目的 探讨京万红软膏联合如意金黄散治疗老年皮肤溃疡的临床疗效。方法 选取2019年6月-2021年6月在郑州市第九人民医院进行治疗的134例老年皮肤溃疡患者为研究对象,根据用药差别将所有患者分为对照组和治疗组,每组各67例。对照组给予如意金黄散,用植物油调和成糊状后敷于患处,1袋/次,1次/d。治疗组在对照组治疗基础上给予京万红软膏,取适量京万红软膏同如意金黄散混合调成糊状,并敷于患处,1次/d,两组均经4周治疗。观察两组临床疗效,比较两组症状好转时间、视觉模拟(VAS)评分、皮肤病生活质量指数(DLQI)评分、血清细胞因子水平。结果经治疗,治疗组总有效率是97.01%,显著高于对照组的83.58%(P<0.05)。经治疗,治疗组溃疡痛消失时间、溃疡面渗出减少时间、溃疡面愈合时间均显著短于对照组(P<0.05)。经治疗,两组VAS评分较治疗前显著降低,而DLQI评分显著升高(P<0.05);治疗后,治疗组相关量表评分改善显著优于对照组(P<0.05)。经治疗,两组C反应蛋白(CRP)、降钙素原(PTC)、白细胞介素-6(IL-6)水平均较治疗前显著降低,而血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平显著升高(P<0.05);治疗后,治疗组血清细胞因子水平显著优于对照组(P<0.05)。结论 京万红软膏联合如意金黄散治疗老年皮肤溃疡具有较好的临床疗效,可有效改善疼痛,降低机体炎症因子水平,促进溃疡面愈合,有着良好临床应用价值。

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

河南省医学科技攻关计划联合共建项目（2018020868）