解毒利湿汤治疗下肢疮疡58例

Fifty-Eight Cases of Lower Limb Sores Treated with Decoction for Detoxification and Removing Dampness

目的:观察解毒利湿汤治疗下肢疮疡患者的临床疗效。方法:将120例下肢疮疡患者按照随机数字表法分为对照组62例和观察组58例。对照组给予五水头孢唑啉钠治疗,观察组在对照组治疗的基础上给予解毒利湿汤治疗。比较两组患者的临床疗效、创面愈合时间及治疗前后中医证候积分、下肢疮疡创面面积变化情况,检测两组患者治疗前后单核细胞/趋化蛋白-1(monocytes chemotactic proteina-1,MCP-1)、正常T细胞表达和分泌因子(Reduced upon activation nornal T cell expressed andsecreted,RANTES)水平、白细胞介素(interleukin,IL)-4、IL-6、IL-10、γ干扰素(interferon-γ,IFN-γ)、外周血T淋巴细胞亚群CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平。结果:观察组有效率为96.77%,对照组有效率为84.48%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分、MCP-1、RANTES、IL-4、IL-6、IL-10、CD8^(+)水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后创面面积小于本组治疗前,且治疗后观察组小于对照组,差异具有统计学意义(P<0.05);观察组愈合时间短于对照组,差异具有统计学意义(P<0.05)。两组患者IFN-γ、CD4^(+)、CD4^(+)/CD8^(+)水平高于本组治疗前,治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。结论:解毒利湿汤治疗下肢疮疡患者,可促进患者创面愈合,降低炎性因子与趋化因子表达,提高免疫功能。

Objective:To observe the clinical curative effect of Decoction for Detoxification and Removing Dampness on lower limb sores.Methods:A total of 120 patients with lower limb sores were randomly divided into the control group with 62 cases and the observation group with 58 cases respectively.The control group was treated with cefazolin sodium pentahydrate,while the observation group was additionally treated with Decoction for Detoxification and Removing Dampness on the basis of the treatment of the control group.The clinical efficacy,wound healing time,the changes of TCM syndrome score and wound area of lower limb sores before and after treatmentwere compared between the two groups.The levels of monocytes/chemotactic protein-1(MCP-1),reduced upon activation normal T cell expression and secreted(RANTES),interleukin(IL)4,IL-6,IL-10,γinterferon-γ(IFN-γ),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)levels of peripheral blood T lymphocyte subsets before and after treatment were tested.Results:The effective rate was 96.77%in the observation group and 84.48%in the control group.There was significant difference between the two groups(P<0.05).After treatment,the TCM syndrome score,MCP-1,RANTES,IL-4,IL-6,IL-10 and CD8^(+)levels of the two groups were lower than those of the same group before treatment,and the above indexes of the observation group were lower than those of the control group after treatment,and all the differences were statistically significant(P<0.05).The wound area of the two groups after treatment was smaller than that of the same group before treatment,and the wound area of the observation group after treatment was smaller than that of the control group,and the difference was statistically significant(P<0.05);the healing time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05);The levels of IFN-γ,CD4^(+),CD4^(+)/CD8^(+)in both groups were higher than those of the same group before treatment,and the above indexes of the observation group were higher than those of the control group after treatment,and all the differences were statistically significant(P<0.05).Conclusion:Decoction for Detoxification and Removing Dampness can promote wound healing,reduce the expression of inflammatory factors and chemokines,and improve immune function.