司明片应用于痔疮术后疗效较显著,对患术后肛门疼痛、出血、水肿和分泌物增加等局部症状控制效果良好,可缩短创面愈合时间,安全性较好,是一种安全有效的痔疮患者围手术期辅助药物。     

龙血竭胶囊外用治疗慢性皮肤溃疡的疗效观察

目的观察龙血竭胶囊外用治疗慢性皮肤溃疡的临床疗效。方法将42例慢性皮肤溃疡患者按抽签方法随机分为治疗组22例和对照组20例,治疗组外用龙血竭胶囊治疗,对照组外用红霉素软膏治疗,2组换药均1次／d,2组疗程均为4周。结果治疗组治愈17例（77．3％）,显效4例（18．2％）,总有效21例（95．5％）;对照组治愈2例（10．0％）,显效4例（20．0％）,总有效6例（30．0％）,2组比较治愈率、总有效率差异有统计学意义（P〈0．05）。结论龙血竭胶囊通过活血化瘀,定痛止血,敛疮生肌而促进创面愈合,且操作简便、疗效好,是治疗慢性皮肤溃疡效果良好的外用药物。     

中西医结合治疗带状疱疹临床疗效观察

目的：对比观察阿昔洛韦片、甲钴胺胶囊联合龙血竭胶囊、板蓝根冲剂治疗带状疱疹的临床疗效。方法：80例患者随机分为治疗组42例和对照组38例,治疗组采用阿昔洛韦片、甲钴胺胶囊联合龙血竭胶囊、板蓝根冲剂治疗,对照组采用阿昔洛韦片、甲钴胺胶囊治疗,两组创面均采用莫匹罗星软膏治疗。记录治疗过程中创面止疱、结痂、止痛和愈合时间及后遗神经痛的发生率,并进行统计学分析。结果：中西医结合方法治疗带状疱疹的结痂时间和止疱时间略低于对照组,差异无显著性（P〉0．05）;但神经痛的发生率和消失时间则明显短于西药治疗组,两组比较差异有显著性（P〈0．05）。结论：阿昔洛韦片、甲钴胺胶囊联合龙血竭胶囊、板蓝根冲剂治疗带状疱疹能有效减少后遗神经痛的发生或明显缩短其疼痛时间,是临床较为有效的治疗带状疱疹的方法。     

黄连油配合杠板归汤对低位肛瘘术后创面愈合影响的临床观察

目的：观察黄连油纱条换药配合杠板归汤坐浴对低位肛瘘术后创面愈合影响的临床疗效观察。方法将60例低位肛瘘术后患者随机分为治疗组和对照组，每组各30例。两组患者均施行肛瘘切开引流术，两组术后均常规予预防感染、止血等治疗。治疗组从术后第1天开始换药前予杠板归汤坐浴，黄连油纱条换药；对照组换药前予杠板归汤坐浴，雷夫奴尔纱条换药。观察术后第24、48、72小时两组病例创面疼痛情况；用药前治疗组第3、5、7天创面分泌物情况；用药后第14、21天创面愈合率及用药后创面愈合时间。结果用药后第24、48、72小时两组创面疼痛有显著性差异（P<0.05）；用药后第3、5、7天创面分泌物较对照组明显减少（P<0.05）；用药后第14天、21天创面愈合率有显著性差异（P<0.05）；治疗组愈合时间明显快于对照组（P<0.05）。结论黄连油纱条换药配合杠板归汤坐浴能有效缓解肛瘘术后创面疼痛、改善创面分泌物、促进创面修复、缩短创面愈合时间。     

