自拟安胃汤联合兰索拉唑对老年胃溃疡患者胃肠激素及IL-6水平的影响

目的探讨老年胃溃疡患者给予自拟安胃汤联合兰索拉唑治疗对胃肠激素及白细胞介素(IL-6)水平的影响。方法选取2018年1月至2020年12月在本院治疗的老年胃溃疡患者84例作为研究对象,按照随机数字表法分成观察组(42例)和对照组(42例),对照组给予兰索拉唑治疗,观察组给予自拟安胃汤联合兰索拉唑治疗,比较两组患者胃肠激素及IL-6水平。结果两组治疗后胃泌素(GAS)、胃动素(MOT)水平明显提高(P<0.05),观察组水平较对照组明显更高(P<0.05);两组治疗后IL-6水平明显降低(P<0.05),与对照组相比,观察组明显更低(P<0.05)。结论老年胃溃疡患者给予自拟安胃汤联合兰索拉唑治疗,能够改善胃肠激素及IL-6水平,应用价值较高。     

金鸡毛草提取物经Wnt/β-catenin信号通路促进大鼠Ⅲ期压疮溃疡愈合的作用研究

目的观察金鸡毛草提取物经Wnt/β-连环蛋白(β-catenin)信号通路促进大鼠Ⅲ期压疮溃疡愈合的作用。方法建立Ⅲ期压疮溃疡大鼠模型,将造模成功的SD大鼠随机分为模型组与金鸡毛草提取物低、中、高(4、8、16 g/kg)剂量组,每组12只。另取12只正常大鼠作为对照组。金鸡毛草提取物低、中、高剂量组大鼠灌胃4、8、16 g/kg的金鸡毛草提取物,灌胃体积10 mL/kg,对照组和模型组大鼠灌胃等体积生理盐水,每天1次,给药周期为2周。给药周期结束后,检测大鼠创面愈合率,酶联免疫吸附试验(ELISA)法测定大鼠血清白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)水平,苏木素-伊红(HE)染色观察大鼠压疮溃疡组织和正常组织病理变化,实时荧光定量PCR及蛋白免疫印迹法测定大鼠压疮溃疡组织和正常组织中Wnt、β-catenin mRNA和蛋白水平。结果对照组大鼠皮肤组织结构正常,可见大量成纤维细胞及毛细血管;模型组大鼠压疮溃疡组织大量炎症细胞浸润,成纤维细胞及毛细血管数目明显减少,表皮明显变薄;金鸡毛草提取物低、中、高剂量组大鼠压疮溃疡创面组织已经出现结痂,且表皮明显增厚,炎性细胞浸润较轻。与对照组比较,模型组大鼠血清IL-2、IL-4、TNF-α、压疮溃疡组织Wnt、β-catenin mRNA和蛋白水平升高(P <0.05);与模型组比较,金鸡毛草提取物低、中、高剂量组大鼠创面愈合率依次升高,血清IL-2、IL-4、TNF-α、压疮溃疡组织Wnt、β-catenin mRNA和蛋白水平依次降低(P <0.05),呈剂量依赖性(P <0.05)。结论金鸡毛草提取物能加速大鼠Ⅲ期压疮溃疡愈合,减轻大鼠Ⅲ期压疮炎症反应;其机制可能与金鸡毛草提取物可促进大鼠Ⅲ期压疮溃疡组织Wnt、β-catenin mRNA和蛋白的表达进而激活Wnt/β-catenin信号通路有关。     

消渴洗剂治疗糖尿病足的临床效果观察

目的评价消渴洗剂外用治疗糖尿病足溃疡的临床效果。方法选取2013年1-12月在本院住院的26例糖尿病足溃疡患者。将其随机分为治疗组13例和对照组13例。对照组应用过氧化氢溶液、高锰酸钾治疗,治疗组在对照组的基础上加用消渴洗剂治疗。比较两组的临床疗效和创面愈合时间。结果治疗组的总有效率为84．62％,明显高于对照组的53．85％,各级的创面愈合时间均短于对照组（P〈0．01）。结论消渴洗剂外用可较好地改善糖尿病足创面炎症的症状,使局部感染得到有效控制,有助于足部创面愈合。     

