| Objectives1. To investigate the effects of occlusive dressing with warm water or urea ointment on the treatment of verruca.2. To compare the effects of pingyangmycin local injection of two different concentrations under the nursing intervention of occlusive dressing with warm water or urea ointment and find out the better concentration.3.To establish a standard operating procedure of local injection in the treatment of verruca.Methods200 patients with verruca were recruited in our study from the department of dermatology in OPD of PLA General Hospital (Among them,183 were actually studied and analyzed). Such research methods as random grouping, contrasting and single blinding were adopted in my study. All patients were randomly divided into three groups:control group, warm water occlusive dressing group and urea ointment occlusive dressing group. Patients in each group were further divided into two sub-groups:those who were given lower concentration of pingyangmycin (0.5mg/ml, group A) and those who were treated with higher concentration of pingyangmycin (1mg/ml, group B). The observation and record indexes include hardness and colors of verrucas, injection resistance, patients’ pain scores and comfort grades. The indexes such as the therapeutic efficiency ratio, recurrence rate, incidence of adverse effects and the time of the wart dropping off after treatment were used to evaluate the efficacy of treatment.Results1. Observation of clinical efficacyRank sum tests of the clinical efficacy of six different methods in treating verruca ulgaris were carried out 4 weeks after treatment. The differences showed statistic significance (P<0.05);The efficacy of urea ointment occlusive dressing group was higher than that of warm water occlusive dressing group. There was difference between group A and group B of the same group, but the difference had no statistic significance (P<0.05).2. Influence of occlusive dressing and concentration on the time of verruca dropping off after treatmentThe differences in time of verruca dropping off among warm water occlusive dressing group, urea ointment occlusive dressing group and control group had no statistic significance (P>0.05);while the difference between group A and group B in the same group had statistic significance(P<0.05).3. Adverse reactions within 7 days after treatmentThere was no significant statistic difference in adverse reactions among warm water group, urea ointment group and control group (P>0.05);However, there was significant statistic difference in adverse reactions between group A and group B in the same group (P<0.05).4. Influence of occlusive dressing and concentration on painVAS was adopted to assess the pain scores of patients in warm water occlusive dressing group, urea ointment occlusive dressing group and control group. There were significant statistic differences(P<0.05);Pain scores of control group were higher than those of occlusive dressing groups. As for the differences in pain scores between group A and group B, they also had statistic significance (P<0.05). The pain scores in group B were higher than those in group A and the pain scores of group B in control group were the highest among 6 groups with the score of 7.19±0.54.5. Influence of occlusive dressing and concentration on comfort grading assessment within 7 days after treatmentComfort grades within 7 days after treatment of warm water occlusive dressing group, urea ointment occlusive dressing group and control group were compared and there were no significant statistic differences (P> 0.05);However, there was significant statistic difference between group A and group B with different concentrations (P<0.05) and the comfort grades in group A were higher than those of group B.6. Influence of occlusive dressing on colors of verrucasColor changes of warts happened to 56 cases. The rates of color change in warm water occlusive dressing group was 96.49%. There was significant statistic difference between the two groups (P<0.01).7. Influence of occlusive dressing on hardness of verrucasThe softening rate of and urea ointment occlusive dressing group were significantly higher than the control group(P<0.01);there is no significant difference between warm water occlusive dressing group and urea ointment occlusive dressing group(P>0.05).8. Influence of occlusive dressing on injection resistanceThere was significant statistic difference in injection resistance among warm water occlusive dressing group, urea ointment occlusive dressing group and control group (P<0.01). The injection resistance in control group was the heaviest.9. Recurrence rate after treatment12 weeks’ follow-up after treatment showed that there was no significant statistical difference in recurrence rates among all groups(P>0.05).Conclusion10% urea ointment occlusive combined with local injection of lower concentration of pingyangmycin (0.5mg/ml, group A) is an effective treatment which has less adverse reactions and causes lower VAS. This therapy is easy to learn for nurses and can be used widely. |
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