中药外用对混合痔术后创面愈合促进作用的临床观察

目的观察外用自制中药活血生肌膏对混合痔术后创面愈合的作用。方法将80例混合痔术后的患者随机分为中药组和对照组,每组各40例,中药组以自制活血生肌膏纱条（三七、白芷、白芨、紫草、轻粉、血竭、地榆、石膏等）换药,每日一次;对照组以凡士林纱条换药,每日一次。观察两组患者手术创面愈合时间。结果创面愈合天数中药组为（12．45±2．33）d,对照组为（15．74±1．96）d（P〈0．05）,结果差异有显著性。结论活血生肌中药膏剂具有活血行气、化瘀生肌的功效,可明显促进混合痔术后创面愈合。     

加味苦参汤熏洗对肛周脓肿术后创面愈合的临床观察

目的观察加味苦参汤熏洗剂对肛周脓肿术后创面愈合的临床疗效。方法将120例肛周脓肿术后患者随机分成实验组与对照组各60例,2组均在术后第2天采用创面熏洗,实验组采用中药加味苦参汤,对照组采用高锰酸钾溶液。2组在术后第3天,第7天各取创面细胞印片一次,计算印片中巨噬细胞数量。同时观察两组的创面愈合时间。结果创面愈合中期,实验组创面渗出液中的巨噬细胞的数量较对照组增多。实验组较对照组创面愈合时间短。结论中药加味苦参汤具有促进肛周脓肿术后创面愈合的作用。     

Potential of Ozonated Sesame Oil to Augment Wound Healing in Rats

The hypothesis that ozonated oil has wound healing property was investigated in an excision wound model using Sprague Dawley rats. The animals were divided into four groups, which were treated with sesame oil (vehicle), framycetin (standard), or two doses of ozonated sesame oil (peroxide values 500 and 700 mEq/1000 g, respectively). The formulations were topically applied on the excision wounds once daily for 11 consecutive days and the animals were euthanized on the 12^th day. Wound healing was assessed by measuring the wound contracture, tensile strength, collagen content and superoxide dismutase activity of skin of the excised wound area. On the terminal day, areas of the wounds of the group receiving high dose ozonated oil were significantly smaller than those of the group treated with vehicle. Ozonated oil treated wounds had significantly higher tensile strength, collagen content and superoxide dismutase activity than that of the vehicle treated wounds. Histopathological analysis of skin of the excised wound area treated with ozonated oil revealed better healing activity vis-à-vis vehicle-treated wounds. Thus, it can be concluded that ozonated oil can be of potential therapeutic use for healing wounds.     

壳聚糖对大鼠Ⅲ度烧伤创面成纤维细胞生物学行为的影响

目的研究壳聚糖对烧伤创面成纤维细胞(FB)生物学行为的影响。方法Wistar大鼠分为1%壳聚糖组(W/V)、2%壳聚糖组(W/V)、4%壳聚糖组(W/V)、成纤维细胞生长因子(贝复剂)组(阳性对照组)、自然愈合组(模型组),制备成大鼠Ⅲ度烧伤模型,记录创面愈合时间,计算创面愈合率,用生化法测定各时相点羟脯氨酸(HOP),流式细胞术检测真皮组织中FB细胞周期,TUNEL法检测FB凋亡。结果4%壳聚糖组(W/V)各个时间点创面愈合率都明显高于自然愈合组(P<0.01);2%壳聚糖组、4%壳聚糖组创面愈合时间较自然愈合组缩短(P<0.05);2%壳聚糖组、4%壳聚糖组烧伤后7 d HOP就达最高值,且其值比自然愈合组最高值大;4%壳聚糖组进入S期的成纤维细胞数明显高于自然愈合组(P<0.05,P<0.01),创面凋亡细胞数量低于自然愈合组(P<0.05,P<0.01)。结论壳聚糖能增加烧伤创面修复细胞FB的增殖,凋亡减少,胶原合成增多,可能是壳聚糖促进大鼠Ⅲ度烧伤创面愈合的原因之一。     

