中医综合外治法联合环形激光治疗臁疮的临床疗效研究

A Clinical Study of the Combined Treatment for Ecthyma: Using Comprehensive External Treatment with Chinese Medicine and Endovenous Laser Ablation

目的探讨中医综合外治法联合环形激光治疗臁疮的临床疗效及1年随访结局,为临床治疗提供借鉴。方法选取2014年11月—2016年10月北京中医药大学东方医院收治的臁疮患者62例,根据治疗方案不同分为观察组30例,对照组32例。两组患者均给予西医常规治疗,观察组在此基础上给予中医综合外治法联合环形激光治疗。观察治疗前、治疗后1个月观察指标(分泌物、疮周红肿、创面不鲜、疼痛、皮肤瘙痒、下肢水肿、色素沉着、静脉反流发生情况),比较两组患者临床疗效,治疗后1年溃疡复发、下肢水肿、疼痛、皮肤瘙痒、静脉反流情况。结果治疗后1个月观察组患者分泌物多、疮面不鲜、疼痛、皮肤瘙痒、下肢水肿、色素沉着、静脉反流发生率低于对照组(P<0.05)。观察组临床疗效优于对照组(P<0.05)。治疗后1年观察组患者溃疡复发、下肢水肿、静脉反流发生率低于对照组(P<0.05)。结论中医综合外治法联合环形激光可通过减轻静脉反流、改善疮面及疮周湿热瘀阻等达到促进臁疮溃疡愈合、减少溃疡复发的目的。

Objective To evaluate the clinical outcome of ecthyma at one month,one year after treatment by comprehensive external treatment with Chinese medicine and endovenous laser ablation（ EVLA）,in order to provide a reference for clinical treatment of the disease. Methods Sixty-two cases were recruited from Dongfang Hospital,Beijing University of Chinese Medicine between November 2014 and October 2016 and divided into the treatment group（ 30 cases） and the control group（ 32 cases） based on the treatment regimen. Both groups were given regular western medicine treatment,the treatment group additionally received comprehensive external treatment with Chinese medicine and EVLA. The efficacy were examined by the ulcer area,status of secretion,the degree of red and swollen around ulcer,unhealthy granulation tissue,pain,itching,lower limb edema,pigmentation and venous reflux at one month after the treatment and the recurrence rate of ulcer,the degree of lower limb edema,pain,itching,and venous reflux at one-year follow-up after treatment. Results At one month after treatment,although patients in the treatment group exhibited significantly larger amount of secretion,they had smaller ulcer areas,and they were less likely to have unhealthy granulation tissue, pain, itching, lower limb edema, pigmentation and venous reflux compared with the control group（ P 0. 05）; the recurrence rate of ulcer,incidence of lower limb edema and venous reflux were significantly lower for the treatment group at one year after the treatment（ P 0. 05）,which indicated that better efficacy was achieved in the treatment group（ P 0. 05）. Conclusion The comprehensive external treatment with Chinese medicine and EVLA can promote ulcer healing and reduce the recurrence risk by reducing the damp-heat and blood stasis on and around ulcer as well as the degree of venous reflux.