【作者】 冯卫华；

【导师】 程春生；

【作者基本信息】 湖南中医药大学 ， 中医骨伤科学， 2012， 硕士

【摘要】 研究目的本研究的目的是通过试验及临床观察白草洗液(白头翁、夏枯草煎剂)湿敷治疗小腿铜绿假单胞菌感染创面疗效,进行数据学处理,从而为临床提供一种有效治疗小腿铜绿假单胞菌感染创面的方法,缩短治疗时间,降低感染复发率。研究方法通过对50只SD大白鼠铜绿假单胞菌感染创面造模,随机分为5组,每组10只,分别采用白草洗液、硫酸庆大霉素、白头翁煎剂、夏枯草煎剂、无菌凡士林油纱外敷,于造模后第1d、3d、5d、9d、14d观察创面渗出液、肉芽生长、创面愈合情况,于第3d、5d、9d、14d进行面积测定,第3天,第5天、第9天、第14天创面组织细菌定量测定,并对第14天的创面做病理学检查,观察巨噬细胞生长情况。2011年4月至2011年12月收治的60例小腿铜绿假单胞菌感染创面患者随机分为2组,观察其创面愈合率、肉芽生长、创面渗出液、细菌检测。研究结果对感染创面的大小、细菌计数,利用SPSS17.0软件包进行数据分析处理,结果采用均数标准差(x±s)表示,各组之间采用方差分析,伤口渗液量,肉芽生长量的情况采用等级资料的秩和检验,P<0.05具有统计学意义。动物实验显示白草洗液组在创面大小上,与硫酸庆大霉素组、白头翁煎剂组、夏枯草煎剂组、无菌凡士林油纱组有显著差异(P<0.01),观察铜绿假单胞菌感染创面的情况,白草洗液组肉芽生长良好,渗出液明显减少,创面缩小,颜色鲜红,病理结果显示白草洗液组铜绿假单胞菌感染创面有大量巨噬细胞,凡士林油纱组第7d死亡2只。两组患者的创面愈合率,采用两组之间的t检验,有差异有统计学意义(P<0.05)。临床疗效评定中,治疗组总有效率为93.3%,治愈率为66.67%,对照组总有效率为80%,治愈率为33.33%。经采用秩和检验,治疗组与对照组比较总体疗效具有差异有统计学意义(P<0.05),结果表明治疗组疗效优于对照组。结论白草洗液治疗小腿铜绿假单胞菌感染创面疗效显著,并明显优于单纯使用硫酸庆大霉素组的疗效。该方法是一个安全有效的中医治疗小腿铜绿假单胞菌感染创面的方案。更多还原

【Abstract】 ObjectiveThe objective of this study is to analyze the clinical effects of using Pennisetum lotion(Pulsatilla and Prunella lotion) in the Treatment Of leg wound combined Pseudomonas aeruginosa,through testing and observing the clinical effects, Data processing. To Provide an effective treatment for leg Pseudomonas aeruginosa wound infection for the clinical, shorten treatment time and reduce the recurrence rate of infection.MethodsThrough modeling50SD rats Skin defects and wound combined with Pseudomonas aeruginosa infection,Then randomly divided into5groups (n=10), were Pennisetum lotion, gentamicin sulfate, Pulsatilla lotion, Prunella vulgaris lotion, sterile Vaseline gauze and topical wound, After the modeling and1d,3d,5d,9d,14d observated the wound exudate, granulation growth, wound healing, determinate area in section3d,5d,9d,14d, and determinated wound tissue bacterial quantitative in the section of3d,5d,9d,14d of. Did The wound’s pathological examination in14days and observed the growth of macrophages. A random control design of clinical trials was adopted. The60Patients whose leg wound combined Pseudomonas aeruginosawere divided into two groups randomly,and observated tThe wound healing rate, growth of granulation, Wound exudate fluid, detection of bacteria.ResultsAnalysised and processed the size of wound infection, bacterial counts by SPSS17.0software package for data, the results using the mean standard deviation (χ±s), between groups using analysis of variance. Amount of wound exudate, the growth of granulation was statisticsed by Rank sum test of ranked data,if the results is P<0.05, Statistically significant results are meaningful. Animal experiments showed that the Pennisetum lotion group in wound size were significant difference from gentamicin sulfate group, Pulsatilla Decoction group, Prunella vulgaris decoction group, sterile vaseline gauze group (P<0.01=. Observed Pseudomonas aeruginosa wound infection, granulation growth of Pennisetum lotion group, significantly reduced exudate, wound narrowed, color was bright red. The pathological results showed that There were a large number of macrophages present in the wound infected by Pseudomonas aeruginosa of the Pennisetum lotion group. Two SD rats of Vaseline gauze group were died7days, Two groups of patients with wound healing rate compared with their own t test, the differences were highly significant (P<0.05) significance. Clinical evaluation, in the treatment group the total effective rate was93.3%, effective rate is66.67%; in the control group total effective rate was80%, effective rate is33.33%. Compared with Ridit test, the treatment group and the control group compared with significant difference (P<0.05), results showed that the treatment group than control group.ConclusionThe Pennisetum lotion treatment of leg Pseudomonas aeruginosa infection of the wound effect was significant, and significantly better than that of the efficacy of gentamicin sulfate group. This was a safe and effective traditional Chinese medicine treatment of leg Pseudomonas aeruginosa wound infection.更多还原