Calmoseptine Ointment Tube皮肤保护剂联合院内制剂妇洁康对失禁性皮炎大鼠的作用及经济效益分析

目的:研究和探讨Calmoseptine Ointment Tube皮肤保护剂联合院内制剂妇洁康对失禁性皮炎大鼠模型的作用,并分析其经济效益,以期选出价格较实惠且效果较好的失禁性皮炎的防治方案。方法:建立失禁性皮炎大鼠模型,成功后将32只大鼠分为四组,即妇洁康洗剂组(A组)、3M液体敷料联合造口护肤粉组(B组)、Calmoseptine Ointment Tube皮肤保护剂组(C组)、妇洁康联合Calmoseptine Ointment Tube皮肤保护剂组(D组),每组8只。根据皮肤的症状评估大鼠的失禁性皮炎严重程度,通过追踪皮炎边缘测量皮炎面积,同时进行组织病理学评估其组织损伤,免疫生化分析其嗜中性粒细胞、巨噬细胞、淋巴细胞以及血管内皮生长因子、增殖细胞核抗原等水平。并结合成本效果分析方法分析其经济效益。结果:治疗后,A、B、C三组大鼠的失禁性皮炎的严重程度、面积和恢复时间比较无显著差异(P>0.05);与D组相比,A、B、C三组大鼠失禁性皮炎的严重程度显著更高,面积更大,恢复时间更长(P<0.05)。组织病理学分析显示,A、B、C三组大鼠表皮萎缩、毛囊萎缩、胶原蛋白流失、水肿等各组织情况评分比较无显著差异(P>0.05),但与D组相比,A、B、C三组大鼠的各组织指标评分显著更高(P<0.05)。免疫生化分析显示,A、B、C、D四组大鼠的PCNA水平比较无显著差异(P>0.05);A、B、C三组大鼠的嗜中性粒细胞、巨噬细胞、淋巴细胞、VEGF水平比较无显著差异(P>0.05);与D组相比,A、B、C三组大鼠的嗜中性粒细胞、巨噬细胞、淋巴细胞、VEGF水平显著更高(P<0.05)。根据不同经济效益分析可知,CEA分析显示,D组>C组>B组>A组;CMA分析显示,D组>C组>B组>A组;C/E分析显示,D组>C组>A组>B组。ΔC/ΔE分析显示,成本额最高为D组,与其他三组进行比较,D组与A组ΔC/ΔE为7.94;D组与B组ΔC/ΔE为11.89;D组与C组ΔC/ΔE为7.57。可见在经济成本上,D组明显要高于其他三组,但从增益量上看,D组虽然治疗成本较高,但所产生的效果也较高,而且,增加的治疗成本可以带来更加满意的增量效果。结论:Calmoseptine Ointment Tube皮肤保护剂联合院内制剂妇洁康对失禁性皮炎具有较好的治疗效果,能够缩小皮炎面积,缩短恢复时间,并改善皮肤组织情况,提高免疫力。同时该治疗方案虽然治疗成本较高,但治疗效果也更好,更具经济性,能够节省治疗的整体费用,值得临床推广应用。

Skin Toxicity of Wufang Babu Ointment to Zebrafish

[Objectives]Using wild-type AB strain of zebrafish as experimental animal,this study investigated the damaging effect of Wufang Babu Ointment on skin cells,in order to evaluate the skin toxicity of Wufang Babu Ointment.[Methods]Wild-type AB strain of zebrafish with an age of 2 d were taken and fed in different concentrations of Wufang Babu Ointment solution for 24 h.The number of deaths in each group of zebrafish was recorded,and the mortality rate was calculated.Using Origin 8.0 software,the maximum non lethal concentration(MNLC)was simulated.Zebrafish raised in different concentrations of Wufang Babu Ointment solution for 24 h were placed under an anatomical microscope for taking photos,to analyze and calculate the incidence of skin damage in zebrafish.Based on the statistical analysis results of this indicator,the skin toxicity of Wufang Babu Ointment was evaluated.[Results]The MNLC of Wufang Babu Ointment on zebrafish was 671μg/mL;Wufang Babu Ointment can induce skin damage at the concentrations of 224μg/mL(1/3 MNLC)and 671μg/mL(MNLC).[Conclusions]Wufang Babu Ointment had certain skin toxicity to zebrafish.

