29例麻风继发性溃疡临床特点及外治体会

Clinical Features and External Treatment Experience of Leprosy Recuperators Secondary Ulcers for 29 Cases

目的分析麻风继发性溃疡临床特点,总结外治体会,为其诊治提供参考。方法收集大连市皮肤病医院2018年6月至2019年6月期间发生继发性溃疡的麻风患者临床资料进行分析,总结治疗体会。结果 29例患者单纯性溃疡14例,复杂性溃疡15例;外伤导致者19例,占比65.5%;所有病例均有营养障碍和压力性病因。继发性溃疡共36处,分布于足部27处,占比88.8%。治疗以中西医结合辨证外治为主,辅助健脾补虚的饮食。单纯性溃疡治愈率100%。复杂性溃疡治愈率66.7%,好转率20%,无效13.3%。结论大连市皮肤病医院麻风患者继发性溃疡最常见于足部,多由外伤导致。预防足部外伤是前提,而改善营养障碍和受压是治疗的关键。采用中西医结合的辩证外治法使患者受益。

Objective To analyze the clinical characteristics of le prosy secondary ulcer, to summarize the experience of external treatment, and to provide reference for its diagnosis and treatment. Methods Clinical data of leprosy patients in Dalian Dermatosis Hospital from June 2018 to June 2019 were collected for analysis, treatment experience was summarized, and literature was reviewed.Results There were 14 cases of simple ulcer and 15 cases of complex ulcer in 29 patients. 19 cases were traumatized, accounting for65.5%. All cases had nutritional disorders and stressors. There were 36 lesions, of them, 27 in the foot, accounting for 88.8 %. The treatment was based on TCM syndrome differentiation and external treatment, supplemented by the diet of spleen strengthening and deficiency, and combined with western medicine. The cure rate of simple ulcer was 100 %. The cure rate of complex ulcer was66.7%, the good rate was 20%, and the ineffective rate was 13.3%. Conclusion In our hospital, secondary ulcer of leprosy patients is most common in the foot, and most caused by trauma. Prevention of foot injury is the premise, while improving nutritional disorders and stress is the key to treatment. The external treatment of integrated traditional Chinese and Western medicine benefits patients.