复方黄柏液涂剂外敷联合泡沫硬化治疗下肢静脉曲张性溃疡疗效及其对TNF-α、IL-6、CRP水平的影响

Clinical Effect of Compound Huangbai Liquid Coating Agent(复方黄柏液涂剂)Combined with Foam Sclerotherapy on Varicose Ulcer of Lower Extremities And Its Influence on Levels of TNF-α,IL-6 and CRP

目的分析复方黄柏液涂剂外敷联合泡沫硬化剂治疗下肢静脉曲张性溃疡的临床疗效及其对患者肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平的影响。方法选取2020年1月—2022年1月收治的122例下肢静脉曲张性溃疡患者作为研究对象。按随机数字表法分为两组,观察组61例,采用复方黄柏液涂剂外敷联合泡沫硬化剂治疗,对照组61例,采用泡沫硬化剂注射治疗。统计分析两组临床疗效、治疗前后TNF-α、IL-6、CRP、疼痛视觉模拟评分法(VAS)评分、静脉临床严重程度评分(VCSS)及并发症数据。结果观察组临床总有效率为93.44%(57/61),明显高于对照组的78.69%(48/61),相比差异有统计学意义(χ^(2)=4.200,P=0.040);两组治疗1个月后血清TNF-α、IL-6及CRP水平均明显下降(P<0.001),观察组治疗1个月后血清TNF-α、IL-6及CRP水平显著低于对照组,相比差异有统计学意义(P<0.001);两组治疗1个月后VAS评分及VCSS评分均明显降低(P<0.01),观察组治疗1个月后VAS评分及VCSS评分显著低于对照组,相比差异有统计学意义(P<0.01);观察组并发症总发生率为6.56%,低于对照组的16.39%,相比差异无统计学意义(χ^(2)=2.311,P=0.128)。结论复方黄柏液涂剂外敷联合泡沫硬化剂治疗下肢静脉曲张性溃疡,能够有效抑制炎症因子表达,降低静脉临床严重程度评分,减轻疼痛,提高临床疗效,并发症少,能够兼顾安全性与有效性,值得临床予以推广应用。

Objective To analyze the clinical efficacy of Compound Huangbai Liquid Coating Agent(复方黄柏液涂剂)combined with foam sclerotherapy in the treatment of varicose ulcer of lower extremity and its influence on the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in patients.Methods A total of 122 patients with varicose ulcer of lower extremity admitted to the hospital from January 2020 to January 2022 were selected as the research objects.According to the random number table method,61 cases in the observation group were treated with Compound Huangbai Liquid Coating Agent combined with foam sclerotherapy,61 cases in the control group were treated with foam sclerotherapy injection.The clinical efficacy,levels of TNF-α,IL-6 and CRP,visual analogue scale(VAS)score,venous clinical severity score(VCSS)and complications before and after treatment were statistically analyzed.Results The total effective rate of the observation group was 93.44%,which was significantly higher than 78.69%of the control group,and the difference was statistically significant(χ^(2)=4.200,P=0.040).The serum levels of TNF-α,IL-6 and CRP in the two groups were significantly decreased after 1 month of treatment(P<0.001).The serum levels of TNF-α,IL-6 and CRP in the observation group were significantly lower than those in the control group after 1 month of treatment(P<0.001).The VAS score and VCSS score of the two groups were significantly decreased after 1 month of treatment(P<0.01),and the VAS score and VCSS score of the observation group were significantly lower than those of the control group after 1 month of treatment,and the differences were statistically significant(P<0.01).The total incidence of complications in the observation group was 6.56%,which was lower than that in the control group(16.39%),and the difference was not statistically significant(χ^(2)=2.311,P=0.128).Conclusions Compound Huangbai Liquid Coating Agent combined with foam sclerosin in the treatment of varicose ulcer of lower extremities can effectively inhibit the expressions of inflammatory factors,reduce the clinical severity score of venous and the pain,improve the clinical efficacy and reduce complications.It can take into account both safety and effectiveness,which is worthy of clinical application.