【作者】 焦占江；

【导师】 王烈；

【作者基本信息】 福建中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：探讨桃红四物汤联合手术治疗下肢静脉性溃疡的临床疗效和机制,提供一种有效的治疗下肢静脉性溃疡的方法。方法：将60例下肢静脉性溃疡患者随机分为研究组(桃红四物汤熏洗联合手术组)、对照组(常规换药联合手术组)两组,术前两组均每日换药2次,对比桃红四物汤熏洗溃疡面与常规换药处理溃疡面的下肢静脉性溃疡患者的溃疡面愈合时间、细菌培养；术前两组患者采用下肢静脉顺行造影检查明确浅、深和交通静脉3个静脉系统的损害范围及程度,对比下肢静脉顺行造影检查与彩色多普勒超声检查在对功能不全的交通支静脉的检出率,并精确定位功能不全的交通支静脉；手术综合处理深、浅和交通静脉3个静脉系统。结果：研究组临床疗效总有效率为100.0%,对照组为73.3%,两组有显著性差异(P<0.05)。研究组在促进溃疡面愈合、抑菌方面优于对照组,两组比较有显著性差异(P<0.05)。下肢静脉顺行造影检查与彩色多普勒超声检查对功能不全的交通支静脉的检出数及检出率无显著性差异(P>0.05)。两组患者经手术治疗后临床症状及体征均改善,未出现并发症,研究组临床症状及体征的改善优于对照组。结论：1、桃红四物汤熏洗溃疡面较常规换药更能促进溃疡面愈合,缩短溃疡面愈合时间,抑菌,为手术创造良好的创面条件。2、桃红四物汤联合手术可显著改善下肢慢性静脉性溃疡的临床症状和体征,是治疗下肢静脉性溃疡的有效方法。更多还原

【Abstract】 Objective:To investigate the therapeutic effect and mechanism of taohongsiwu decoction combined with surgery in treating venous ulceration of lower extremity, and to provide a new effective treatment for venous ulceration of lower extremity.Methods:60 cases of venous ulceration were divided into two groups randomly. The study group (30 patients) changes the dressing of the wounded area with taohongsiwu decoction fumigation preoperation and the control group (30 patients) changes the dressing of the wounded area with traditional dressing preoperation. Two groups change the dressing two times a day preoperation. To observe the wound healing time and bacterial culture between the two groups. All patients underwent venous anterograde visualization, to define the scope and extent of the damage of deep vein, superficial vein and perforating vein. Compare the positive rates of incompetent perforator veins by the examination of color doppler ultrasonography and venous anterograde visualization, to precise localization of incompetent perforator veins. To deal with the deep vein, superficial vein and perforating vein properly by surgery.Results:The clinical result show:the total effective rate of study group and control group is 100.0 per and 73.3 per respectively. The difference was significant (P<0.05). Ulcer healing and bacteriostasis in study group were better than control group. There were significant difference between two groups (P<0.05).There were no significant different in the positive rates incompetent perforator veins between the two methods of detection (P> 0.05). The two groups can improve the clinical symptoms and signs in treating venous ulceration of lower extremity in postoperative, no complications. The study group can improve the clinical symptoms and signs better than the control group.Conclusion:1、Taohongsiwu decoction fumigate the wound is an effective applicatin for wound healing, which is better than traditional dressing methods in treating patients with lower extremity. It can shorten the wound healing time, create favorable conditions for the operation.2、Taohongsiwu decoction combine with surgery can improve the clinical symptoms and signs in treating venous ulceration of lower extremity, which is a new effective treatment for venous ulceration of lower extremity.更多还原