生肌象皮膏治疗慢性难愈性溃疡临床疗效及初步机制

Effect Observation and Preliminery Mechanism Exploration of Shengji Corium Elephatis Mastic in Treating Chronic Refractory Skin Ulcer

目的观察生肌象皮膏治疗慢性难愈性溃疡的临床效果,并分析其初步机制。方法将处于生肌收口期的慢性难愈性溃疡患者62例随机分为2组,治疗组(32例)采用生肌象皮膏换药,对照组(30例)采用凡士林纱条换药,治疗4周。观察愈合率、创面缩小情况及创面分泌物中血管内皮生长因子(VEGF)含量。结果 2组痊愈率、总有效率比较,差异有统计学有意义(P<0.05)。治疗2周时,治疗组创面平均缩小82.31%,对照组为66.32%;治疗4周时,治疗组创面平均缩小90.35%,对照组为78.7%。2组比较差异有统计学意义(P<0.05)。换药1、2、3周时,治疗组分泌物中VEGF含量与对照组比较差异有统计学意义(P<0.05)。结论生肌象皮膏能促进慢性难愈性创面愈合,可能与其增加创面VEGF表达而促进创面修复有关。

Objective To observe the effect of Shensi corium elephatis mastic in treating chronic refractory skin ulcer, and analyze its preliminary mechanism. Methods Totally 62 patients with chronic refractory skin ulcer in granulation stage were randomly divided into two groups, 32 cases of treatment group were treated with Shengji corium elephatis mastic, and 30 cases of control group were treated with Vaseline gauze. All patients were treated for 4 weeks. The rate of wound healing, wound reduction ratio and wound secretion level of VEGF were observed, Results The cure rate and the total effective rate between the two groups had significant difference （P〈0.05）. After 2 weeks treatment, the mean wound reduction area of treatment group and control group was 82.31% and 66.32% respectively. After 4 weeks treatment, the mean wound reduction area of treatment group and control group was 90.35% and 78.7% respectively, the difference was statistically significant （P〈0.05）. After 1, 2 and 3 weeks treatment, the treatment group had significant difference with the control group in wound secretion VEGF level （P 〈 0.05）. Conclusion Shengji corium elephatis mastic can promote wound healing of chronic refractory skin ulcer. The possible mechanism is that Shengji corium elephatis mastic promotes the generation of VEGF in wound thus promotes wound repair.