金榆敛疮膏治疗重症心力衰竭患者压力性损伤的疗效观察
Observation on Effect of Jinyu Lianchuang Ointment on Pressure Injury in Patients with Severe Heart Failure
-
摘要: 目的 观察金榆敛疮膏治疗重症心力衰竭(简称心衰)患者压力性损伤(PI)的临床疗效。方法 选取2015年12月至2019年9月符合纳入标准的重症心衰患者309例,随机分为对照组(152例)和中药组(157例),常规清创、抗菌处理基础上,中药组给予金榆敛疮膏外敷,对照组给予美皮康银离子敷料外敷,治疗21 d后观察2组患者压力性损伤愈合评分(PUSH评分)、创面愈合时间、21 d创面愈合率、疼痛和心功能改善情况,以及血清炎症因子白介素-6(IL-6)、超敏C反应蛋白(hsCRP)、N末端B型利尿肽前体(NT-proBNP)水平变化。结果 治疗后与对照组相比较,中药组Ⅰ期重症心衰PI患者进展为Ⅱ~Ⅳ期的人数明显降低(P<0.05),Ⅱ、Ⅲ期PI患者的21 d总有效率显著高于对照组(P<0.05),创面愈合时间显著少于对照组(P<0.05),创面PUSH评分和VAS疼痛评分明显低于对照组(P<0.05),IL-6、hsCRP和NT-ProBNP水平显著低于对照组(P<0.05~0.01)。结论 金榆敛疮膏预防和治疗重症心衰患者PI疗效显著,有效缩短创面愈合时间,减轻疼痛,有助于炎症控制和心功能改善。Abstract: OBJECTIVE To observe the clinical effect of Jinyu Lianchuang ointment for the treatment of pressure injury (PI) in patients with severe heart failure. METHODS 309 patients with severe heart failure from December 2015 to September 2019 were enrolled. They were randomly divided into the control group (152 cases) and Chinese medicine group (157 cases). In addition to regular debridement and antibacterial treatment, the Chinese medicine group was given Jinyu Lianchuang ointment and the control group was given Mepilex silver dressings. After 21 days of treatment, improvement of the pressure injury healing score (PUSH score), wound healing time, 21 day wound healing rate, clinical treatment effect, pain, heart function, and changes in serum inflammatory factor interleukin-6 (IL-6), hypersensitive C-reactive protein (hsCRP), and N-terminal B-type diuretic peptide precursor (NT-proBNP) were measured. RESULTS After treatment, compared with the control group, the rate of stage Ⅰ PI patients with severe heart failure progressing to stageⅡ-Ⅳwas significantly reduced in the Chinese medicine group (P<0.05) . The 21-day total effective rate of the Chinese medicine group of PI patients in stage Ⅱ and Ⅲ was significantly higher than that in the control group (P<0.05), and the wound healing time of patients in the Chinese medicine group was significantly shorter than that in the control group (P<0.05). The PUSH scores of wound surface and VAS pain scores in the Chinese medicine group were significantly lower than those in the control group (P<0.05), and the levels of IL-6, hsCRP and NT-ProBNP in the Chinese medicine group were significantly lower than that in the control group (P<0.05, P<0.01). CONCLUSION Jinyu Lianchuang ointment is effective in preventing and treating pressure injury in patients with severe heart failure. It can effectively shorten the healing time of the wound surface, reduce pain, control inflammation and improve cardiac function.