威伐光照射联合云南白药散外敷治疗慢性皮肤溃疡

目的 观察威伐光照射联合云南白药散外敷治疗慢性皮肤溃疡的临床疗效及安全性。方法 将100例符合条件的慢性皮肤溃疡患者随机分为4组：对照组、光疗组、药物组和联合组,每组各25例。对照组给予常规外科清创换药,光疗组、药物组和联合组均在对照组的基础上分别予以威伐光照射,云南白药散外敷和威伐光照射加云南白药散外敷治疗,疗程均为4周。观察各组患者治疗前后伤口渗出、疼痛程度、肉芽组织生长情况和溃疡面积的变化,比较各组临床疗效。结果 治疗后联合组总有效率为92.00%,优于光疗组的66.67%和对照组的43.48%（P<0.05）,与药物组（70.83%）比较差异无统计学意义（P>0.05）。治疗后各组的各项临床症状积分与治疗前相比均有改善（P<0.05）;除渗出情况积分与光疗组相比无明显差别外,联合组的各项积分均优于其他各组（P<0.05）。各组均未发生明显不良反应。结论 威伐光照射联合云南白药散外敷治疗慢性皮肤溃疡疗效确切,安全性好。

Treatment of chronic skin ulcer by water-filtered infrared-A combined with Yunnan Baiyao

Objective To observe the clinical efficacy and safety of water-filtered infrared-A combined with Yunnan Baiyao in the treatment of chronic skin ulcer (CSU). Methods One hundred eligible chronic skin ulcer (CSU) patients were randomly divided into a control group, a phototherapy group, a drug group and a combined group, each of which had 25 cases. The control group was given conventional surgical debridement and dressing; the phototherapy group, the drug group and the combined group were given water-filtered infrared-A irradiation, external application of Yunnan Baiyao powders and both the above treatments for four weeks respectively, apart from conventional surgical debridement and dressing. The changes of wound exudation, degree of pain, granulation tissue growth and ulcer area, were observed before and after treatment, and the clinical efficacy of each group was compared. Results The total effective rate of the combined group after treatment was 92.00%, this was significantly higher than that of the phototherapy group (66.67%) and the control group (43.48%, P<0.05), but not statistically different from that of the drug group (70.83%,P>0.05). Post-treatment symptom scores of each group were improved when compared to pre-treatment scores (P<0.05). Except that there was no significant difference from the phototherapy group in the scores of exudation, the symptom scores of the combined group were better than those of the other groups (P<0.05). No obvious adverse reactions occurred in all groups. Conclusion The combined application of water-filtered infrared-A and Yunnan Baiyao is effective and safe in the treatment of CSU.