象皮生肌膏治疗慢性难愈性皮肤溃疡

Clinical observation of elephantiasis myogenic cream for treatment of chronic refractory skin ulcer

目的 评价象皮生肌膏治疗慢性难愈性皮肤溃疡的疗效。方法 将符合入选标准的91例慢性难愈性皮肤溃疡患者,采用随机数字表法分为对照组45例和治疗组46例。对照组予以常规清创换药治疗,治疗组予以象皮生肌膏换药治疗。2组均连续治疗4周。采用ELISA法检测成纤维细胞生长因子-2(fibroblast growth factor-2, FGF-2)、VEGF及纤维连接蛋白(fiber connection, Fn)水平,采用VAS量表评估创面疼痛程度,记录溃疡创面愈合时间,评价临床疗效。结果 治疗组总有效率为87.0%(40/46)、对照组为66.7%(30/45),2组比较差异有统计学意义(χ^2=5.275,P=0.022)。治疗后2、4周,治疗组VAS评分均低于对照组(t值分别为10.456、12.266,P值均<0.01)。治疗组治疗后溃疡愈合时间较对照组缩短(t=2.911,P=0.002)。治疗后,治疗组创面分泌物FGF-2[(7.72±0.58)ng/ml比(6.37±0.50)ng/ml,t=11.881]、VEGF[(24.85±5.63)ng/ml比(18.75±4.51)ng/ml,t=5.697]及Fn[(4.15±0.42)ng/ml比(3.47±0.38)ng/ml,t=8.093]水平高于对照组(P<0.01)。结论 象皮生肌膏可缓解慢性难愈性皮肤溃疡患者的创面疼痛,促进溃疡创面愈合,提高临床疗效。

Objective To explore clinical efficacy of elephantiasis myogenic cream for treatment of chronic refractory skin ulcer. Methods A total of 91 chronic refractory skin ulcer patients were randomized into the treatment group (n=46) and the control group (n=45) by random number table method. Patients of control group were treated with conventional debridement, while the treatment group were treated with elephantiasis myogenic cream. The two groups were treated for 4 weeks. Clinical curative effect was evaluated after treatment. The pain score at the times of debridement and ulcer wound healing time of the two groups were compared. The FGF-2, VEGF and fiber connection (Fn) of wound secretion of the two groups before and after treatment were compared. Results Total effective rate of treatment group was 87.0% (40/46), which was significantly higher than the control group 66.7% (30/45), and the difference was statistically significant (χ^2=5.275, P=0.022). The pain score at the time of 2 w and 4 w after treatment in the treatment group were significantly lower than those in the control group (t value were 10.456, 12.266, all Ps<0.01). After treatment, ulcer wound healing time in the treatment group were significantly lower than those in the control group (t=2.911, P=0.002). After treatment, the FGF-2 (7.72 ± 0.58 ng/ml vs. 6.37 ± 0.50 ng/ml, t=11.881), VEGF (24.85 ± 5.63 ng/ml vs. 18.75 ± 4.51 ng/ml, t=5.697) and Fn (4.15 ± 0.42 ng/ml vs. 3.47 ± 0.38 ng/ml, t=8.093) of wound secretion in the treatment group were significantly higher than those in the control group (P<0.05). There were no serious adverse reaction of the two groups during treatment. Conclusions The elephantiasis myogenic cream for treatment of chronic refractory skin ulcer has a good efficacy and low adverse reactions, can relieve patients' pain, improve the wound heal, reduce heal times.