川芎嗪注射液加快威克伤负压引流创面肉芽组织生长的临床观察
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摘要
目的：通过观察创面的肉芽组织生长情况、可行Ⅱ期手术闭合创面的时间等指标，观察中医活血化瘀类药物川芎嗪注射液对威克伤负压引流下急性创面的愈合是否有相加作用，并探讨其机理及相互影响情况。
方法：采取前瞻性随机对照试验的研究方法，通过对2006年7月到2007年3月之间43例应用威克伤负压引流治疗急性创面的病例，按简单随机化法分为治疗组和对照组。治疗组在每次威克伤术后应用川芎嗪注射液治疗，对照组在每次威克伤术后不应用活血化瘀类药物治疗。疗程至患者拆除威克伤闭合创面。观察两组创面的肉芽组织生长情况、可行Ⅱ期手术闭合创面的时间、术前及术后的血液流变学等指标。
结果：
1.治疗组与对照组的患者在第一次拆除威克伤时创面肉芽组织生长情况评分及行Ⅱ期手术闭合创面的时间上相比较，有显著性差异(P＜0.05)，提示治疗组可加快威克伤负压引流创面的肉芽组织生长，缩短行Ⅱ期手术闭合创面的时间。但在最后一次拆除威克伤时创面肉芽组织生长情况评分上相比较，无显著性差异(P＞0.05)，提示急性创面经威克伤负压引流治疗一段时间后肉芽组织均生长良好。
2.对照组的血液流变学中的还原粘度及血沉方程K积分术前与术后相比较及两组术后相比较，有显著性差异(P＜0.05)；治疗组术前与术后相比较，无显著性差异(P＞0.05)，提示治疗组可改善术后患者静脉血的高凝状态。
3.治疗组与对照组的病例治愈率相比较，无显著性差异(P＞0.05)，提示绝大部分急性创面经威克伤负压引流治疗后均可行Ⅱ期手术(直接缝合、游离植皮或皮瓣移植)闭合创面而愈合。
4.治疗过程中进行血、尿、大便常规及心、肝、肾功能检查，两组均无异常变化，治疗过程中未见局部过敏反应或其他不良反应。
结论：
1.川芎嗪注射液可加快威克伤负压引流创面的肉芽组织生长，缩短行Ⅱ期手术(直接缝合、游离植皮或皮瓣移植)闭合创面的时间，缩短了住院时间及减少住院费用。
2.静滴川芎嗪注射液可改善威克伤负压引流术后患者静脉血的高凝状态，改善创面血液的血液流变学情况。
3.急性创面经威克伤负压引流治疗后肉芽组织均生长良好，绝大部分可经Ⅱ期手术闭合创面而愈合。
4.治疗组及对照组病例在安全性指标上均无异常，说明应用川芎嗪注射液治疗威克伤负压引流创面在安全性上可行的。
Objective: The aim of the study was to assess the effect of the drug for promoting blood circulation- Ligustrazine Phosphate and Glucose Injection on the acute wound treating by Vacuum-assisted Closure, and to confer the mechanism of them through observing the growing of granulation of the skin wound and the time to do the stageⅡoperation to close the wound.
Methods: 43 patients from July, 2006 to March, 2007 treating by Vacuum-assisted Closure were randomly assigned to the treating group or to the control group. Thetreating group was treated by Vacuum-assisted Closure combined with Ligustrazine Phosphate and Glucose Injection, and thee control group was treated only by Vacuum-assisted Closure. The course was ended when removing Vacuum-assisted Closure. growing of granulation of the skin wound and the time to do the stageⅡoperation to close the wound of two groups were observed and compared.
Results:
1. The index of growing of granulation of the skin wound when removing the Vacuum-assisted Closure for the first time and the time to do the stageⅡoperation to close the wound of treating group and control group has significant difference (P＞0.05). It shows that management of treating group could improve the the growing of granulation of the skin wound and shorten the time to do the stageⅡoperation to close the wound. The index of growing of granulation of the skin wound when removing the Vacuum-assisted Closure at last of two groups have no significant difference(P＞0.05) which showed the granulation grew well by the management of the Vacuum-assisted Closure.
2. Arbe, index K of treating group have significant difference (P＜0.05) after operation compared with pre-treatment. Arbe, index K of the treating group have significant difference (P＜0.05) after operation compared with the control group. Hemorheology of control group have no significant difference (P＞0.05) whether before or after. It showed the management of the treating group was better than the control group in reducing the high coefficient of viscosity after operation..
3. The cure rate of treating group and control group have no significant difference (P＞0.05) that showed Most of acute wound can close the wound by stageⅡoperation. Most of them can close the wound by stageⅡoperation.
4. Both of the two groups have no significant difference in routine blood test, routine urine test, routine stool test, heart function, liver function, kidney function during the study comparing with the pre-treatment. There is no allergic reaction and adverse drug reactions during the treating.
Conclusion:
1. Ligustrazine Phosphate and Glucose Injection can improve the growing of granulation of the wound and shorten the time to do the stageⅡoperation to close the wound, shorten the days to be hospitalized and reduce the cost.
2. Ligustrazine Phosphate and Glucose Injection can reducing the high coefficient of viscosity after operation and improve hemorheology of the acute wound.
3. Granulation of the acute skin wound grew well when treating by the Vacuum-assisted Closure. Most of them can close the wound by stageⅡoperation.
