Clinical Study Of Negative Pressure Irrigation Combined With Shengjiyuyang Ointment In The Treatment Of Stage Ⅱ-Ⅲ Pressure Ulcers And Its Effect On MMP-9 And TIMP-1 In Wound Tissue

Objective:To observe the clinical efficacy of negative pressure perfusion irrigation of compound Huangbai liquid combined with Shengjiyuyang ointment treatment of stage Ⅱ-Ⅲ pressure ulcers(accumulation toxin and decay syndrome),and to monitor and explore the effect of negative pressure perfusion irrigation of compound Huangbai liquid combined with Shengjiyuyang ointment treatment on wound tissue MMP-9 and TIMP-1 in patients with stage Ⅱ-Ⅲ pressure ulcers.Methods:In this clinical study,60 patients with pressure ulcers who were hospitalized in the Department of Traditional Chinese Medicine Surgery of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from December 2021 to December 2022 and were in line with the syndrome of accumulation toxin rot were randomly divided into treatment group and control group.Sixty patients were treated for 28 days.The balance of general information of patients in each group was ensured during grouping.Both groups were given the same basic treatment,such as regular turning over,nutritional support,anti-infection,etc.Selective sterile debridement was performed on the wound,and VSD sponge was filled to cover the wound.At the end of the operation,both groups were given 200ml compound Huangbai solution diluted in 500 ml 0.9%sodium chloride injection combined with VSD continuous perfusion to wash the wound.The negative pressure irrigation was maintained for 30 minutes each time,twice a day,and the negative pressure device was removed after 7 days of treatment.Before dressing change,sterile gauze was trimmed according to the size of the wound,and a single layer was tiled.The prepared Shengjiyuyang ointment was evenly applied on both sides of the gauze,with a thickness of about 0.2-0.3 cm,to make Shengjiyuyang ointment gauze.The patients were covered with sterile gauze and fixed with bandage once a day.If the wound was deep enough to form a cavity,the sutures made of myogenic Yuyang plaster were filled into the internal cavity;The control group was given recombinant human epidermal growth factor gel treatment on the basis of the treatment,the operation method was the same as the treatment group.During the treatment,TCM symptom score,wound PUSH score,wound ulcer area,wound healing rate,wound healing speed,and MMP-9 and TIMP-1 content in wound tissue were used as clinical efficacy indicators,and the corresponding statistical analysis was performed to observe whether there were side effects and other adverse reactions in the patients of each group during the whole treatment period.Outcome:1.There were no significant differences in baseline data and efficacy observation indicators between the two groups before treatment(P>0.05),which were comparable.2.Comparison of clinical efficacy between the two groups:the total effective rate of the treatment group was 93%,the total effective rate of the control group was 83%,the treatment group was significantly better than the control group(P<0.05).3.Comparison between groups of efficacy indicators:after the end of treatment,the differences in medical syndrome score,wound PUSH score,wound ulcer area,wound healing rate,wound healing speed,and MMP-9 and TIMP-1 content in sored tissue were statistically significant(P<0.05),and the treatment group was better than the control group.4.Comparison of efficacy indicators within the two groups:TCM syndrome score:the treatment group finally decreased from the initial(16.60±3.86)score to(4.33±2.92)score,and the control group decreased from the initial(15.53±4.95)score to(6.47±3.35)score;Wound PUSH score:the treatment group decreased from the initial(14.13±1.20)score to(2.47±1.43)score,and the control group decreased from the initial(14.77±1.52)score to(3.87±1.76)score.Wound ulcer area:the wound ulcer area in the treatment group decreased from(33.73±6.88)cm2 to(3.33±1.77)cm2.MMP-9:the treatment group changed from(106.03±8.75)ng/l to(29.93±6.25)ng/I,and the control group changed from(109.60±9.33)ng/l to(35.83±5.94)ng/l.TIMP-1:the treatment group changed from the initial(6.37±2.19)ng/l to(3.067±1.26)ng/l,and the control group changed from the initial(5.83±2.05)ng/l to(5.03±1.85)ng/l;MMP-9/TIMP-1 ratio:the treatment group changed from(18.50±6.33)ng/l to(8.57±3.30)ng/l,and the control group changed from(21.07±9.37)ng/l to(11.20±2.83)ng/l;The clinical efficacy indexes of the two groups before and after treatment were improved compared with those before treatment and were statistically significant(P<0.05).Conclusion:1.The effect of negative pressure irrigation combined with Shengjiyuyang ointment treatment on stage Ⅱ-Ⅲ pressure ulcers is positive,and it is better than the treatment of recombinant human epidermal growth factor gel in the control group.2.Negative pressure irrigation combined with Shengjiyuyang ointment treatment promotes wound repair,which may be achieved by regulating the expression levels of MMP-9 and TIMP-1 in wound tissue.