木豆叶煎液外洗治疗四肢创伤创面的临床观察

目的：观察木豆叶煎液外洗治疗四肢软组织缺损的临床疗效.方法：将226例软组织缺损患者随机分为2组,每组113例.清创结束后,治疗组用木豆叶煎液外洗处理创面,对照组用5%呋喃西林溶液处理创面.每日2次.观察2组患者的创面愈合率、创面愈合时间、创面分泌物细菌培养结果及临床疗效.结果：①创面愈合率.治疗后不同时间患者的创面愈合率的差异总体上有统计学意义,即存在时间效应（F=111.562,P=0.000）;2组患者治疗后不同时间创面愈合率的组间差异总体上有统计学意义,即存在分组效应（F=1757.082,P=0.000）,治疗组各时间点创面愈合率均高于对照组（54.43±24.77）,（42.96±19.99）,t=5.171,P=0.006;（83.74±13.79）,（55.81±21.59）,t=15.746,P=0.000;（94.07±9.28）,（65.37±21.80）,t=17.163,P=0.000;（97.49±6.16）,（77.75±20.76）,t=13.875,P=0.000];时间因素和分组因素存在交互效应（F=188.500,P=0.003）.②创面愈合时间.治疗组创面愈合时间比对照组短,差异有统计学意义（33.47±7.22）,（43.37±11.39）,t=-11.692,P=0.008].③创面分泌物细菌培养结果.治疗前2组患者创面分泌物细菌培养阳性率比较,差异无统计学意义（χ2=0.398,P=0.528）,治疗开始后1周、2周、3周、4周治疗组创面分泌物细菌培养阳性率均低于对照组,差异有统计学意义（χ2=33.275,P=0.000;χ2=20.884,P=0.000;χ2=11.760,P=0.001;χ2=7.706,P=0.006）.④临床疗效.治疗组治愈88例、显效23例、有效2例,对照组治愈12例、显效45例、有效39例、无效17例.治疗组疗效优于对照组（u=1 474.500,P=0.000）.结论：木豆叶煎液能提高创面愈合率,缩短创面愈合时间,抑制创面细菌繁殖,可有效促进四肢软组织创伤创面的愈合.

Therapeutic effect of cajanus leaf decoction washing on the treatment of wound surfaces in the limbs

Objective：To observe the clinical effects of cajanus leaf decoction washing on the treatment of soft tissue defects in the limbs. Methods：Two hundred and twenty-six patients with soft tissue defects were randomly divided into treatment group and control group, 113 cases in each group. After debridement, the patients in treatment group were treated with cajanus leaf decoction washing, while the oth- ers in control group were treated with 5 % nitrofurazone solution washing,2 times a day. Then the wound healing rate, healing time, wound secretion germieuhure result and clinical effects were observed between the 2 groups. Results：In general,there was statistical difference in wound healing rate among time points（ F = 111. 562, P = 0. 000）, in other words, there was time effect. There was statistical difference in wound healing rate between the 2 groups in general（ F = 1757. 082, P = 0. 000） , in other words, there was group effect. The wound healing rate of treatment group was higher than that of control group at each time points （ （54.43 ＋/- 24.77 ）, （42.96 ＋/- 19.99 ）, t = 5. 171, P = 0.006; （83.74 ＋/- 13.79）, （55.81 ＋/-21.59） ,t = 15. 746,P =0.000; （94.07 ＋/-9.28）, （65.37 ＋/-21.80） ,t = 17. 163 ,P =0.000; （97.49 ＋/- 6.16）, （ 77.75 ＋/- 20.76 ）, t = 13. 875, P = 0. 000 ）. There was interaction between time factor and grouping factor （ F = 188. 500,P = 0. 003 ）. The wound healing time of treatment group was shorter than that of control group, and there was statistical difference between the 2 groups （ （ 33.47 ＋/- 7.22 ）, （43.37 ＋/- 11.39 ）, t = - 11. 692, P = 0. 008 ）. There was no statistical difference in the germi- culture positive rate of wound secretion between the 2 groups before treatment （X2 = 0. 398, P = 0. 528 ）, the germiculture positive rate of wound secretion in treatment group was lower than that of control group 1 week, 2 weeks, 3 weeks and 4 weeks after treatment, and there were statistical differences between the 2 groups （X2 = 33. 275, P = 0. 000 ;X2 = 20. 884, P = 0. 000 ;X2 = 11. 760, P = 0. 001 ;X2 = 7. 706, P = 0. 006 ）. Eighty-eight patients obtained an excellent clinical curative effects ,23 good, and 2 fair in the treatment group ; while 12 patients obtained an excellent clinical curative effects ,45 good ,39 fair, and 17 poor in the control group. The treatment group surpassed the control group in the total curative effect （ u = 1 474. 500, P = 0. 000 ）. Conclusion： The therapy of cajanus leaf decoction washing can im- prove wound healing rate, shorten the wound healing time, inhibit wound bacteria breeding, so it can promote the wound healing of soft tissue in the limbs effectively.