多糖生物医用胶对创面修复作用的研究

目的 观察多糖生物医用胶促进创面组织再生、创面修复的作用。方法 SD大鼠,♀♂各半,分为聚维酮碘组、多糖生物医用胶组及生理盐水组。大鼠右侧背部利用电烙铁烫伤方式,使皮肤造成直径为2 cm的圆形深Ⅱ度烫伤创面。用透明膜标记法记录伤后3,7,14,28 d创面面积,7,14,28 d取创面修复组织作病理学观测,考察多糖生物医用胶对创面修复的影响。结果 与生理盐水组比较,多糖生物医用胶组在伤后7,14,28 d创面面积显著减少(P<0.05)。病理组织学检查显示在创伤修复过程中多糖生物医用胶组明显改善组织新生及促进组织修复。结论 多糖生物医用胶对创面修复具有一定的改善作用。     

重组人碱性成纤维细胞生长因子治疗人体Ⅱ度烧伤的疗效观察

目的 :观察重组人碱性成纤维细胞生长因子 (rh -bFGF)治疗人体Ⅱ度烧伤的疗效。方法 :采用开放性临床观察 ,选择同体、同深度、相近或对称部位烧伤创面、肉芽创面和溃疡面进行随机自身对照观察。结果 :浅Ⅱ度创面平均愈合时间为 (14 08±2 47)天 ,深Ⅱ度创面平均愈合时间为 (18 35±5 14)天 ,分别较对照创面缩短3 09天和3 90天 ;rh -bFGF治疗浅Ⅱ度创面、慢性创面总有效率均为100 % ,治疗深Ⅱ度创面总有效率为95.24 %。结论 :rh -bFGF能够有效促进深Ⅱ度、浅Ⅱ度烧伤创面及慢性创面的愈合 ,未发现明显的药物不良反应     

Evaluation of Wound Healing Potential of Bauhinia purpurea Leaf Extracts in Rats

The present study was carried out to evaluate the effect of methanol and chloroform extracts of Bauhinia purpurea on experimentally induced excision, incision, burn and dead space wound models in Sprague Dawley rats. Formulations of methanol and chloroform extracts of Bauhinia purpurea were prepared in carbopol and simple ointment base at concentrations of 2.5% and 5% and applied to the wounds. In the excision and burn wound models, animals treated with high doses of methanol and chloroform showed significant reduction in time taken for epithelization and wound contraction (50%) compared to control. A significant increase in breaking strength was found in incision wound model with methanol and chloroform extracts compared to their respective bases. In the dead space wound model, methanol and chloroform extract treatment (100 and 500 mg/kg) orally produced a significant increase in the breaking strength, dry tissue weight and hydroxyproline content of the granulation tissue when compared to control. Among the extracts, methanol extract exhibited more activity followed by the chloroform extract. In conclusion, the present study indicated that Bauhinia purpurea leaves exhibited wound healing activity.     

The reduction in inflammation and impairment in wound healing by using strontium chloride hexahydrate

Background: Numerous growth factors, cytokine, mitogen and chemotactic factors are involved in wound healing. Even though inflammation is important for the stimulation of proliferative phase, excessive inflammation also causes impairment in wound healing. Strontium salts suppress keratinocyte-induced TNF-alpha and interleukin-1 and interleukin-6 in in vitro cultures. This study was conducted to determine the effects of administration of topical strontium chloride hexahydrate on wound healing through TNF-alpha and TGF-beta in surgical wound healing model of in-vivo rat skin.

Material and methods: Twenty-four rats were used in the study. After approximately 2?cm cutaneous–subcutaneous incision was horizontally carried out on the mid-neckline of the rats, the incision was again closed using 2.0 vicryl. The rats were assigned into three groups including eight rats in each group. Placebo emollient ointment and also the ointments, which were containing 5% and 10% strontium chloride hexahydrate and were prepared at the same base with placebo ointment, were administered to the groups by a blind executor twice a day for a week. At the end of seventh day, the rats were sacrificed and cutaneous and subcutaneous tissue of their wound site was resected for histopathological examination. Scoring of histopathological wound healing and scoring of tissue TNF-alpha and TGF-beta level with immunohistochemical staining were performed.