溃疡生肌散治疗慢性皮肤溃疡的效果观察

目的：探讨溃疡生肌散治疗慢性皮肤溃疡的临床效果。方法选择2013年1月~2014年7月来本院治疗慢性皮肤溃疡的64例患者作为研究对象,随机分为两组,每组32例。对照组采用美宝湿润烧伤膏外敷,观察组采用溃疡生肌散外敷,每2天换药1次,连续治疗8周,观察和对比临床疗效、创面愈合时间及创面愈合率。结果观察组的总有效率、创面愈合率均高于对照组,创面愈合时间短于对照组,差异有统计学意义(P<0.05)。结论溃疡生肌散治疗慢性皮肤溃疡具有很好的临床效果,值得临床推广应用。     

The effect of PPIs Alone,PPIs plus cytoprotective agent,and H2RA plus cytoprotective agent on ulcer healing after endoscopic submucosal dissection: A prospective randomized controlled trial

Background and Study AimsEndoscopic submucosal dissection (ESD) is the most effective treatment for early gastric cancer or gastric adenoma. However, ESD results in iatrogenic ulcers and postoperative bleeding from ulcers. This study aimed to evaluate the effect of using a proton pump inhibitor (PPI) alone, a PPI + rebamipide combination therapy, and an H2 receptor antagonist (H2RA) + rebamipide combination therapy on ulcer healing after ESD.Patients and MethodsA total of 204 patients who underwent ESD from April 2014 to July 2017 at Dong-A University Hospital were randomly assigned to the following groups: PPI-alone group, PPI + rebamipide combination therapy group, and H2RA + rebamipide combination therapy group. However, only 156 patients were studied since we excluded those who were lost to follow-up or had diseases other than early gastric cancer or gastric adenoma. Twenty-eight days after ESD, we evaluated the ulcer residual ratio, S stage rates, ulcer bleeding ratio, and gastric pH.ResultsThis study included 156 patients (PPI-alone group: 52 patients; PPI + rebamipide group: 52 patients; H2RA + rebamipide group: 52 patients). The ulcer residual ratios were 24.3 ± 14.2%, 17.0 ± 12.1%, and 21.0 ± 13.8% in the PPI alone, PPI + rebamipide, and H2RA + rebamipide groups, respectively (P = 0.048).ConclusionsPPI + rebamipide was more effective in reducing the ulcer residual ratio after ESD. There was no statistical difference in ulcer stage and delayed bleeding after ESD among the groups. These findings showed that PPI + rebamipide had limited benefits after ESD.     

消化性溃疡与幽门螺杆菌感染关系的中西医结合研究

经过纤维胃镜检查的３６１０例病人中有７７８例为消化性溃疡病人。对其中４０１例消化性溃疡病人胃窦部粘膜作了幽门螺杆菌（ＨＰ）检测、ＨＰ阳性者为３５６例，阳性率为８６．６％。与同期检测胃炎组阳性率５５．１％相比明显为高，差异显著。ＨＰ被认为是慢性胃窦炎的主要病因，也是消化性溃疡的重要致病因素。根除ＨＰ可提高ＤＵ治愈率，降低ＤＵ复发。ＨＰ阳性率在中医证型中表现为非脾虚组明显高于脾虚组，其中以脾胃湿热组最高。     

