自拟益气养血生肌汤联合弹力袜治疗下肢静脉溃疡的疗效观察

Therapeutic effects of self-made Yiqiyangshengshengji decoction combined with elastic socks on lower extremity venous ulcer

目的观察中药汤剂(自拟益气养血生肌汤)联合弹力袜治疗下肢静脉溃疡的临床疗效,并分析其作用机制。方法选择2015年1月至2016年3月就诊的下肢静脉溃疡患者62例,随机分为观察组和对照组,每组31例。2组患者均采取非手术方式进行治疗,对照组给予0.9%氯化钠溶液外敷,同时运用压力治疗(弹力袜)的方案;观察组在此基础上给予自拟中药汤剂益气养血生肌汤(当归15 g,黄芩15 g,羌活15 g,茵陈30 g,苦参15 g,人参15 g,升麻15 g,葛根15 g,白术15 g,苍术15 g,泽泻15 g,猪苓15 g,知母15 g,防风15 g,甘草10 g,生黄芪60 g,牛膝15 g)1剂/d,水煎200 ml,早晚分2次口服。结果2组患者临床治疗效果比较观察组与对照组患者的治疗总有效率分别为96.77%与67.74%,差异有统计学意义(P<0.05)。经弹力袜加中药益气活血生肌汤联合治疗后,在离院前发放满意度调查表,从治疗时长和治疗效果两方面进行评价,比较2组患者满意程度,分满意、一般、不满意三种,由患者填写,回收后比较2组间的差别。观察组患者总满意率(93.54%)较对照组(48.38%)明显提高,差异有统计学意义(P<0.05)。全部溃疡愈合患者中2组共有40例获得半年随访,39例获得1年随访。观察组中半年(7.69%)和1年(11.5)溃疡复发率均明显低于对照组(64.3%,84.6%),差异有统计学意义(P<0.05)。结论对下肢静脉性溃疡患者采取加压治疗联合中药汤剂(自拟益气养血生肌汤)口服能够促进创面愈合,临床疗效显著,值得推广。

Objective To observe the therapeutic effects of self-made Yiqiyangshengshengji decoction combined with elastic socks on lower extremity venous ulcer,and to explore its action mechanism.Methods A total of 62 patients with lower extremity venous ulcer who were treated in our hospital from January 2015 to March 2016 were randomly divided into observation group(n=31)and control group(n=31).The patients in both groups were treated by non-surgical methods.The patients in control group were treated by 0.9%sodium chloride solution external application combined with elastic socks,however,the patients in observation group,on the basis of control group,were treated by Yiqiyangshengshengji decoction(Angelica 15g,Scutellaria 15g,notopterygium 15g,wormwood 30g,Sophora flavescens 15g,ginseng 15g,Cimicifuga 15g,Pueraria 15g,Atractylodes macrocephala 15g,Alisma 15g,Polyporus umbellatus 15g,Anemarrhena 15g,Fangfeng 15g,liquorice 10g,raw Astragalus 60g,Achyranthes bidentata 15g)1 dose a day,water decoction 200ml,twice oral in the morning and evening.Results There were significant difference in the total effective rates between the two groups(96.77%vs 67.74%,P<0.05).According to the satisfaction degree questionnaire,the total satisfaction rate in observation group was 93.54%,which was significantly higher than that(48.38%)in control group(P<0.05).A total 40 patients whose ulcer was healed in both groups were followed up for half a year,and the other 39 patients were followed up for one year.The recurrence rate of ulcer in observation group in the middle half year was 7.69%,which in the first year was 11.5,which were significantly lower than those(64.3%,84.6%)in control group(P<0.05).Conclusion The combination application of pressure therapy and self-made Yiqiyangshengshengji decoction can promote wound healing in patients with lower extremity venous ulcer,which has significant clinical effects,therefor,it is worth popularizing in clinical practice.