Preparation Process and Quality Standard of Rougan Huaxian Ointment

[Objectives] To establish the preparation process and quality standard of Rougan Huaxian ointment.[Methods] The L_(9)(3^(4)) orthogonal test was employed to optimize the preparation process by considering the multiplication of water addition, extraction time, and extraction frequency as influencing factors. The dry paste yield was utilized as the evaluation criterion, in conjunction with the actual production conditions. Thin layer chromatography was employed to identify Radix Astragali, Lycii Fructus, Herba Dendrobii, and Rhizoma Polygoni Cuspidati. Ethanol served as the solvent for the determination of ethanol-soluble extractives using the cold immersion method.[Results] The preparation process was conducted as follows: the specified quantity of medicinal materials was combined with water for extraction purposes, performed in two separate stages. In each stage, eight times the amount of water was added. The first extraction lasted for 1.5 h, while the second extraction was completed in 1.0 h. The resulting liquid was then concentrated into a thick paste with a relative density ranging from 1.25 to 1.30 at a temperature of 60 ℃. The thin-layer chromatography analysis of Radix Astragali, Lycii Fructus, Herba Dendrobii, and Rhizoma Polygoni Cuspidati demonstrated distinct spots, effective separation, and the absence of interference from negative samples. Additionally, the ethanol-soluble extractives yielded a minimum of 8.0% in terms of dry weight.[Conclusions] The preparation process for Rougan Huaxian ointment is both stable and feasible. Furthermore, the quality standards established for this preparation are unique and reproducible, thereby facilitating effective quality control.

Clinical Efficacy of Huanglian Ointment in the Treatment of Chronic Eczema

Objective:To investigate and analyze the clinical efficacy of Huanglian ointment in the treatment of chronic eczema.Methods:114 cases of chronic eczema patients admitted to the Department of Dermatology of our hospital from January 2023 to January 2024 were selected as the study subjects.They were divided into a study group(n=57)and a reference group(n=57)using the double-blind method.The study group was treated with dialyzed Huanglian ointment,while the reference group was treated with conventional treatment.Symptom scores,inflammatory levels,treatment effects,and immune indexes of the two groups were similar before treatment.Results:After treatment,the symptom scores of the study group were significantly lower than those in the reference group(P<0.05).Besides,the interleukin-2(IL-2),tumor necrosis factor-a(TNF-a),interferon-(IFN-),and other inflammatory indicators of the study group were significantly better than those of the reference group(P<0.05).The total efficacy of treatment in the study group was significantly higher than that in the reference group(P<0.05).Furthermore,after treatment,the immunity indexes such as CD3+,CD4+,and CD8+of the study group were significantly better than those of the reference group,(P<0.05).Conclusion:Huanglian ointment is extremely effective for treating chronic eczema so this treatment program should be popularized.

复肾膏联合真武汤治疗脾肾阳虚型肾性水肿的疗效及对肾小管损害标志物、凝血指标的影响

目的 观察复肾膏联合真武汤治疗肾性水肿脾肾阳虚型的疗效及对肾小管损害标志物、凝血指标的影响。方法 选取80例肾性水肿脾肾阳虚型患者为研究对象,按照随机数字表法分为对照组和治疗组,对照组40例予真武汤治疗,治疗组40例复肾膏联合真武汤治疗。2组均10天为1个疗程,连续3个疗程后统计疗效。比较2组治疗前及治疗1、2、3个疗程后肾小管损害标志物[中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)]、肾功能[24 h尿蛋白定量(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、血清白蛋白(ALB)]、凝血功能[D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)]变化,观察记录2组治疗过程中不良反应情况。结果 治疗组总有效率92.50%(37/40),明显高于对照组的70.00%(28/40)(P<0.05)。治疗1、2、3个疗程后,2组NGAL、KIM-1、24 h Upro、BUN、SCr水平均较本组治疗前明显降低(P<0.05),ALB均较本组治疗前明显升高(P<0.05),且2组组间同期比较差异均有统计学意义(P<0.05)。治疗1、2、3个疗程后,2组D-D、APTT均较本组治疗前明显降低(P<0.05),且治疗组均低于对照组同期(P<0.05);治疗3个疗程后,2组PLT均较本组治疗前明显降低(P<0.05),且治疗组低于对照组同期(P<0.05)。治疗组不良反应发生率为7.50%(3/40),对照组为12.50%(5/40),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 复肾膏联合真武汤治疗肾性水肿脾肾阳虚型可有效改善肾功能及凝血功能,降低NGAL、KIM-1水平,效果显著。

