综合疗法治疗难治性皮肤溃疡的临床研究

目的探索难治性皮肤溃疡治疗方法 ,为临床治疗此类疾病提供经验与方法。方法将120例我院门诊或住院收治的难治性皮肤溃疡患者随机分为微创清理创口配合激光及中药湿敷(联合治疗)组,微创清理创口配合激光(清创激光)组,微创清理创口配合硼酸湿敷(清创湿敷)组,每组40例,分别记录各组治疗前,治疗2、6周,随访8、12周"臁疮"评分、疗效指数、愈显率、皮肤病生活质量(DLQI)评分及不良反应和复查情况,对比各组的治疗效果。结果联合治疗组与清创激光组、清创湿敷组比较,治疗2、6周,随访8、12周,渗出、面积、疼痛,明显低于其他两组(P <0.05);清创激光组和清创湿敷组治疗2、6周,随访8、12周渗出、面积、疼痛无明显差异(P> 0.05)。联合治疗组治疗2、6周,随访8、12周,疗效均明显高于清创激光组和清创湿敷组(P均<0.05)。治疗2、6周,随访8、12周,联合治疗组DLQI评分显著低于清创激光组和清创湿敷组(P均<0.05)。三组患者不良反应及复查指标无明显差异(P均> 0.05)。结论西医清创配合激光及中医药、民族医药治疗难治性皮肤溃疡临床有优势,安全可靠,值得推广。

Clinical study of comprehensive therapy for refractory skin ulcer

Objective To study the treatment of refractory skin ulcer,and to provide experience and methods for clinical treatment of such diseases.Methods 120 patients with refractory skin ulcer were randomly divided into three groups:minimally invasive debridement combined with laser and traditional Chinese medicine wet compress(combined treatment group),minimally invasive debridement combined with laser(debridement laser group),minimally invasive debridement combined with boric acid wet compress(debridement wet compress group),40 cases of each group.The"dejection"score,efficacy index,more obvious rate,dermatosis quality of life(DLQI)score and adverse reactions and re-examination data were recorded before treatment,treatment for 2,6 weeks,and follow-up for 8,12 weeks,and compared the treatment effect between groups.Results Compared with the laser group and the debridement wet compress group,the exudation,lesion area and pain level of the combined treatment group were significantly lower than that of the laser group and the debridement wet compress group(P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,while there were no significant differences between the laser group and the debridement wet compress group.The curative effect of the combined treatment group was significantly higher than that of the debridement laser group and the debridement wet compress group(all P<0.05)after treatment for 2,6 weeks,and follow-up for 8,12 weeks,and also the DLQI score of combined treatment group was significantly lower than that of debridement laser group and debridement wet compress group(all P<0.05).There were no significant differences in adverse reactions and re-examination indexes among the three groups(all P >0.05).Conclusion Modern Western medicine debridement combined with laser,traditional Chinese medicine,and ethnic medicine has advantages in the treatment of refractory skin ulcer,and is safe and reliable,which is worthy of clinical promotion.