| Objective: By comparing the use of Moist Expose Burn Ointment/ Moist Expose Burn Therapy(MEBO/MEBT)and MEBO/MEBT combining with "Bu Tuo method",the study observed the efficacy,safety and basic mechanism of treating pressure ulcers.Method: 60 cases of pressure ulcers were selected and randomly divided into treatment group and control group,with 30 cases in each group.Both groups were given conventional treatment,and the pressure ulcers patients in the control group was treated by MEBO/MEBT twice a day,and moderate debridement was carried out according to the wound condition.The treatment group was given Bazhen decoction on the basis of the control group,and the total course of treatment was 4 weeks.(1)On the 7th,14 th,21st and 28 th days of treatment,the wound area,the amount of exudate and the tissue type of the wound were recorded,and then PUSH score was performed to evaluate the healing status,the emergence time of new epithelial cells on the wound,and adverse reactions were recorded to evaluate the safety;(2)At the same time points,the ulcers tissue was stained to observe the histopathological morphological changes of the wound tissue of the two groups,and the expression of CK19 in the wound tissue of the pressure ulcer was detected by Western blot.(3)The clinical observation results and the detection results of CK19 were statistically analyzed.Result:In this study,7 patients in the treatment group and 8 in the control group were removed or eliminated,and 23 patients in the treatment group and 2 in the control group were included in the test results.(1)Clinical observation results(1)Comparison between groups was made based on the ratio of ulcers area and depth reduction rate of 0d and 28d: the effective rate in the treatment group was 87.96%;The effective rate of control group was 40.10%.The difference was statistically significant(P< 0.05).And the effective rate in treatment group was significantly higher than that in control group.(2)The area and depth of pressure ulcers in both groups decreased before and after treatment,but it were greater in treatment group than control group.The diffence was statistically significant(P <0.05).(3)The time of the neoepithelial emergence was significantly different between the two groups(P <0.05),and the time in the control group was higher than that in the treatment group.(4)Safety comparison showed there were 2 cases of mild adverse reactions in the treatment group and 1 case in the control group,respectively.No statistical significance(P> 0.05)(2)Experimental observation results(1)The pressure ulcer PUSH score of the two groups before and after treatment is compared,and there is statistical difference(P mean to 0.05).The pressure ulcer PUSH score of the two groups is changed before and after treatment,that is,the pressure ulcer in the two groups is better than before treatment.After treatment,there was statistical difference in PUSH score between the two groups(P <0.05),and the treatment group was lower than the control group According to the group,namely the treatment group pressure ulcer healing better than the control group.(2)Based on the PUSH score,the effect of ""Bu Tuo method" combined with MEBO/MEBT in the treatment of pressure ulcers at stage I and IV(qi and blood deficiency syndrome)was evaluated.There were 22 cases in the treatment group and 1 case in the treatment group,with a total effective rate of 95.65%.There were 12 cases in the control group and 10 cases in the control group,with a total effective rate of 54.55%.The difference was statistically significant(P <0.05).(3)There were overall differences in the expression of CK19 between the two groups at different time points(P <0.05).There were no significant differences in the expression of CK19 between the two groups at 7d and 14 d,0d and 14 d,between the at 7d and 28 d in treatment group,and between at 0d and 21 d in the control group.There were statistical differences at two time points in every other two groups(P< 0.05)Conclusion :(1)The "Bu Tuo method" can promote the formation of granulation tissue,epidermal tissue and accessory organs in ulcer tissue of patients with pressure ulcers at the democratic stage and IV(qi and blood deficiency syndrome).(2)During MEBO/MEBT treatment of pressure ulcers at the plate stage and IV(qi and blood deficiency syndrome),the content of CK19 in wound tissue showed a trend of first decreasing,then increasing and decreasing.The addition of "Bu Tuo method" did not change its basic trend,but could promote the expression of epidermal stem cell marker CK19 in ulcer tissue after 2 weeks of use.(3)The "Bu Tuo method" can promote the ulcer healing of patients with pressure ulcers at stage IV and IV(qi and blood deficiency syndrome),and it is relatively safe.Its promoting healing mechanism may be related to promoting the expression of epidermal stem cell marker CK19. |
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