三黄散外敷治疗犬伤伤口感染肿痛的临床效果

Clinical effect on external application of Sanhuang Powder in treating swelling and pain of dog wound infection

目的探讨三黄散外敷治疗犬伤伤口感染肿痛的临床效果。方法选取2018年10月—2020年10月于鲤城区江南医院犬伤门诊就诊的66例犬伤患者,根据随机数字表法分为对照组和治疗组,其中对照组按规范进行常规伤口处置并口服抗生素治疗,每日3次,连续用药2周;治疗组在对照组基础上外敷三黄散,隔日1次,共治疗7次。比较两组治疗前后血清C反应蛋白(CRP)、白细胞计数(WBC)、红细胞沉降率(ESR)、视觉模拟评分(VAS)、伤口肿胀程度、创面面积及治疗后细菌培养转阴率、创面愈合时间、临床疗效。结果犬咬伤感染伤口细菌培养发现主要以未分类的革兰氏阴性杆菌和厌氧菌(混合感染时出现)、金黄色葡萄球菌、链球菌属、犬属巴斯菌、奈瑟菌属、腐生葡萄球菌、表皮葡萄球菌为主。治疗组治疗后细菌培养转阴率高于对照组(P<0.05)。治疗后,两组CRP、WBC、ESR水平及VAS评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组伤口肿胀程度及创面面积均小于治疗前,且治疗组小于对照组,差异有统计学意义(P<0.05)。治疗组创面愈合时间短于对照组,差异有统计学意义(P<0.05)。治疗组治疗后总有效率、愈显率均高于对照组,差异有统计学意义(P<0.05)。结论三黄散外敷对犬咬伤伤口为多成分、多环节、多靶点的治疗,能消肿止痛,促进创面愈合,缩短治疗时间,简便效廉,值得临床推广。

Objective To explore the clinical effect on external application of Sanhuang Powder in treating swelling and pain of dog wound infection.Methods Sixty-six patients with dog injury treated in Dog Injury Clinic of Jiangnan Hospital of Licheng District from October 2018 to October 2020 were selected and divided into control group and treatment group according to the random number table method.Control group received routine wound treatment and oral antibiotic treatment according to the standard,three times a day for two weeks;On the basis of control group,treatment group was treated with Sanhuang Powder once every other day for seven times.Serum C-reactive protein(CRP),white blood cell count(WBC),erythrocyte sedimentation rate(ESR),visual analogue scale(VAS),wound swelling degree and wound area before and after treatment,and negative rate of bacterial culture,wound healing time and clinical effect after treatment were compared between two groups.Results The bacterial culture of dog bite infection wound was mainly composed of unclassified Gram-negative bacilli and Anaerobic bacteria(appearing in mixed infection),Staphylococcus aureus,Streptococcus,Basiella canis,Neisseria,Staphylococcus saprophyticus and Staphylococcus epidermidis.The negative rate of bacterial culture in treatment group was higher than that in control group(P<0.05).After treatment,the levels of CRP,WBC,ESR and VAS in two groups were lower than those before treatment,and treatment group was lower than that control group,the differences were statistically significant(P<0.05).After treatment,the degree of wound swelling and wound area in two groups were less than those before treatment,and treatment group was less than that control group,the differences were statistically significant(P<0.05).The wound healing time in treatment group was shorter than that in control group(P<0.05).Total effective rate and good improvement rate in treatment group were higher than those in control group(P<0.05).Conclusion The external application of Sanhuang Powder is a multi-component,multi link and multi-target treatment for dog bite wounds.It can reduce swelling and pain,promote wound healing and shorten the treatment time of patients.It is simple,effective and cheap.It is worthy of clinical promotion.