| [Objective]By collecting the clinical data of patients with venous leg ulcers of damp heat and blood stasis type,the characteristics of the disease were observed.To evaluate the curative effect of modified Simiao pill on ulcer area,wound syndrome,lower limb edema,wound pain and other symptoms in patients with venous ulcer of lower extremity by comparative test,to evaluate the clinical efficacy and safety of modified Simiao pill in the treatment of venous leg ulcers with damp-heat and blood stasis,and to explore its mechanism of action.To explore the intervention effect of this prescription on venous leg ulcers of damp-heat and blood stasis type,and to provide a preliminary basis for clinical promotion.[Methodology]In this study,a total of 50 patients with venous leg ulcers of damp-heat and blood stasis type were collected and randomly divided into treatment group and control group,with 25 cases in each group.Under the basic treatment of pressure treatment,raising the affected limb and wound care,the control group was given diosmin tablets,900 mg once,twice a day orally.The treatment group was given modified Simiao Pills(Huangbai 20g,Cangzhu 15g,Niuxi 10g,Yiyiren 30g,Chishao 15g,Danpi 10g,Danggui 15g,Chuanxiong 10g,Danshen 30g,Dandelion 15g,Zicao 15g,Shenggancao 12g,Shenghuangqi 30g,Baiji 6g)orally,1 dose 2 bags per day,1 bag at a time.1 day 2 times,with 150 ml boiling water,morning and evening two times.The two groups were treated for 4 weeks.Before and after treatment,the ulcer area measurement,ulcer healing rate calculation,pain score,wound exudation,new granulation and skin condition assessment,lower limb edema degree and other related TCM syndrome score statistics were performed on the patients,and safety indicators were measured before and after treatment.Combined with ulcer healing and syndrome improvement,the clinical efficacy was evaluated comprehensively.[Results]1 Characteristics of onsetThrough the analysis of 50 patients included in this study,the predilection age of venous leg ulcer with damp-heat and blood stasis type is 66-70 years old.Ulcers can occur in the left lower limbs,right lower limbs or both lower limbs,and most of them occur in the left lower limbs.The most common site of ulcer is the medial side of the ankle,and a small number of patients attack on the lateral-side of the ankle or the anterior tibial area.2 Ulcer area healing rateAfter 4 weeks of treatment,compared with before treatment,the lower limb ulcer area of the observation group and the control group was significantly reduced(P<0.05).The ulcer reduction area of the two groups was 8.43±3.90cm2 and 5.78±2.33cm2.The ulcer healing rate was 86.12%±19.05%and 67.84±22.53%.There was a significant statistical difference between the two groups(P<0.05).The observation group was better than the control group in promoting the healing of lower limb ulcer wounds.3 TCM syndrome scoreAfter 4 weeks of treatment,compared with before treatment,the TCM syndrome scores of the observation group and the control group were significantly reduced(P<0.05).The TCM syndrome scores of the two groups were reduced by 34.16±7.27 and 26.04±7.56,,and the comparison between the two groups was statistically significant(P<0.05).The observation group was better than the control group in improving the TCM syndromes such as wound exudation,surrounding skin condition,edema and pain.4 Lower limb circumferenceAfter 4 weeks of treatment,the lower limb circumference of the observation group and the control group was significantly reduced(P<0.05).The total lower limb circumference of the two groups before treatment was 104.67±4.63 cm and 104.23±4.33 cm.After treatment,they were 101.11±5.00 cm and 101.92±4.64 cm.The comparison between the two groups was statistically significant(P<0.05).The observation group was better than the control group in relieving limb edema5 Wound painAfter 4 weeks of treatment,the VAS pain scores of the observation group and the control group were significantly lower than those before treatment(P<0.05).The VAS pain scores of the two groups before treatment were 3.72±1.74 and 3.84±1.84.After treatment,they were 0.52±0.59 and 1.52±1.61.The comparison between the two groups was statistically significant(P<0.05).The observation group was better than the control group in reducing the pain of ulcer wounds.6 Comparison of effective rateBased on the ulcer healing rate before and after treatment,12 cases were cured,6 cases were markedly effective,6 cases were effective,1 case was ineffective,and the total effective rate was 96%.In the control group,4 cases were cured,6 cases were markedly effective,12 cases were effective,3 cases were ineffective,and the total effective rate was 88%.Comparison between the two groups P<0.05.The improvement rate of TCM syndromes was calculated based on TCM syndrome scores.In the observation group,1 case was cured,15 cases were markedly effective,8 cases were effective,1 case was ineffective,and the total effective rate was 96%.In the control group,0 cases were cured,8 cases were markedly effective,12 cases were effective,5 cases were ineffective,and the total effective rate was 80%.Comparison between the two groups P<0.05.Based on two different evaluation methods,the difference of effective index between the two groups after treatment was statistically significant(P<0.05),which proved that the effective rate of the observation group was better than that of the control group after 4 weeks of treatment.7 Recurrence rate analysisAfter 3 months of follow-up after treatment,2 cases of recurrence and 1 case of loss of follow-up were found in the observation group.In the control group,9 cases recurred and 3 cases were lost to follow-up.The loss of follow-up in the observation group was regarded as recurrence,and the loss of follow-up in the control group was regarded as no recurrence.The recurrence rate of the observation group was 12%,and the recurrence rate of the control group was 36%.The comparison between the two groups was P<0.05.The recurrence rate of the observation group was lower than that of the control group after 3 months of treatment.[Conclution]1 The age of onset of patients with venous leg ulcer of damp-heat and blood stasis type is mainly between 66-70 years old.Ulcers can occur in any limb of both lower limbs or at the same time,and most of them occur in the left lower limb.The predilection site of ulcer was medial superior malleolus,and a few occurred in lateral superior malleolus or anterior tibial area.2 Modified Simiao Pill can promote the healing of wounds in patients with venous leg ulcer of damp-heat and blood stasis type,improve clinical symptoms such as wound exudation,degree of decay,and surrounding skin damage,reduce the circumference of edema in the affected limb of the ulcer,and reduce the pain around the wound and wound.3 Modified Simiao pill oral treatment of damp heat and blood stasis type of venous leg ulcer curative effect is clear,the recurrence rate is low,high safety,simple operation,good patient compliance,is worth promoting in clinical. |
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