下肢静脉性溃疡中西医结合外治的护理研究

Study on the Nursing of Combination Method of Traditional Chinese Medicine and Western Medicine for Venous Leg Ulcer

目的探讨中医外治法联合伤口湿性愈合敷料治疗护理下肢静脉性溃疡的临床疗效。方法采用方便采样方式选择符合纳入标准的下肢静脉性溃疡患者60例,按随机数字表法分成常规外治组(30例)和中西医结合外治组(30例)。常规外治组伤口采用聚维酮碘软膏、伤口湿性愈合敷料换药,以及运用压力治疗的方案;中西医结合外治组在采用常规外治组的方案同时,配合中医艾灸法。随访3个月,记录治疗前及第10天后溃疡面积,疼痛评分、踝肱指数(ABI)、伤口痊愈时间等指标。结果两组在治疗前创面面积、ABI及疼痛评分上等一般资料无明显差异,经治疗第10天时观察中西医结合外治组在伤口面积、疼痛评分及ABI等指标明显优于常规组,差异有显著性(P<0.05),其愈合时间中西医结合外治组明显短于常规组(P<0.05),而ABI无显著性差异(P>0.05)。结论中医艾灸可以促进下肢血流动力学改善、缓解疼痛,中西医结合外治可以缩短下肢静脉性溃疡愈合时间,提高疗效。

Objective To explore the clinical effect of combination method of traditional Chinese and Western medicine in the treatment of venous leg ulcer （VLU）. Methods 60 patients diagnosed with VLU were randomly divided into two groups, with 30 cases in each group. The routine treatment group received the bacterial culture, cleaning and disinfection of bacterial culture, and filling with povidone-iodine ointment, covering moist healing dressings and pressure therapy. The combination treatment group accepted Moxibustion treatment in addition to treatments in routine treatment group. All cases were followed up for 3 months. The ulcer area, VAS, ankle-brachial index （ABI）, wound healing time before and 10 days after treatment were recorded. Results The differences of ulcer area, VAS and ABI before treatment between two groups were not statistically significant （P 〉0.05）. 10 day after treatment, the ulcer area, VAS and ABI in combination treatment group were superior to routine treatment group, with statistical significant differences （P 〈0.05）; the healing time of combination treatment group was obviously shorter than that of routine treatment group （P 〈0.05）; the difference of ABI was not statistically significant between two groups （P 〉0.05）. Conclusions Moxibustion can promote lower extremity hemodynamic improvement, inhibit bacterial infection and reduce leakage to accelerate wound healing.