腔内激光微创手术联合中药紫归膏治疗下肢静脉性溃疡的临床探究.pdf

提 要 目的：探讨腔内激光微创手术联合中药紫归膏治疗下肢静脉性溃疡的效果及中药 紫归膏的作用机理，为指导临床辨证论治提供理论支持。方法：选择 2008 年 1 月至 2010 年 12 月的 120 例下肢静脉性溃疡患者，随机分为治疗组和对照组，治疗组 60 例，腔内激光微创手术联合外用紫归膏创面换药；对照组 60 例，腔内激光微创手术 联合外用黄连膏创面换药。观察溃疡面愈合情况。以 t 检验比较组内治疗前后及组间 有关参数差异的显著性；X2 检验比较组间有关参数差异的显著性；Ridit 分析法做等 级分组资料间比较。结果：治疗组有效率为 95 ％，对照组有效率为 75 ％，两组比较 有显著性差异(P0.01) ；各种大小创面愈合时间，治疗组为26.75±11.26 天，对照组为 40.12±15.02 天，两组比较有非常显著性差异(P0.01) ；治疗前后溃疡面分泌物细菌培 养情况，治疗组治疗后溃疡分泌物培养细菌菌株明显减少，对照组培养细菌菌株也有 减少，但两组比较有显著性差异，治疗组治疗后细菌菌株明显少于对照组(P0.05) 。 结论：腔内激光微创手术治疗下肢静脉曲张术式简便，微创，美观；紫归膏具有明显 改善创面血液循环、抑菌抗炎及促进创面愈合的作用。为临床辨证论治提供理论依据。 关键词 腔内；激光；微创；紫归膏；下肢；静脉性溃疡 Clinical Study on Treating Venous Ulceration of Lower Extremity with Micro-invasive Surgery by Intravenous Laser and ZiGui Ointment Specialty：Surgery of Integrated Traditional Chinese and Western Internal Medicine Author ：Hu Wenxian Tutor：Professor Hou Yufen Abstract Object: To investigate the effects of intravenous laser with micro-invasive surgery treatment and therapeutic mechanism of ZiGui ointment on venous ulceration of lower extremity, in order to guide the TCM differential treatment. Method: 120 patients (2008.1～2010.12) with venous ulceration of lower extremity were divided into two group atrandom ．60 patients were treated with micro-invasive surgery treatment and ZiGui Ointment as treatment group and 60 patients were treated with micro-invasive surgery treatment and huanglian Ointment as control group. Then we observed the change of the wound surface. T-test of significance to compare before and after treatment in groups, and the differences of parameters between two groups; Chi-square test to compare differences of parameters between the groups was significan