摘要
目的比较中药浸浴后中西医结合治疗与单纯应用磺胺嘧啶银霜治疗大面积深度烧伤后残余创面的临床效果。方法 2003年7月-2009年12月,将收治的128例大面积深度烧伤后残余创面患者随机分为两组。中西医结合治疗组70例(试验组):男45例,女25例;年龄18～60岁,平均38.6岁。致伤原因:火焰烧伤34例,钢水烧伤28例,化学灼伤8例。烧伤面积平均57.6%总体表面积(total body surface area,TBSA),残余创面平均7.4%TBSA。西医对照组58例(对照组):男50例,女8例;年龄20～59岁,平均37.9岁。致伤原因:火焰烧伤26例,热水烫伤12例,钢水烧伤16例,化学灼伤4例。烧伤面积平均56.5%TBSA,残余创面平均6.9%TBSA。两组患者一般资料比较,差异均无统计学意义(P>0.05),具有可比性。试验组先行中药浸浴,然后采用中西药联合换药;对照组采用洗必泰溶液清洁创面后外涂磺胺嘧啶银霜。观察两组患者创面用药后疼痛缓解、创面愈合时间及瘢痕发生率。结果创面用药后试验组疼痛情况分级,优23例,良30例,中17例;对照组优17例,良20例,中13例,差5例,极差3例。试验组创面愈合时间为(13.45±4.74)d,较对照组的(23.87±14.45)d明显缩短。创面愈合2周后,试验组15例(21.4%)出现瘢痕,对照组35例(60.3%)出现瘢痕。以上指标两组比较,差异均有统计学意义(P<0.05)。结论在中药浸浴基础上采用中西医结合治疗烧伤残余创面具有愈合快、疼痛轻、瘢痕少、住院时间短等优点,优于单纯应用磺胺嘧啶银霜疗法。
Objective To compare the effectiveness of dressing by a combination of traditional Chinese medicine （TCM）-Western medicine （WM） after TCM bath and by the silver sulfadiazine cream （SD-Ag） in treating residual deep burn wound. Methods A total of 128 cases of residual deep burn wound between July 2003 and December 2009 were randomly divided into the TCM-WM treatment group （70 cases） and the WM control group （58 cases）. In the treatment group, there were 45 males and 25 females with an average age of 38.6 years （range, 18-60 years）, including 34 cases of flame burns, 28 cases of molten steel burns, and 8 cases of chemical burns with an average burn area of 57.6% total body surface area （TBSA） and an average residual wound of 7.4% TBSA. In the control group, there were 50 males and 8 females with an average of 37.9 years （range, 20-59 years）, including 26 cases of flame burns, 12 cases of hot water burns, 16 cases of molten steel burns, and 4 cases of chemical burns with an average burn area of 56.5% TBSA and an average residual wound of 6.9% TBSA. There was no significant difference in general data between 2 groups （P〈0.05）, so the clinical data of 2 groups had comparability. In the treatment group, the patients had a bath with TCM, and then the wounds were treated with dressing change of combined TCM-WM. In the control group, the wounds were treated with SD-Ag after cleaning the wounds with chlorhexidine solution. The pain, wound healing time, and the rate of scar formation were observed in 2 groups after treatment. Results According to wound pain classification after medication, the results were excellent in 23 cases, good in 30 cases, fair in 17 cases in the treatment group; were excellent in 17 cases, good in 20 cases, fair in 13 cases, poor in 5 cases, and fairly poor in 3 cases in the control group. The wound healing time of the treatment group （13.45 ± 4.74） days was significantly shorter than that of the control group [（23.87 ± 14.45） days, P〈0.05）]. After 2 weeks of treatment, scar occurred in 15 patients （21.4%） of the treatment group and 35 patients （60.3%） of the control group, showing significant difference （P〈0.05）. Conclusion Based on TCM bath, a combination of TCM-WM for the residual burn wounds is obviously superior to SD-Ag. It has the advantages of rapid healing, light pain, no obvious scar, and short hospitalization time.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第8期937-939,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
深度烧伤
残余创面
中西医结合
磺胺嘧啶银霜
疗效比较
Deep burns Residual wound Traditional Chinese medicine and western medicine Silver sulfadiazine cream Effectiveness comparison