4. Both of the two groups have no difference on safty index. Ligustrazine Phosphate and Glucose Injection is safe and feasible onthe the acute wound treating by Vacuum-assisted Closure.
方法：采取前瞻性随机对照试验的研究方法，通过对2006年7月到2007年3月之间43例应用威克伤负压引流治疗急性创面的病例，按简单随机化法分为治疗组和对照组。治疗组在每次威克伤术后应用川芎嗪注射液治疗，对照组在每次威克伤术后不应用活血化瘀类药物治疗。疗程至患者拆除威克伤闭合创面。观察两组创面的肉芽组织生长情况、可行Ⅱ期手术闭合创面的时间、术前及术后的血液流变学等指标。
结果：
1.治疗组与对照组的患者在第一次拆除威克伤时创面肉芽组织生长情况评分及行Ⅱ期手术闭合创面的时间上相比较，有显著性差异(P＜0.05)，提示治疗组可加快威克伤负压引流创面的肉芽组织生长，缩短行Ⅱ期手术闭合创面的时间。但在最后一次拆除威克伤时创面肉芽组织生长情况评分上相比较，无显著性差异(P＞0.05)，提示急性创面经威克伤负压引流治疗一段时间后肉芽组织均生长良好。
2.对照组的血液流变学中的还原粘度及血沉方程K积分术前与术后相比较及两组术后相比较，有显著性差异(P＜0.05)；治疗组术前与术后相比较，无显著性差异(P＞0.05)，提示治疗组可改善术后患者静脉血的高凝状态。
3.治疗组与对照组的病例治愈率相比较，无显著性差异(P＞0.05)，提示绝大部分急性创面经威克伤负压引流治疗后均可行Ⅱ期手术(直接缝合、游离植皮或皮瓣移植)闭合创面而愈合。
4.治疗过程中进行血、尿、大便常规及心、肝、肾功能检查，两组均无异常变化，治疗过程中未见局部过敏反应或其他不良反应。
结论：
1.川芎嗪注射液可加快威克伤负压引流创面的肉芽组织生长，缩短行Ⅱ期手术(直接缝合、游离植皮或皮瓣移植)闭合创面的时间，缩短了住院时间及减少住院费用。
2.静滴川芎嗪注射液可改善威克伤负压引流术后患者静脉血的高凝状态，改善创面血液的血液流变学情况。
3.急性创面经威克伤负压引流治疗后肉芽组织均生长良好，绝大部分可经Ⅱ期手术闭合创面而愈合。
4.治疗组及对照组病例在安全性指标上均无异常，说明应用川芎嗪注射液治疗威克伤负压引流创面在安全性上可行的。
Objective: The aim of the study was to assess the effect of the drug for promoting blood circulation- Ligustrazine Phosphate and Glucose Injection on the acute wound treating by Vacuum-assisted Closure, and to confer the mechanism of them through observing the growing of granulation of the skin wound and the time to do the stageⅡoperation to close the wound.
Methods: 43 patients from July, 2006 to March, 2007 treating by Vacuum-assisted Closure were randomly assigned to the treating group or to the control group. Thetreating group was treated by Vacuum-assisted Closure combined with Ligustrazine Phosphate and Glucose Injection, and thee control group was treated only by Vacuum-assisted Closure. The course was ended when removing Vacuum-assisted Closure. growing of granulation of the skin wound and the time to do the stageⅡoperation to close the wound of two groups were observed and compared.
Results:
1. The index of growing of granulation of the skin wound when removing the Vacuum-assisted Closure for the first time and the time to do the stageⅡoperation to close the wound of treating group and control group has significant difference (P＞0.05). It shows that management of treating group could improve the the growing of granulation of the skin wound and shorten the time to do the stageⅡoperation to close the wound. The index of growing of granulation of the skin wound when removing the Vacuum-assisted Closure at last of two groups have no significant difference(P＞0.05) which showed the granulation grew well by the management of the Vacuum-assisted Closure.
2. Arbe, index K of treating group have significant difference (P＜0.05) after operation compared with pre-treatment. Arbe, index K of the treating group have significant difference (P＜0.05) after operation compared with the control group. Hemorheology of control group have no significant difference (P＞0.05) whether before or after. It showed the management of the treating group was better than the control group in reducing the high coefficient of viscosity after operation..
3. The cure rate of treating group and control group have no significant difference (P＞0.05) that showed Most of acute wound can close the wound by stageⅡoperation. Most of them can close the wound by stageⅡoperation.
4. Both of the two groups have no significant difference in routine blood test, routine urine test, routine stool test, heart function, liver function, kidney function during the study comparing with the pre-treatment. There is no allergic reaction and adverse drug reactions during the treating.
Conclusion:
1. Ligustrazine Phosphate and Glucose Injection can improve the growing of granulation of the wound and shorten the time to do the stageⅡoperation to close the wound, shorten the days to be hospitalized and reduce the cost.
2. Ligustrazine Phosphate and Glucose Injection can reducing the high coefficient of viscosity after operation and improve hemorheology of the acute wound.
3. Granulation of the acute skin wound grew well when treating by the Vacuum-assisted Closure. Most of them can close the wound by stageⅡoperation.
4. Both of the two groups have no difference on safty index. Ligustrazine Phosphate and Glucose Injection is safe and feasible onthe the acute wound treating by Vacuum-assisted Closure.
引文
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