目的 探討京萬紅軟膏聯(lián)合如意金黃散治療老年皮膚潰瘍的臨床療效。方法 選取2019年6月-2021年6月在鄭州市第九人民醫(yī)院進行治療的134例老年皮膚潰瘍患者為研究對象,根據(jù)用藥差別將所有患者分為對照組和治療組,每組各67例。對照組給予如意金黃散,用植物油調(diào)和成糊狀后敷于患處,1袋/次,1次/d。治療組在對照組治療基礎(chǔ)上給予京萬紅軟膏,取適量京萬紅軟膏同如意金黃散混合調(diào)成糊狀,并敷于患處,1次/d,兩組均經(jīng)4周治療。觀察兩組臨床療效,比較兩組癥狀好轉(zhuǎn)時間、視覺模擬(VAS)評分、皮膚病生活質(zhì)量指數(shù)(DLQI)評分、血清細(xì)胞因子水平。結(jié)果經(jīng)治療,治療組總有效率是97.01%,顯著高于對照組的83.58%(P<0.05)。經(jīng)治療,治療組潰瘍痛消失時間、潰瘍面滲出減少時間、潰瘍面愈合時間均顯著短于對照組(P<0.05)。經(jīng)治療,兩組VAS評分較治療前顯著降低,而DLQI評分顯著升高(P<0.05);治療后,治療組相關(guān)量表評分改善顯著優(yōu)于對照組(P<0.05)。經(jīng)治療,兩組C反應(yīng)蛋白(CRP)、降鈣素原(PTC)、白細(xì)胞介素-6(IL-6)水平均較治療前顯著降低,而血清血管內(nèi)皮生長因子(VEGF)、堿性成纖維細(xì)胞生長因子(bFGF)水平顯著升高(P<0.05);治療后,治療組血清細(xì)胞因子水平顯著優(yōu)于對照組(P<0.05)。結(jié)論 京萬紅軟膏聯(lián)合如意金黃散治療老年皮膚潰瘍具有較好的臨床療效,可有效改善疼痛,降低機體炎癥因子水平,促進潰瘍面愈合,有著良好臨床應(yīng)用價值。

Objective To explore the clinical efficacy of Jingwanhong Ointment combined with Ruyi Jinhuang Powder in treatment of senile skin ulcer. Methods A total of 134 elderly patients with skin ulcer treated in Ninth People’s Hospital of Zhengzhou from June 2019 to June 2021 were selected as the research objects. According to the difference in medication, all patients were divided into control group and treatment group, with 67 cases in each group. Patients in the control group were given Ruyi Jinhuang Powder, mixed with vegetable oil into paste and applied to the affected area, 1 bag/time, once daily. Patients in the treatment group was given Jingwanhong Ointment on the basis of the treatment in the control group. Appropriate amount of Jingwanhong Ointment were mixed into paste and applied to the affected area once daily. Both groups were treated for 4 weeks. Clinical efficacy of the two groups were observed, symptom improvement time, visual analog scale (VAS) score, skin disease quality of life index (DLQI) score and serum factor level were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.01%, significantly higher than that of the control group 83.58% (P < 0.05). After treatment, the disappearance time of ulcer pain, the reduction time of ulcer exudation and the healing time of ulcer surface in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, VAS score in both groups was significantly decreased, while DLQI score was significantly increased (P < 0.05). After treatment, the improvement of related scale scores in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PTC), and interleukin-6 (IL-6) in two groups were significantly decreased compared with before treatment, while the levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were increased (P < 0.05). After treatment, serum cytokine level in treatment group was significantly better than that in control group (P < 0.05). Conclusion Jingwanhong Ointment combined with Ruyi Jinhuang Powder has good clinical effect in treatment of senile skin ulcer, and can effectively improve pain, reduce the level of inflammatory factors, promote the healing of ulcer surface, which has good clinical application value.

R986

河南省醫(yī)學(xué)科技攻關(guān)計劃聯(lián)合共建項目（2018020868）