十二指肠球部溃疡患者球部黏膜白细胞介素-10、白细胞介素-12和干扰素-γ的水平及其临床意义

背景:溃疡病患者常出现各种细胞免疫和体液免疫障碍。目的:探讨细胞因子白细胞介素（IL）-10、IL-12和干扰素（IFN）-γ在十二指肠球部溃疡（DU）发生中的作用。方法:在奥美拉唑、克拉霉素、替硝唑一周三联疗法治疗之前和之后4～6周从DU患者的球部钳取轴膜组织,应用酶联免疫吸附测定（ELISA）检测IL-10、IL-12和IFN-γ的含量,并对照组进行比较。结果:一周三联疗法治疗前,DU患者球部劾膜的IL-10、IL-12和IFN-γ含量（17.983pg/ml±8.676pg/ml、44098 pg/ml±12.842 pg/ml±和82.373pg/ml±17.264pg/ml±）均显著高于对照组（85.99 pg/ml±4.147 pg/ml、17.550 pg/ml±5.980 pg/ml和26.298pg/ml±10.385 pg/ml,p<0.01）,且IL-10与IL-12的含量呈正相关（r=0.87,P<0.01）,IL-10与IFN-γ的含量也呈正相关（r=0.92,P<0.01）。治疗后,DU患者球部轴膜的IL-10IFN-γ含量均有所下降（17.289 pg/ml±3.939 pg/ml和27.030 pg/ml±3.753 pg/ml,P<0.01）,但IL-10的含量仍持续维持在较高水平（26.098 pg/ml±15.152 pg/ml,P<0.01）。结论:细胞因子IL-10、IL-12和IFN-γ可能在DU的发生机制中起重要作用。一周三联疗法治疗后,促炎症细胞因子IL-12和IFN-γ分泌得到有效抑制,而抗炎症细胞因子IL-10持续维待在较高水平,为黏     

雷贝拉唑联合硫糖铝治疗活动性胃溃疡78例

目的研究探讨雷贝拉唑联合硫糖铝治疗Hp感染活动期胃溃疡的临床疗效。方法选取2010年10月-2012年8月期间我院收治的活动性胃溃疡患者156例,随机分为观察组和对照组,各78例。第1周两组患者均接受标准3联疗法根除Hp,第2-8周观察组给予雷贝拉唑联合硫糖铝;对照组给予雷贝拉唑治疗。疗程结束后行胃镜及病理检查,随诊所有患者1年溃疡复发率。结果治疗8周后,两组患者的临床症状和溃疡情况均得到显著改善,组问差异无统计学意义（P〉O．05）;观察组在1年内的溃疡复发率（14．1％）明显低于对照组（35．9％）,差异有统计学意义（P〈0．05）。结论雷贝拉唑联合硫糖铝治疗活动胜胃溃疡安全有效,复发率低,值得临床推广应用。     

The efficacy and safety of Grafix® for the treatment of chronic diabetic foot ulcers: results of a multi‐centre,controlled, randomised,blinded, clinical trial

In a randomised, controlled study, we compared the efficacy of Grafix^®, a human viable wound matrix (hVWM) (N = 50), to standard wound care (n = 47) to heal diabetic foot ulcers (DFUs). The primary endpoint was the proportion of patients with complete wound closure by 12 weeks. Secondary endpoints included the time to wound closure, adverse events and wound closure in the crossover phase. The proportion of patients who achieved complete wound closure was significantly higher in patients who received Grafix (62%) compared with controls (21%, P = 0·0001). The median time to healing was 42 days in Grafix patients compared with 69·5 days in controls (P = 0·019). There were fewer Grafix patients with adverse events (44% versus 66%, P = 0·031) and fewer Grafix patients with wound‐related infections (18% versus 36·2%, P = 0·044). Among the study subjects that healed, ulcers remained closed in 82·1% of patients (23 of 28 patients) in the Grafix group versus 70% (7 of 10 patients) in the control group (P = 0·419). Treatment with Grafix significantly improved DFU healing compared with standard wound therapy. Importantly, Grafix also reduced DFU‐related complications. The results of this well‐controlled study showed that Grafix is a safe and more effective therapy for treating DFUs than standard wound therapy.