复方黄柏液蜡疗治疗不同分期下肢血栓性静脉炎的疗效及对血清炎症因子的影响

Efficacy of compound cortex phellodendron solution wax therapy in the treatment of thrombophlebitis of the lower extremities in different stages and its effect on serum inflammatory factors.

目的探讨复方黄柏液蜡疗治疗不同分期下肢血栓性静脉炎(THLE)的疗效及对血清炎症因子的影响。方法将2020年1月至2021年11月河北省中医院收治的155例THLE患者纳入本次回顾性研究,根据治疗方案不同将其分为研究组(n=105)和对照组(n=50),两组患者基于分期不同又分为3个亚组(Ⅰ组、Ⅱ组、Ⅲ组)。研究组患者接受复方黄柏液蜡疗治疗,对照组患者接受50%硫酸镁湿敷治疗,治疗持续10 d。分别对研究组和对照组、不同分期亚组临床症状评分改善情况、血清炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)]的变化、临床疗效和两组复发情况进行对比。结果研究组治疗后的皮肤色红、患肢肿胀、患肢疼痛和硬索结节积分分别为(1.11±0.22)、(1.15±0.20)、(1.14±0.29)、(1.20±0.20)分,均较对照组[(1.60±0.25)、(1.52±0.24)、(1.59±0.27)、(1.85±0.24)分]显著下降,差异均有统计学意义(P<0.05);研究组不同分期患者症状积分下降值存在显著差异,其中以Ⅲ期患者下降最为明显,差异有统计学意义(P<0.05)。研究组治疗结束后的血清CRP、IL-6、TNF-α分别为(1.94±0.58)mg/L、(125.48±6.88)ng/mL和(1.32±0.07)g/L,均较对照组[(2.86±0.69)mg/L、(134.70±7.09)ng/mL、(1.51±0.08)g/L]显著下降,而血清IL-10为(22.85±3.02)ng/mL,较对照组[(17.32±2.80)ng/mL]显著上升,差异均有统计学意义(P<0.05);研究组中不同分期患者治疗后的血清CRP、IL-6、TNF-α、IL-10下降值或上升值存在显著差异,且Ⅲ期患者下降值或上升值最大,差异有统计学意义(P<0.05)。研究组的临床疗效优于对照组(总有效率:97.14%vs.88.00%),差异有统计学意义(P<0.05);研究组中不同分期患者的临床疗效差异也具有统计学意义(P<0.05)。研究组随访6个月的复发率为1.9%,较对照组(10.0%)显著下降,差异有统计学意义(P<0.05)。结论复方黄柏液蜡疗治疗不同分期THLE的疗效均良好,可显著改善患者的临床症状,抑制炎症反应,且能降低复发率。

Objective To investigate the clinical efficacy of compound cortex phellodendron solution wax therapy in the treatment of thrombophlebitis of the lower extremities(THLE)in different stages and its effect on serum inflammatory factors.Methods A total of 155 patients with treated in Hebei Hospital of Traditional Chinese Medicine from January 2020 to November 2021 were enrolled in the retrospective study,and were divided into study group(n=105)and control group(n=50)according to different treatment methods,and patients in the two groups were divided into 3 subgroups(groupⅠ,ⅡandⅢ).The patients in the study group received compound cortex phellodendron solution wax therapy,and the patients in the control group received 50%magnesium sulfate wet compress treatment for 10 days.The improvement of clinical symptom scores,the changes of serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)],clinical efficacy of study group and control group,patients with different stages of study group and control group,patients with different stages,recurrence of study group and control group were compared.Results After treatment,the skin redness score,limb swelling score,limb pain score and hard cord nodule score in the study group were(1.11±0.22),(1.15±0.20),(1.14±0.29)and(1.20±0.20)pionts,respectively,which were evidently lower than those in the control group[(1.60±0.25),(1.52±0.24),(1.59±0.27)and(1.85±0.24)pionts],the differences were statistically significant(P<0.05);there were significant differences in the decrease of symptom scores among patients with different stages in the study group,especially in patients withⅢstage.After treatment,the levels of serum CRP,IL-6 and TNF-αin the study group were(1.94±0.58)mg/L,(125.48±6.88)ng/mL and(1.32±0.07)g/L,respectively,which were dramatically lower than those in the control group[(2.86±0.69)mg/L,(134.70±7.09)ng/mL,(1.51±0.08)g/L],while the level of serum IL-10 was(22.85±3.02)ng/mL,which was dramatically higher than that in the control group[(17.32±2.80)ng/mL],the differences were statistically significant(P<0.05).In the study group,there were significant differences on the decrease or increase of serum CRP,IL-6,TNF-αand IL-10 in different stages after treatment,and the decrease or increase of serum CRP,IL-6,TNF-αand IL-10 was the highest in patients withⅢstage.The clinical efficacy of the study group was better than that of the control group(total effective rate:97.14%vs.88.00%),the difference was statistically significant(P<0.05).There were significant differences on clinical efficacy among patients of different stages in the study group(P<0.05).The recurrence rate of the study group was 1.90%after follow-up for 6 months,which was lower than that of the control group(10.00%),the difference was statistically significant(P<0.05).Conclusion Compound cortex phellodendron solution wax therapy is effective in the treatment of THLE,significantly improve the clinical symptoms,inhibit inflammatory reaction and reduce the recurrence rate,and its effect is better for stage I andⅡpatients.