目的:中医外治药物回阳生肌散对慢性难愈性皮肤溃疡伴酮绿假单胞茵感染的治疗作用;方法:选择临床上分泌物培养为铜绿假单胞菌的慢性难愈性属阴证疮面31例。入选标准:疮面色晦褐污秽,疮形平塌,无新生肉芽;疮周皮色淡黯,遇凉有酸痛、抽痛,分泌物清稀,或如粉浆,或干涸。应用回阳生肌散或膏剂、纱条治疗,疮面分泌物增加稠厚或有肉芽组织生长或10~15天时再次行分泌物培养。结果:治疗后分泌物培养为杆菌的有9例,其中仍为铜绿假单胞菌1例,大肠埃希氏菌(2)肺炎克雷伯茵(2)、阴沟肠杆菌(2)、奇异变形杆菌(1)、鲍曼不动杆菌(1);球茵的有18例,金黄色葡萄球菌(12)、表皮葡萄球菌(3)、屎肠球菌(2)、鹑鸡肠球菌(1),无细菌生长4例。治疗前抗菌素敏感率平均为52.82%,治疗后杆菌为50.23%,球菌为54.87%,与治疗前比较P=0.32。结论:回阳生肌散不仅可以杀茵、抑菌,对病原菌抗药性影响较小或无影响,而且能促进疮面失活组织去除、肉芽增生、细胞激活,体现了中医药整体、辨证论治的优势。
Objective:To observe the efficacy of Huiyang Shengji Ointment, a TCM drug for external use,in treating chronic skin ulcer with pseudomonas aeruginosa infection. Methods:We selected 31 patients whose ulcer secretion cultures were pseudo- monas aeruginosa. Inclusion criteria:brown and unclean ulcer; collapsed sore -shaped;without newly grown granulation tissue; pale sore periderm;in the cold case more sore and twitch;dilute or like slurry or dry. Huiyang Shengji Ointment was applied no mater in what dosage form paste, powder or yarn, wound secretions were more stiff than before and granulation tissue started to grow. About l0 or 15 days later, we made another wound secretion culture. Results :After treatment, the wound secretion culture re- sults were as follows : pseudomonas aernginosa( 1 ) , Eseherichia coli ( 2 ) , Klebsiella pneumoniae ( 2 ), Sewer enterobacter ( 2 ), Pro- teus mirabilis ( 1 ) , Aeinetobac~r baumannii ( 1 ) , Staphylococcus aureus ( 12 ) , Staphylococcus epidermidis ( 3 ), Shit enterocoecus (2) , Quail chicken enteroeoeeus ( 1 ) , No bacterial growth ( 4 ). Before treatment the rate of antibiotic - sensitive was just 52. 82%. After treatment bacillus antibiotics sensitive rate was 50.23% and coccus' was 54.87%. Compared with before treatment, there was a significant difference (P = 0.32). Conclusion:The Huiyang Shengji Ointment can be bactericidal and baeteriostatic, re- move wound inactivation organization, promote the growth of granulation tissue and promote wound cell activation, showing the ad- vantages of traditional Chinese medicine.