止痛生肌散联合生肌象皮膏治疗下肢静脉性溃疡疗效研究

目的:探究止痛生肌散联合生肌象皮膏治疗下肢静脉性溃疡(气虚血瘀型)疗效及对患者创面愈合和血清基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制因子-1(TIMP-1)表达的影响。方法:随机抛掷硬币方式将116例确诊为气虚血瘀型下肢静脉性溃疡患者分为两组。对照组使用清创、去除坏死分泌物、凡士林纱条外敷等常规治疗,治疗组在此基础上采用止痛生肌散联合生肌象皮膏治疗,均治疗4周。观察比较两组临床效果、中医证候积分、创面愈合(创面愈合时间、创面面积减小率)、血清指标(MMP-3、TIMP-1)、创面肉芽组织生长情况及不良反应。结果:治疗4周后,治疗组总有效率为91.38%,对照组为77.59%,治疗组优于对照组(P<0.05); 治疗4周后,两组患者各项中医症候积分、MMP-3、TIMP-1水平均较治疗前下降(P<0.05); 治疗4周后,治疗组创面愈合时间较对照组明显更短(P<0.05),而创面面积减小率较对照组明显更高(P<0.05); 治疗4周后,两组患者创面肉芽组织生长较治疗前均更优(P<0.05),且治疗组较对照组更优(P<0.05); 治疗过程中,治疗组应用止痛生肌散后出现不同程度的疼痛,平均持续20 min。结论:止痛生肌散联合生肌象皮膏治疗气虚血瘀型下肢静脉性溃疡疗效理想,可降低MMP-3、TIMP-1表达,促进创面愈合。

Efficacy of Zhitong Shengji powder combined with Shengji Xiangpi ointment in the treatment of lower limb venous ulcers

Objective:To explore the efficacy of Zhitong Shengji powder combined with Shengji Xiangpi ointment in the treatment of lower limb venous ulcers(Qi deficiency and blood stasis type)and its effects on wound healing and expressions of serum matrix metalloproteinase-3(MMP-3)and tissue inhibitor of metalloproteinase-1(TIMP-1).Methods:Totally 116 patients diagnosed as lower limb venous ulcers of Qi deficiency and blood stasis type were divided into two groups according to the random coin tossing method.Control group received conventional treatments such as debridement,removal of necrotic secretions and topical application of vaseline gauze,and treatment group was given Zhitong Shengji powder combined with Shengji Xiangpi ointment on this basis,and all the patients were treated for 4 weeks.The clinical effects,TCM syndromes scores,wound healing(wound healing time,wound area reduction rate),serum indicators(MMP-3,TIMP-1),wound granulation tissue growth and adverse reactions were observed and compared between the two groups.Results:After 4 weeks of treatment,the total effective rate of treatment group was better than that of control group(91.38% vs. 77.59%,P<0.05).After 4 weeks of treatment,the scores of TCM syndromes and levels of MMP-3 and TIMP-1 in the two groups were lower than those before treatment(P<0.05).After 4 weeks of treatment,the wound healing time of treatment group was significantly shorter than that of control group(P<0.05),and the reduction rate of wound area was significantly higher than that of control group(P<0.05).After 4 weeks of treatment,the growth of wound granulation tissue in the two groups was better than that before treatment(P<0.05),and the growth of treatment group was better than that of control group(P<0.05).During treatment,treatment group experienced different degrees of pain after applying Zhitong Shengji powder,which lasted for 20 min on average.Conclusion:Zhitong Shengji powder combined with Shengji Xiangpi ointment has an ideal efficacy on lower limb venous ulcers of Qi deficiency and blood stasis type.It can reduce the expressions of MMP-3 and TIMP-1 and promote wound healing.