Results: The groups, to which both 5% and 10% strontium chloride hexahydrate was administered, had lower immunohistochemical TNF-alpha levels and histopathological wound scores compared to controls, which was statistically significant (p?Conclusion: Strontium chloride hexahydrate can lead to impairment in wound healing by suppressing inflammation through TNF-alpha.     

冷宁康敷料治疗烧伤创面的临床应用与安全性研究

目的探讨冷宁康敷料治疗烧伤创面的临床疗效及其安全性。方法将符合临床试验要求的560例各类烧伤患者随机均分为两组,各280例。对照组使用磺胺嘧啶银治疗,治疗组使用冷宁康敷料治疗。观察记录患者创面疼痛情况、创面完全愈合时间,并对创面愈合质量进行评价。结果治疗后治疗组0～Ⅰ级疼痛占93.93%,而对照组0～Ⅰ级疼痛占19.64%,两组比较差异有统计学意义(P<0.05)。与对照组比较,治疗组浅Ⅱ度创面平均愈合时间缩短3.23 d,深Ⅱ度创面平均愈合时间缩短4.57 d。治疗过程中两组均未见不良反应。结论冷宁康敷料不仅能减轻患者痛苦,还能促进烧伤创面愈合,是一种治疗烧伤的良好外用敷料,值得临床推广。     

伤口感染病原菌分布及耐药性分析

目的了解医院2011年9月至2012年8月伤口分泌物培养的病原菌分布及常见致病菌的耐药情况。方法伤口分泌物标本统一接种血培养基、巧克力培养基和沙保氏培养基,采用ATB鉴定药敏分析仪作鉴定和药敏试验。结果在593份标本中,共分离致病菌364株,阳性率为61.4%,其中革兰阴性菌237株(65.1%),革兰阳性菌114株(31.3%),真菌13株(3.6%)。感染率居前3位的细菌依次是铜绿假单胞菌(17.3%)、金黄色葡萄球菌(15.4%)、大肠埃希菌(13.5%)。肠杆菌科细菌对碳青霉烯类耐药率为0%,大肠埃希菌、克雷伯菌属超广谱β-内酰胺酶(ESBLs)检出率分别为73.5%和37.5%。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌阳性率分别是35.7%和81.3%。未发现耐万古霉素的葡萄球菌和肠球菌。结论伤口化脓性感染的主要病原菌是革兰阴性杆菌,临床医生应及时进行细菌培养及药敏试验,为临床抗菌治疗提供依据,从而有效控制伤口院内感染发生率。     

Collagen‐based wound dressing for doxycycline delivery: in‐vivo evaluation in an infected excisional wound model in rats

Objectives A novel collagen‐based dressing consisting of 2,3‐dihydroxybenzoic‐acid‐modified gelatin microspheres loaded with doxycycline has previously been reported to address both infection and matrix degradation. In the present study the potential benefits of the dressing were investigated in an excisional wound model in rats challenged with Pseudomonas aeruginosa. Methods A full‐thick excisional wound (1.5 times 1.5 cm) was created on the dorsum of the rats and infection induced by injecting 10⁵ colony‐forming units (CFU) of P. aeruginosa. The healing pattern was assessed from wound reduction, matrix metalloprotease (MMP) levels, CFU reduction and histological and biochemical analysis. Key findings The treated group exhibited complete healing by day 15, compared with day 24 in the control group. Early subsidence of infection (99.9% by day 9) resulted in faster epidermal resurfacing and fibroplasias, whereas the microbial load exceeded 10³ CFU even on day 15 in the control group and caused severe inflammation. Biochemical analysis showed that the expression of both collagen and hexosamine was significantly increased in the treated group. Gelatin zymography revealed prolonged expression of MMPs 2, 8 and 9 in the control group compared with the treated group. Conclusions The study indicates that the developed dressing attenuated both infection and metalloprotease levels, and may therefore have potential application in wound healing.