制污穴刺血疗法联合四妙汤加减治疗3、4期压力性损伤疗效观察及对肉芽组织生长因子的影响

Observation of Curative Effect of Combination Use of Pricking Blood at Zhiwu Point and Modified Simiao Decoction on Stress Injury in StagesⅢandⅣand Its Effect on Growth Factor in Granulation Tissue

目的:观察制污穴刺血疗法联合四妙汤加减治疗3、4期压力性损伤的疗效及对肉芽组织生长因子的影响。方法:选取120例3、4期压力性损伤患者,按随机数字表法分为对照组及观察组各60例。对照组接受常规治疗,观察组在对照组基础上采用制污穴刺血疗法联合四妙汤加减治疗。比较2组临床疗效及不良反应发生情况,比较2组治疗前后Bates-Jensen伤口评估与效果评价量表(BWAT)评分、肉芽组织出现时间、肉芽覆盖创面时间、肉芽组织生长因子[转化生长因子-β1(TGF-β1)、基质金属蛋白酶(MMP-9)、血管内皮生长因子(VEGF)]的变化。结果:观察组临床疗效总有效率为98.33%,对照组为86.67%,2组临床疗效比较,差异有统计学意义(P<0.05)。治疗后,2组BWAT评分均较治疗前下降(P<0.05),观察组BWAT评分低于对照组(P<0.05)。观察组肉芽组织出现时间、肉芽覆盖创面时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组TGF-β1、VEGF指标值均较治疗前升高(P<0.05),MMP-9指标值均较治疗前下降(P<0.05);观察组TGF-β1、VEGF指标值均高于对照组(P<0.05),MMP-9指标值低于对照组(P<0.05)。治疗期间,2组均无明显不良反应发生。结论:制污穴刺血疗法联合四妙汤加减治疗3、4期压力性损伤疗效较好,可缩短肉芽组织出现时间及肉芽覆盖创面时间,促进肉芽组织生长,有利于快速恢复。

Objective:To observe the curative effect of the combination use of pricking blood at Zhiwu Point and modified Simiao Decoction on stress injury in stagesⅢandⅣand its effect on growth factor in granulation tissue.Methods:A total of 120 patients with stress injury in stagesⅢandⅣwere selected and divided into the control group and the observation group according to the random number table methods,with 60 cases in each group.The control group was given routine treatment,and the observation group was additionally treated with pricking blood at Zhiwu Point combined with modified Simiao Decoction based on the treatment of the control group.The clinical effects,incidence of adverse reactions,and the changes in scores of Bates-Jensen Wound Assessment Tool(BWAT),occurrence time of granulation tissue,time of granulation covering the wound and growth factors in granulation tissue[transforming growth factor-β1(TGF-β1),matrix metalloprotein-9(MMP-9)and vascular endothelial growth factor(VEGF)]before and after treatment were compared between the two groups.Results:The total clinical effective rate was 98.33%in the observation group and 86.67%in the control group,the difference being significant(P<0.05).After treatment,the BWAT scores in the two groups were reduced when compared with those before treatment(P<0.05),and the BWAT score in the observation group was lower than that in the control group(P<0.05).The occurrence time of granulation tissue and the time of granulation covering the wound in the observation group were respectively shorter than those in the control group,differences being significant(P<0.05).After treatment,the indexes of TGF-β1 and VEGF in the two groups were elevated when compared with those before treatment(P<0.05),and the MMP-9 indexes were down�regulated when compared with those before treatment(P<0.05);the indexes of TGF-β1 and VEGF in the observation group were higher than those in the control group(P<0.05),and the MMP-9 index was lower than that in the control group(P<0.05).During the treatment,no obvious adverse reactions occurred in both groups.Conclusion:The combination use of pricking blood at Zhiwu Point and modified Simiao Decoction has a great curative effect on pressure injury in stagesⅢandⅣ,which can shorten the occurrence time of granulation tissue and the time of granulation covering the wound,promote the growth of granulation tissue,and is conducive to rapid recovery.