给氧负压封闭引流联合湿润烧伤膏序贯治疗高海拔地区下肢慢性溃疡疗效分析

目的探讨给氧负压封闭引流联合湿润烧伤膏序贯治疗高海拔地区下肢慢性溃疡的临床疗效。方法选取2019年1月至2023年3月若尔盖县人民医院收治的60例下肢慢性溃疡患者作为研究对象,按照创面不同治疗方法将其分为观察组(30例)和对照组(30例),观察组患者予以给氧负压封闭引流联合湿润烧伤膏序贯治疗,对照组患者单纯予以湿润烧伤膏治疗,对比两组患者创面肉芽组织状态、病原菌感染情况、愈合率以及住院时间。结果治疗3周后,观察组患者创面肉芽组织评分明显高于对照组、病原菌阳性率低于对照组(Z/χ^(2)=-4.332、4.800,P<0.001、P=0.028);观察组患者治疗3周后创面愈合率明显高于对照组、住院时间明显短于对照组(t=6.517、7.211,P均<0.001)。结论给氧负压封闭引流联合湿润烧伤膏序贯治疗高海拔地区下肢慢性溃疡创面,能够有效促进肉芽组织生长,抑制病原菌增殖,加快创面愈合,缩短住院时间。

固本防喘膏在儿童哮喘缓解期的应用效果

目的探讨固本防喘膏在儿童哮喘缓解期的应用效果。方法选取2022年3月至2024年3月于常州市中医医院儿科就诊的90例哮喘缓解期患儿作为研究对象,采用随机数字表法分为对照组和试验组,每组45例。对照组给予玉屏风颗粒治疗,试验组采用固本防喘膏治疗,比较两组患儿临床疗效、肺功能及免疫功能。结果治疗后,试验组总体控制率优于对照组(91.11%vs 75.56%)(P<0.05);试验组第1秒用力呼气容积、用力肺活量、呼气流量峰值均高于对照组(P<0.05);试验组血清免疫球蛋白(Ig)A、IgG、IgM、CD4^(+)和CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组(P<0.05)。结论固本防喘膏在儿童哮喘缓解期具有较好的应用效果,可提高总体控制率,改善肺功能及免疫功能。

五物甘草生摩膏穴位推拿防治肺脾气虚证脑瘫患儿反复呼吸道感染临床研究

目的:观察五物甘草生摩膏穴位推拿防治肺脾气虚证脑瘫患儿反复呼吸道感染(RRTI)的临床疗效。方法:将60例2022年3月—2023年4月于河南中医药大学第一附属医院就诊的肺脾气虚证RRTI脑瘫患儿,采用随机数字表法分为观察组与对照组各30例。观察组以五物甘草生摩膏为介质进行穴位推拿治疗,对照组给予口服脾氨肽治疗。疗程8周,观察2组临床疗效、中医证候评分;随访12个月,记录2组呼吸道感染减少次数及不良反应。结果:观察组总有效率为93.33%(27/30),对照组为63.33%(19/30),2组比较,差异有统计学意义(P<0.05)。治疗后,2组恶风、自汗、气短、面色苍白、少气懒言、不思饮食、形体消瘦、大便溏薄等中医证候评分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。随访12个月,观察组呼吸道感染减少次数明显多于对照组(P<0.05);其中观察组上呼吸道感染减少次数多于对照组(P<0.05),2组下呼吸道感染(包括气管炎/支气管炎感染、肺炎感染)减少次数比较,差异无统计学意义(P>0.05)。治疗期间,2组患儿均未见明显不良反应。结论:五物甘草生摩膏穴位推拿治疗能改善肺脾气虚证脑瘫患儿RRTI的临床症状,减少上呼吸道感染次数,且远期疗效较好。

