| ObjectiveTo evaluate clinical efficacy of the surgical excision combined with postoperative radiotherapy, injection of BTXA during and postoperation (Botul-inum toxin A) for pathological scar.MethodsIn this paper, taking patients with scar in the in-patient department of university town hospital of TCM hospital of Guangdong Province as the research objects. They were divided into three groups:Group A, the control group, scar tissue cores were removed by operation.with the electron beam of 6MeV radiotherapy after surgery excision early.Determine the position and mark firstly. In general, the irradiation range was expanded from 1 to 2cm by surgical incision. Espouse dose every time is 100-200cGy, Depending on the color, thickness and parts of the scar, once a day,6 days for a period of treatment, a total of two period of treatment, a total dose of 1200-2400cGy. Group B, the treatment group, scar tissue cores were removed by operation with BTXA injected, the method of BTXA injection is lcm in the edge of scar tissue in the dermis of skin,0.1mL/point, interval of lcm, the total dose not exceeding 100U every person. The times and dose of radiotherapy are the same as Group A combined early postoperative electron beam radiotherapy. Group C, the treatment group, the surgical resection,the method of intraoperative and postoperative,3-6months, BTXA injection, the number and dose of radiotherapy are the same as Group B. All patients were not followed up for less than 12 months.In the process of treatment and follow-up,according to the integral standard we observed the volume, color, hardness and accompanying symptoms of scar preoperation and the 6th,12th month postoperation in the control and trea-tment group, and maked a detailed record and taked pictures, at the same time, assessed the constitution of traditional Chinese medicine on the patients.ResultsFrom 2012 to 2015, a total of 41 cases, a total of 66 pieces of scar, after 12 months of follow-up, the total effective rate of control group A, n=28, was 71.43%; the total effective rate of control group B, n=17, was 76.47%;the total effective rate of control group C, n=21, was 90.48%. Comparing the clincal efficacy of group A and group B, P> 0.05, two groups of efficient was not significant difference. Comparision of the clincal efficacy of group C and group A, group B,P (0.05,The difference was statistically significant, The clinical curative effect of group C showed significantly better than that of group B and group A.41 patients with scar constitution of TCM dialectical type, most of them were Stagnant Blood constitution and phlegm-dampness constitution.The third one was damp-heat constitution.Conclusion1. It is an effective method for the treatment of pathological scars by postoperative electron beam radiation therapy combined with surgical excision of scar. But the recurrence rate is high, the specific methods need to be improved.2. There was better clinical curative effect in the cure of surgery combined electron beam radiotherapy and local injection of BTXA. BTXA significantly reduced scar patients’ symptoms, such as itching, pain, and soften scar contra-ction, and high safety, It is worthy of clinical application.3. the patients with scar constitution of TCM dialectical type gived priority to with blood stasis constitution, the second was phlegm-dampness constitution and damp-heat constitution. |
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