中药熏洗联合泡沫硬化剂治疗大隐静脉曲张合并下肢溃疡的临床观察

Clinical observation of Chinese herbs fumigating and washing combined with foam sclerosing agent in the treatment of varicose great saphenous vein complicated with lower limb ulcer

目的观察中药熏洗(溃疡洗剂)联合泡沫硬化剂(聚多卡醇)治疗大隐静脉曲张合并下肢溃疡的临床疗效。方法将50例大隐静脉合并下肢溃疡的病人随机分成两组,对照组和治疗组各25例。治疗组在常规抗炎(青霉素800U、血栓通2支)和口服静脉活性药物(迈之灵)的基础上,溃疡疮面给予中药熏洗(溃疡洗剂)14d后,在超声辅助下用泡沫硬化剂(聚多卡醇)行浅表静脉硬化治疗;对照组治疗方法同上,仅将中药熏洗溃疡创面变为外科常规换药,用生理盐水(0.9%生理盐水100ml加10%生理盐水10ml两支)冲洗。结果经过中药熏洗联合泡沫硬化剂治疗后,术后3d、7d、14d治疗组的治愈率分别为78.26%、82.61%、91.30%,对照组的治愈率分别为36.37%、54.55%、86.36%,治疗组的治愈率明显优于对照组,尤其在治疗后3d和7d时的差异具有统计学意义(P<0.05)。结论中药熏洗联合泡沫硬化剂治疗大隐静脉曲张合并下肢溃疡病人康复周期短,效果明显,有一定的优势,在临床上值得推广应用。

Objective To observe the clinical efficacy of Chinese herbs fumigating and washing（ulcerative lotion）combined with foam sclerosing agent（polidocanol）in the treatment of varicose great saphenous vein complicated with lower limb ulcer. Methods 50 patients with varicose great saphenous vein complicated with lower limb ulcer were randomly divided into two groups：control group（n =25）and treatment group（n =25）.In the treatment group,after 14 days of fumigating and washing of Chinese herbs（ulcerative lotion）on ulcer wound,superficial venous sclerotherapy was done with ultrasound assisted using foam sclerosing agent（polidocanol）on the basis of routine anti-inflammation（penicillin 800 U,2 Xueshuantong）and oral intravenous active drugs（Maizhiling）.The control group were treated with the same method as the treatment group,only fumigating and washing of Chinese herbs for ulcer wound was changed into surgical routine dressing,and washed with saline（100 ml of 0.9% saline＋two 10 ml of 10%saline）. Results After treating with Chinese herbs fumigating and washing combined with foam sclerosing agent,the cure rate of the treatment group was respectively78.26% and 82.61% and 91.30%at the third,seventh and fourteenth day after treatment,and that of the control group was 36.37%,54.55% and 86.36%,respectively.The cure rate of the treatment group was significantly better than that of the control group,especially at the third and the seventh day after treatment,difference was statistically significant（P〈 0.05）. Conclusion Chinese herbs fumigating and washing combined with foam sclerosing agent for patients with varicose great saphenous vein complicated with lower limb ulcer has short rehabilitation period,obvious effect and certain advantages,which is worthy of popularization and application in clinical pratice.