Methodology Validation of Microbial Limit Test of Bupi Qiangli Ointment

[Objective] This study was conducted to establish a microbial limit test method for Bupi Qiangli Ointment. [Method] The conventional method and medium dilution method were used for bacterial, mold and yeast counting in sample recovery test. [Result] The medium dilution method （1：10 test solution, 0.5 ml/plate） could effectively eliminate the inhibition effect of the Bupi Qiangli Ointment, and the recovery of Staphylococcus aureus was greater than 70% in the 3 batches of samples; and the conventional method exhibited the recoveries of E. coil, Bacillus subtilis, Candida albicans and Aspergillus greater than 70% in the 3 batches of samples. [Conclusion] Due to Bupi Qiangli Ointment has strongly antibacterial effect on Staphylococcus au- reus, the medium dilution method was used for bacterial counting, and the conventional method was used for mold and yeast counting; and the conventional method was used for controlled bacterium examination of E. coll.

盐酸米诺环素软膏联合双波长激光治疗牙周牙髓联合病变疗效观察

目的:探讨盐酸米诺环素软膏联合掺钕铒钇铝石榴石双波长(Nd∶YAG,Er∶YAG)激光治疗牙周牙髓联合病变的疗效。方法:选择2021年3月-2022年12月笔者医院就诊的106例牙周牙髓联合病变患者,采取随机数字法按1:1比例分为软膏组(53例,患牙89颗)和联合组(53例,患牙92颗)。两组均先行基础治疗,采用双氧水或生理盐水冲洗龈沟、牙周袋,软膏组向牙袋内注射盐酸米诺环素软膏,同时进行根管治疗至完善根管填充;联合组采用盐酸米诺环素软膏处理牙周袋,联合铒钕双波长激光消毒根管。比较两组临床疗效,于术后次日、12周比较两组视觉模拟疼痛评分(VAS),记录术前,术后6周、12周牙周指标[菌斑指数(Plaque index,PLI)、出血指数(Bleeding index,BI)、牙周探诊深度(Probing depth,PD)、临床附着水平(Clinical attachment level,CAL)]、龈沟液生化指标[单核细胞趋化蛋白-1(Active monocyte chemotactic protein 1,MCP-1)、基质金属蛋白酶-8(Matrix metalloproteinase-8,MMP-8)及白细胞介素-6(Interleukin-6,IL-6)]变化并行锥形束CT测量,对比两组术后6个月并发症发生情况及美观满意度。结果:联合组治疗总有效率为90.22%,显著高于软膏组的70.79%(P<0.05);治疗结束时、治疗后第6周,两组VAS评分逐渐降低,组内不同时间点差异有统计学意义(P<0.05),且联合组评分均显著低于软膏组(P<0.05);治疗后第6周、第12周,除软膏组PLI,两组间PLI、BI、PD、CAL逐渐降低,组内不同时间点比较差异有统计学意义(P<0.05),且联合组上述指标低于软膏组(P<0.05);治疗后第6周,两组牙槽骨高度和骨密度面积均显著升高,且联合组高于软膏组(均P<0.05),两组MCP-1、MMP-8、IL-6水平均显著降低,且联合组指标显著低于软膏组(均P<0.05);联合组牙周炎、牙齿叩痛、牙齿松动等并发症发生率显著低于软膏组(P<0.05),患者美观满意度显著高于软膏组(P<0.05)。结论:盐酸米诺环素联合双波长激光治疗牙周牙髓联合病疗效显著,能显著降低患者疼痛度,改善口腔环境和牙周健康,减少炎症发生,且并发症少,满意度高,值得临床推荐。

湿润烧伤膏治疗寻常型银屑病临床研究

目的研究湿润烧伤膏治疗寻常型银屑病的临床疗效。方法选取2021年7月至2023年4月濮阳市油田总医院收治的68例中重度寻常型银屑病患者作为研究对象,按照不同治疗方法将其分为观察组(34例)与对照组(34例)。对照组患者采用异维A酸软胶囊口服治疗,观察组患者在异维A酸软胶囊口服基础上加用湿润烧伤膏治疗,对比观察两组患者血清血管内皮生长因子(VEGF)与肿瘤坏死因子-α(TNF-α)水平、皮损严重程度、生活质量及临床疗效。结果治疗8周后,观察组患者血清VEGF、TNF-α水平以及银屑病皮损面积和严重性指数(PASI)与皮肤病生活质量指数(DLQI)评分均明显低于对照组(t=5.047、3.921、3.539、4.236,P均<0.001)。观察组患者临床总有效率为94.12%,明显高于对照组患者的临床总有效率76.47%(χ^(2)=4.221,P=0.040)。结论湿润烧伤膏能够通过降低局部增生及炎症水平改善寻常型银屑病患者临床症状,疗效显著。

