通讯作者: 冯琦, lsq112233l@163.com

DOI：10.12201/bmr.202410.00023

Efficacy and safety of Zhangs Qingre Xiaoyu Decoction combined with VSD in the treatment of open tibia and fibula fracture wound infection

• 摘要：目的 研究循张氏清热消瘀汤联合负压封闭引流技术(Vacuum Sealing Drainage,VSD)治疗胫腓骨开放性骨折创面感染疗效及安全性。方法 采用随机数字表法将2022年1月～2024年1月在诊治的70例胫腓骨开放性骨折创面感染患者分为对照组(VSD治疗)和观察组(张氏清热消瘀汤联合VSD治疗),比较两组患者成纤维细胞形态、增殖能力、疗效、并发症、炎症因子、T淋巴细胞、CD64、CRP、Alb、纤维性胶原差异。结果 观察组成纤维细胞形态及增殖能力优于对照组。观察组胫腓骨折感染患者治疗后创面愈合率、创面肉芽组织生长评分均显著高于对照组患者(P<0.05),病原学阳性率、小腿肿胀消失时间及VAS评分均显著低于对照组患者(P<0.05)。观察组和对照组胫腓骨折感染患者消化道反应、肝肾功能损伤、局部皮炎、深静脉血栓发生率方面无统计学差异(P>0.05)。观察组和对照组患者治疗前PCT、TNF-α、IL-1β、IL-6、IL-8、CD3+、CD4+、CD8+、CD64、CRP、Alb、CRP/Alb、COL Ⅰ、COL Ⅲ、COL Ⅴ和COL Ⅺ均无统计学差异(P>0.05),治疗后PCT、TNF-α、IL-1β、IL-6、IL-8、CD3+、CD8+、CD64、CRP、Alb、CRP/Alb均较治疗前显著降低(均P<0.05),CD4+、COL Ⅰ、COL Ⅲ、COL Ⅴ和COL Ⅺ较治疗前显著增高(均P<0.05)。观察组患者治疗后PCT、TNF-α、IL-1β、IL-6、IL-8、CD3+、CD8+、CD64、CRP、Alb、CRP/Alb显著低于对照组患者(均P<0.05),CD4+、COL Ⅰ、COL Ⅲ、COL Ⅴ和COL Ⅺ显著高于对照组(均P<0.05)。结论 张氏清热消瘀汤联合VSD治疗胫腓骨开放性骨折创面感染可显著促进成纤维细胞增殖及纤维性胶原合成并降低炎症反应,其疗效及安全性优于传统的VSD治疗。

  关键词： 胫腓骨开放性骨折; 创面感染; 张氏清热消瘀汤; VSD; 疗效; 安全性

   

  Abstract: Objective To study the efficacy and safety of Zhangs Qingre Xiaoyu Decoction combined with VSD in the treatment of infected wounds of open tibia and fibula fractures. Methods The random number table method was used to divide 70 patients with open tibia and fibula fracture infection who were1 diagnosed and treated from January 2022 to January 2024 into the control group (VSD treatment) and the observation group (Zhangs Qingre Xiaoyu Decoction combined with VSD treatment). , compare the differences in fibroblast morphology, proliferation ability, efficacy, complications, inflammatory factors, T lymphocytes, CD64, CRP, Alb, and fibrillar collagen between the two groups of patients. Results The observed fibroblast morphology and proliferation ability were better than those in the control group. The wound healing rate and wound granulation tissue growth score of patients with tibiofibular fracture infection in the observation group after treatment were significantly higher than those of the control group (P<0.05). The positive rate of etiology, the disappearance time of calf swelling, and the VAS score were all significantly lower than those of the control group. group of patients (P<0.05). There were no statistically significant differences in the incidence of gastrointestinal reactions, liver and kidney function damage, local dermatitis, and deep vein thrombosis between the observation group and the control group (P>0.05). PCT, TNF-α, IL-1β, IL-6, IL-8, CD3+, CD4+, CD8+, CD64, CRP, Alb, CRP/Alb, COL Ⅰ, COL Ⅲ, COL Ⅴ before treatment in the observation group and control group There was no statistical difference (P>0.05) between PCT, TNF-α, IL-1β, IL-6, IL-8, CD3+, CD8+, CD64, CRP, Alb, and CRP/Alb after treatment. were significantly lower than those before treatment (all P<0.05), and CD4+, COL Ⅰ, COL Ⅲ, COL Ⅴ and COL Ⅺ were significantly higher than those before treatment (all P<0.05). After treatment, the PCT, TNF-α, IL-1β, IL-6, IL-8, CD3+, CD8+, CD64, CRP, Alb, and CRP/Alb of the patients in the observation group were significantly lower than those of the patients in the control group (all P<0.05). , CD4+, COL Ⅰ, COL Ⅲ, COL Ⅴ and COL Ⅺ were significantly higher than those in the control group (all P<0.05). Conclusion Zhangs Qingre Xiaoyu Decoction combined with VSD can significantly promote fibroblast proliferation and fibrous collagen synthesis and reduce inflammatory response in the treatment of infected wounds of open tibia and fibula fractures. Its efficacy and safety are better than traditional VSD treatment.

  Key words: open tibia and fibula fractures; infected wounds; Zhangs Qingre Xiaoyu Decoction; VSD; efficacy; safety

  提交时间：2024-10-10

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• 序号	提交日期	编号	操作
  1	2024-08-15	bmr.202410.00023V1	下载

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