三黄消炎方结合银敷料湿性换药治疗糖尿病足感染(多重耐药菌)临床观察

Clinical Observation of Sanhuang Xiaoyan Prescription(三黄消炎方)Combined with Wet Dressing Change of Silver Dressing in Treatment of Diabetic Foot Infection(Multiple Drug Resistant Bacteria)

目的观察三黄消炎方结合银敷料湿性换药治疗糖尿病足感染(多重耐药菌)临床效果。方法研究纳入86例糖尿病足感染(多重耐药菌)患者(2019年12月—2021年6月收治),将患者以随机数字表法分成对照组与观察组,各43例,对照组患者银敷料湿性换药治疗治疗,观察组患者三黄消炎方结合银敷料湿性换药治疗。观察疗效、治疗前后中医证候(创面疼痛、溃破腐烂、皮肤暗紫、身热口干、便秘溲赤等)积分变化及创面面积变化、白细胞介素-1(IL-1)和肿瘤坏死因子-α(TNF-α)的水平变化、不良反应。结果观察组有效率为93.02%(40/43),对照组为76.74%(33/43),观察组有效率更高(P<0.05);治疗前,两组患者中医证候(创面疼痛、溃破腐烂、皮肤暗紫、身热口干、便秘溲赤等)积分、创面面积、IL-1及TNF-α水平比较无统计学意义(P>0.05)。治疗后各组患者中医证候(创面疼痛、溃破腐烂、皮肤暗紫、身热口干、便秘溲赤等)积分、创面面积、IL-1及TNF-α水平均改善,且观察组水平优于对照组(P<0.05);两组均无不良反应。结论三黄消炎方结合银敷料湿性换药治疗糖尿病足感染(多重耐药菌)临床效果显著,患者创面愈合好,安全可靠,值得应用。

Objective To observe the clinical effect of Sanhuang Xiaoyan Prescription(三黄消炎方)combined with wet dressing change of silver dressing in the treatment of diabetic foot infection(multi-drug resistant bacteria).Methods Eighty-six cases of diabetic foot infections(multi-resistant bacteria)patients(December 2019-June 2021)were enrolled and according to the random number table method were divided into control group and observation group,43 cases in each group.The control group's patients were treated with wet dressing change of silver dressing.The observation group's patients were treated with Sanhuang Xiaoyan Prescription combined with wet dressing change of silver dressing.The curative effect,TCM syndrome scores before and after treatment(wound pain,ulceration and decay,skin dark purple,body heat and dry mouth,urinate naked and so on)and the change of wound area,the levels of interleukin-1(IL-1)and tumor necrosis factor-α(TNF-α)and adverse reactions of two groups were observed.Results The effective rate was 93.02%(40/43)in the observation group and 76.74%(33/43)in the control group,which was higher in the observation group(P<0.05).Before treatment,the comparison of TCM syndrome scores(wound pain,ulceration and decay,dark purple skin,hot body and dry mouth,constipation and so on),wound area,the levels of IL-1 and TNF-α between the two groups had no significant difference(P>0.05).After treatment,the TCM syndrome scores(wound pain,ulceration and decay,dark purple skin,hot body and dry mouth,urinating naked skin,etc.),wound area and the levels of IL-1 and TNF-α were improved in each group.And those in the observation group were better than those in the control group(P<0.05).There were no adverse reactions in both groups.Conclusion Sanhuang Xiaoyan Prescription combined with wet dressing change of silver dressing in the treatment of diabetic foot infection(multi-drug resistant bacteria)has a significant clinical effect.The patients'wound healing is good.It is safe and reliable,worthy of application.