全蝎通络膏对小儿目劄肝经风热型疗效观察

目的:探讨全蝎通络膏对小儿目劄肝经风热型疗效观察。方法:选取2019年1月至2023年12月佳木斯市中医医院眼科确诊为小儿目劄患儿66例,随机分为对照组及通络组,对照组予以西医常规治疗,通络组在对照组基础上加用全蝎通络膏治疗,观察两组治疗效果、瞬目次数、证候积分、泪膜破裂时间等。结果:经治疗,通络组有效率为84.38%,对照组有效率为66.67%,两组对比有统计学意义(χ^(2)=4.340,P<0.05)。两组治疗前瞬目次数、证候积分及BUT对比,无统计学差异(P>0.05);治疗后通络组瞬目次数、证候积分、BUT均有明显改善,相比治疗前存在统计学差异(P<0.05),且通络组治疗后与对照组比较,存在统计学差异(t=3.256、4.569、2.379,P<0.05);对照组治疗前后仅瞬目次数存在统计学差异(P<0.05)。结论:全蝎通络膏对小儿目劄肝经风热型疗效观察疗效较好。

硝酸甘油软膏联合九华痔疮栓治疗混合痔患者术后疼痛的疗效观察

目的探究混合痔患者接受硝酸甘油软膏联合九华痔疮栓治疗对其术后疼痛的影响。方法选择焦作职工医学院附属医院于2021年1月至2023年12月接受外剥内扎手术治疗的100例混合痔患者作为本次研究对象,所有患者均接受基础治疗(头孢克肟片及肛泰软膏),根据随机数字表法分为对照组(50例,基础治疗的基础上使用九华痔疮栓治疗)与研究组(50例,基础治疗的基础上使用硝酸甘油软膏联合九华痔疮栓治疗),两组患者均治疗1周,对比两组治疗效果。结果两组患者治疗第3天与治疗周期结束后视觉模拟评分(VAS)较治疗前降低,治疗周期结束后的VAS评分低于治疗第3天,且治疗后各个时间点研究组VAS低于对照组,差异具有统计学意义(P<0.05)。与对照组相比,研究组治疗有效率较高、术后自行排尿率较高,差异具有统计学意义(P<0.05)。研究组水肿、疼痛感完全消失时间与首次排尿时间均短于对照组,术后8 h总尿量多于对照组,差异具有统计学意义(P<0.05)。研究组追加止痛药物的患者例数少于对照组,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论运用硝酸甘油软膏联合九华痔疮栓治疗混合痔可有效降低患者疼痛程度、提高治疗效果、缩短不适症状时间与首次排尿时间、增加术后总尿量,减少止痛药物使用量,安全可靠,值得临床应用。

饵激光、308 nm LED紫外线联合卤米松乳膏治疗白癜风临床效果

目的:观察饵激光、308 nm LED紫外线联合卤米松乳膏治疗白癜风患者的临床效果。方法:招募2022年1月—2023年1月东莞市大朗医院及东莞市滨海湾中心医院皮肤科60例稳定期白癜风患者。按随机数字表法将患者分为对照组和试验组,每组30例。对照组采用308 nm LED紫外线联合外涂卤米松乳膏治疗,试验组采用饵激光、308 nm LED紫外线联合外涂卤米松乳膏治疗。比较两组白癜风面积评分指数(vitiligo area scoring index,VASI)、WOOD灯评分及治疗效果。结果:治疗前,两组VASI比较,差异无统计学意义(P>0.05),开始治疗第3个月,试验组VASI较对照组降低,但比较差异无统计学意义(P>0.05),开始治疗第6个月和第12个月,试验组VASI均较对照组降低(P<0.05)。开始治疗第3、6、12个月,试验组WOOD灯评分均较对照组升高(P<0.05)。试验组总有效率比对照组高(P<0.05)。结论:饵激光、308 nm LED紫外线联合卤米松乳膏治疗白癜风效果更好,色素恢复更为明显。

