摘要
目的:观察加味大黄牡丹汤联合阿莫西林克拉维酸钾治疗下肢丹毒继发淋巴水肿患者的效果。方法:回顾性收集320例湿热毒蕴型下肢丹毒继发淋巴水肿患者的临床资料,根据治疗方案的不同将患者分为试验组与对照组各160例。2组均予阿莫西林克拉维酸钾静脉滴注、口服序贯治疗,试验组用加味大黄牡丹汤外敷,对照组用硼酸氯霉素溶液外敷。2组均以连续治疗7 d为1个周期,共治疗2个周期。比较治疗前、治疗满2个周期时的中医证候评分、白细胞计数、中性粒细胞计数、C-反应蛋白(CRP)水平及双下肢外周径差,比较2组的临床疗效、下肢肿胀程度与不良反应发生率。结果:治疗2个周期,试验组临床疗效总有效率为92.50%,高于对照组的85.63%,差异有统计学意义(P<0.05)。2组中医证候评分均低于治疗前,试验组中医证候评分低于对照组,差异均有统计学意义(P<0.01)。试验组下肢红肿程度的改善情况优于对照组(P<0.05)。2组白细胞计数、中性粒细胞计数及血清CRP水平均较治疗前降低,双下肢外周径差均较治疗前减少,差异均有统计学意义(P<0.01);试验组各项指标值均低于对照组,差异均有统计学意义(P<0.01)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:加味大黄牡丹汤联合阿莫西林克拉维酸钾治疗可有效减轻湿热毒蕴型下肢丹毒继发淋巴水肿患者的临床症状与下肢肿胀程度,减轻炎症反应,显著提高临床疗效。
Objective:To observe the effect of the therapy of modified Dahuang Mudan tang combined with amoxicillin and clavulanate potassium on patients with lymphedema secondary to lower limb erysipelas.Methods:A total of 320 cases of clinical data of patients with lymphedema secondary to lower limb erysipelas of dampness-heat toxin accumulation type were retrospectively selected and divided into the experiment group and the control group according to the different treatment,with 160 cases in each group.Both groups were treated with intravenous infusion and oral sequential therapy of amoxicillin and clavulanate potassium.The experiment group was additionally treated with external application of modified Dahuang Mudan tang,and the control group was additionally treated with external application of Chloramphenicol borate solution.Both groups were continuously treated for two cycles,seven days being a cycle.Before and after two cycles of treatment,the Chinese medicine syndrome scores,white blood cell count,neutrophil count,C-reactive protein(CRP)and differences of the circumference of lower limbs were compared.The clinical effects,swelling degree of lower limbs and incidence of adverse reactions were compared between the two groups.Results:After two cycles of treatment,the total clinical effective rate was 92.50%in the experiment group,higher than that of 85.63%in the control group,the difference being significant(P<0.05).The Chinese medicine syndrome scores in the two groups were lower than those before treatment,and the Chinese medicine syndrome scores in the experiment group were lower than that in the control group,differences being significant(P<0.01).The erythema and swelling degree of lower limbs in the experiment group was better than that in the control group(P<0.05).The levels of white blood cell count,neutrophil count and serum CRP in the two groups were decreased when compared with those before treatment,and the differences of circumference of lower limbs were decreased,differences being significant(P<0.01).The above four indexes in the experiment group were lower than those in the control group,differences being significant(P<0.01).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The therapy of modified Dahuang Mudan tang combined with amoxicillin and clavulanate potassium can effectively reduce the clinical symptoms and swelling degree of lower limbs in patients with lymphedema secondary to lower limb erysipelas of dampness-heat toxin accumulation type,reduce the inflammatory responses,and significantly improve the clinical effect.
作者
茅迪敏
王海明
张萍萍
MAO Dimin;WANG Haiming;ZHANG Pingping
出处
《新中医》
CAS
2022年第16期15-19,共5页
New Chinese Medicine
基金
浙江省中医药科技计划项目(2021ZB230)。
关键词
下肢丹毒
淋巴水肿
湿热毒蕴证
大黄牡丹汤
炎症反应
Lower limb erysipelas
Lymphedema
Dampness-heat toxin accumulation syndrome
Dahuang Mudan tang
Inflammatory responses
作者简介
茅迪敏(1985-),男,医学硕士,主治医师,E-mail:maodimin@163.com;通信作者:王海明(1968-),男,医学硕士,主任医师,E-mail:wwanghmcf@163.com。