烧伤再生医疗技术治愈双足背深Ⅱ度烧伤1例报告

给予2020年2月南充市中医医院收治的1例双足背烧伤患者在敏感抗生素抗感染、营养支持、调控血糖、抗休克等对症支持治疗的基础上加用黄连解毒汤口服,并给予局部创面于坏死组织清除、耕耘减张处理后采用烧伤再生医疗技术治疗,治疗第22天,双足背创面基本愈合,患者出院;出院7 d后随访,创面完全愈合,愈后皮肤无明显瘢痕增生,运动功能正常。

Study on effect of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema

Objective:To study the effects of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema.Methods:DNCB acetone solution was used to sensitize the skin of back and ears of 36 rats in order to establish chronic eczema model.A total of 36 rats were divided into four groups of 9 randomly including oral medicine group,external inunctum group,combination therapy group,and model control group respectively.Besides,the blank group of 4 healthy rats were set.The oral medicine group was given Traditional Chinese Medicine Jianpi Chushi decoction [(Poria cocos,Chinese yam,Cortex dictamni,Zaocys dhumnade,Rhizoma atractylodis,Pericarpium citri reticulatae,Scutellaria baicalensis,Radix Sophorae Flavescentis,Raw Radix Paeoniae Alba,Licorice roots(Northwest Origin)] by gastric infusion(1.6 g/m L·5 m L/d); the external inunctum group was given Qingpeng ointment on the skin,the combination therapy group was given Jianpi Chushi decoction by gastric infusion and Qingpeng ointment combination therapy.The model control group was given normal saline(NS) of the same volume by gastric infusion and vaseline on skin.Continuous administration 15 d and stopped for 3 d.The thickness difference and weight difference of left and right ear of every group were measured and the degree of ear swelling were evaluated.The CD4^+ and CD8^+ content and the IL-2,IL-4 level of serum were detected,and the inflammatory cells counts of back skin were recorded.Results:After treatment,the degree of ear swelling of oral medicine group,external inunctum group and combination therapy group significant decreased compared with model control group(P<0.05).The CD4^+,CD8^+ cell content and IL-2 level of oral medicine group,external inunctum group,combination therapy group and model control group significant decreased compared with blank group,and IL-2 level and the inflammatory cells count increased.After 15 d of treatment,the CD4^+,CD8^+ cell content and IL-2 level of serum of oral medicine group,external inunctum group and combination therapy group raised and the IL-4 level and the inflammatory cells count had significant decreased compared with model control group,and the effect of combination therapy group was more obvious(P<0.05).Conclusions:Qral Jianpi Chushi decoction could treat chronic eczema effectively,and oral Chinese medicine combined with ointment could enhance and speed up the efficacy.

湿润烧伤膏联合纳米银敷料治疗重度烧伤患者的效果

目的:观察湿润烧伤膏联合纳米银敷料治疗重度烧伤患者的效果。方法:选取2020年9月至2023年5月于该院行清创植皮术的78例重度烧伤患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各39例。两组均给予清创植皮术,在此基础上,对照组给予纳米银敷料治疗,观察组在对照组基础上联合湿润烧伤膏治疗。比较两组临床疗效,预后指标(14 d创面细菌培养阳性率、创面感染率、色素沉着率)水平,瘢痕严重程度[温哥华瘢痕量表(VSS)]评分,创面愈合时间,治疗前后炎性因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,以及并发症发生率。结果:观察组治疗总有效率为94.87%(37/39),高于对照组的74.36%(29/39),差异有统计学意义(P<0.05);观察组14 d创面细菌培养阳性率、创面感染率、色素沉着率均低于对照组,差异有统计学意义(P<0.05);观察组VSS评分低于对照组,创面愈合时间短于对照组,差异均有统计学意义(P<0.05);治疗后,两组IL-2、IL-6、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.56%(1/39),低于对照组的20.51%(8/39),差异有统计学意义(P<0.05)。结论:湿润烧伤膏联合纳米银敷料治疗重度烧伤患者可提高临床疗效,改善预后,减轻瘢痕和机体炎症反应,降低并发症发生率,效果优于单纯纳米银敷料治疗。

Treating aplasia cutis congenita in a newborn with the combination of ionic silver dressing and moist exposed burn ointment: A case report

BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.

人表皮生长因子联合湿润烧伤膏治疗烧伤患儿的效果

目的:观察人表皮生长因子联合湿润烧伤膏治疗烧伤患儿的效果。方法:选取2022年5月至2023年10月该院收治的90例烧伤患儿进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各45例。对照组给予湿润烧伤膏治疗,研究组在对照组基础上联合人表皮生长因子治疗。比较两组临床疗效,创面愈合时间和红斑持续时间,治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-8(IL-8)]、T细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+))水平,以及不良反应发生率。结果:研究组治疗总有效率为88.89%(40/45),高于对照组的71.11%(32/45),差异有统计学意义(P<0.05);治疗后,两组TNF-α、IL-2、IL-8水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组创面愈合时间、红斑持续时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组CD3^(+)、CD4^(+)水平均高于治疗前,且研究组高于对照组,两组CD8^(+)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:人表皮生长因子联合湿润烧伤膏治疗烧伤患儿可提高治疗总有效率,缩短创面愈合时间和红斑持续时间,改善T细胞亚群指标水平,以及降低炎性因子水平的效果优于单纯湿润烧伤膏治疗。

Efficiency and safety evaluation of Baimai ointment for alleviating hypermyotonia following cerebral infarction

Baimai ointment has Shujin and Huoluo efficiency. It has been confirmed by basic pharmacodynamic experiments that Baimai ointment has some therapeutic effects on stroke. However, the detailed evaluations of Baimai ointment on clinically treating stroke patients for function recovery are still insufficient with little reports. OBJECTIVE： To observe the efficiency and safety of Baimai ointment on alleviating hypermyotonia following cerebral infarction DESIGN： A randomized, parallel and controlled experiment. SETTING： Department of Neurology, Beijing Aerospace General Hospital. PARTICIPANTS： A total of 120 patients with acute front-cycle cerebral infarction were selected from Department of Neurology, Beijing Aerospace General Hospital from July to December 2006 and met the diagnosis criteria modified by Forth National Seminar on Cerebrovascular Disease. The experiment had got confirmed consent from local ethic committee. All 120 patients with cerebral infarction were randomly divided into experimental group （n =80; 32 in the acute phase, 32 in the recovery phase and 16 in the sequela phase） and control group （n =40; 16 in the acute phase, 16 in the recovery phase and 8 in the sequela phase）. METHODS： Within 4 weeks after the patients were enrolled in this study, no other traditional Chinese medicines containing similar components were adopted besides routine supporting therapy. The Baimai ointment being consisted of jianghuang, Roudoukou, Gansong, Yangqishi, Gancao, She, shannai, Zanghuixiang, Zangchangpu, Huajiao and dianhua was used by trial group （20 g/ampoule, Tibet Lingzhiqizheng Tibetan Drug Factory; batch number： 050403）, 2-3 times per day, the ointment was moderately coated traveling parts of Baimai. MAIN OUTCOME MEASURES： The evaluation of National Institutes of Health Stroke Scale （NIHSS）, Modified Rankin Scale and Modified Ashworth Scale were performed before administration, 2 and 4 weeks after administration. RESULTS： All 120 patients with acute front-cycle cerebral infarction were involved in the final analysis. ① Evaluation of therapeutic effects： After 4 weeks, the comparison of overall muscular tension and muscular tension in acute phase between the two groups （acute phase, chronic phase and recovery phase） demonstrated that the experimental group improved significantly （Z = - 2.25, - 2.06, P 〈 0.05）. After 2 weeks, the change of muscular tension was not significantly different from baseline （P 〉 0.05）. Whereas after 4 weeks, the change of muscular tension in acute phase was significantly different from baseline （P 〈 0.05）; however, the change of muscular tension in recovery phase and sequelae phase was not significantly different from baseline （P 〉 0.05）. After the treatment, the overall NIHSS and disability score of both groups did not change significantly （P 〉 0.05）. ② Adverse reaction and side effect： There were two adverse events in experimental groups. One patient underwent petechia, and the symptom disappeared following stopping medication which did not reappear after remedication. The other patient complained of a pain coming from the place where the medication was used, and the symptom went away without treatment. Two cases of adverse events were not significantly correlated with the usage of medication, so both of which could not be confirmed to be adverse reactions. CONCLUSION： Baimai ointment achieves some therapeutic effects on treating hypermyotonia of cerebral infarction patients, especially significantly preventing the hypermyotonia in acute phase with good safety.