本文關(guān)鍵詞：黃芩油膏在增生性瘢痕點(diǎn)陣二氧化碳激光治療后創(chuàng)面修復(fù)的療效評(píng)價(jià)　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 點(diǎn)陣二氧化碳激光 黃芩油膏 增生性瘢痕 創(chuàng)面愈合修復(fù)

【摘要】：目的:評(píng)估黃芩油膏在增生性瘢痕點(diǎn)陣二氧化碳(cO2)激光治療后創(chuàng)面修復(fù)的臨床療效和安全性。方法:采用CO_2點(diǎn)陣激光治療頭面部增生性瘢痕的患者30例,所有患者均來自江蘇省中醫(yī)院整形美容外科門診,男女不限,年齡18～45歲,隨機(jī)分為治療組與對(duì)照組,各15例,治療組使用黃芩油膏涂抹創(chuàng)面,對(duì)照組使用金霉素眼膏涂抹創(chuàng)面。在患者術(shù)后觀測30min、24h、3天、7天這四個(gè)時(shí)間段的疼痛指數(shù);分別取術(shù)前、術(shù)后3d、術(shù)后7d瘢痕肉芽組織病理,行HE染色,并采用免疫組化檢測表皮干細(xì)胞標(biāo)志分子角蛋白19(CK19)、轉(zhuǎn)錄因子63(P63)在肉芽、各不同時(shí)期瘢痕及正常皮膚中的表達(dá);最后的創(chuàng)面愈合時(shí)間;術(shù)前、術(shù)后一個(gè)月、術(shù)后三個(gè)月的溫哥華瘢痕量表評(píng)分,來評(píng)價(jià)點(diǎn)陣激光治療增生性瘢痕點(diǎn)陣二氧化碳(CO_2)激光治療后利用黃芩油膏修復(fù)創(chuàng)面的療效。結(jié)果:1、疼痛指數(shù):兩組治療后均有痛感,前三天治療組疼痛指數(shù)均低于對(duì)照組,且疼痛緩解時(shí)間明顯縮短,組間差異有統(tǒng)計(jì)學(xué)意義(P0.05),7d時(shí)兩組均無明顯疼痛,無統(tǒng)計(jì)學(xué)意義。2、病理組織學(xué)觀察:治療組和對(duì)照組的纖維束呈均質(zhì)性紅染,且較治療前排列整齊、纖維細(xì)胞少,瘢痕組織內(nèi)血管少。3、免疫組化觀察:兩組治療前CK19、P63表達(dá)極少,治療組CK19、P63的表達(dá)在治療后第3天增多,第7天時(shí)達(dá)到高峰;對(duì)照治療后第3天CK19、P63表達(dá)達(dá)到高峰,第7天減少。治療組CK19、P63強(qiáng)陽性表達(dá)率(80%、73.33%)明顯高于對(duì)照組(33.33%、26.67%),組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4、最后的創(chuàng)面愈合時(shí)間:創(chuàng)面愈合時(shí)間治療組的(8.23±2.78)d明顯優(yōu)于對(duì)照組的(10.55±2.98)d,組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5、溫哥華瘢痕量表評(píng)分:治療前兩組瘢痕評(píng)分差別無統(tǒng)計(jì)學(xué)意義(P0.05),治療組經(jīng)治療后,較同期對(duì)照組低,有顯著性差異(P0.05)。6、治療組總有效率86.67%明顯高于對(duì)照組的46.67%,有顯著性差異(P0.05)。7、色素沉著在治療3個(gè)月后兩組均有發(fā)生,治療組6.67%發(fā)生率明顯低于對(duì)照組46.67%,有顯著性差異(P0.05)。結(jié)論:增生性瘢痕點(diǎn)陣二氧化碳(CO_2)激光治療后的創(chuàng)面,采用黃芩油膏醫(yī)療技術(shù),不僅可以促進(jìn)創(chuàng)面修復(fù),加速愈合,還可以減輕激光治療后的的疼痛,更可以改善外觀,減少色素沉著,療效明顯,值得推廣。
[Abstract]:Objective: To evaluate the clinical efficacy and safety of Scutellaria ointment after laser treatment of hypertrophic scar lattice carbon dioxide (cO2) laser. Methods: 30 cases of CO_2 laser treatment of facial scar patients, all patients were from Jiangsu Province Traditional Chinese Medicine Hospital of plastic surgery clinic, male or female, aged 18 to 45 years old, were randomly divided into treatment group and control group, 15 patients in each treatment group, using baicalin ointment wipe the wound, the control group using eyeointment smear the wound. In patients with postoperative observation of 30min, 24h and 3 days, 7 days of the four time periods of pain index respectively; preoperative and postoperative 3D, 7d scar granulation tissue pathology, HE staining, and immunohistochemical detection of epidermal stem cell marker cytokeratin 19 (CK19), transcription factor 63 (P63) expression in different period of granulation and scar and normal skin in the last time; wound healing; three months before surgery, one month after operation, the Vancouver scar scale, to evaluate the laser treatment of hyperplastic scar matrix (CO_2) effect of baicalin ointment with carbon dioxide to repair the wound the use of laser therapy. Results: 1. Pain index: two groups had pain after treatment. The pain index of the treatment group was lower than that of the control group in the first three days, and the pain relief time was significantly shortened. There was a significant difference between the two groups (P0.05). There was no significant pain in the two groups at 7d. 2. Histopathological observation: the fiber bundles in the treatment group and the control group were homogeneous red, and were arranged more orderly than before treatment, with less fibroblasts and less blood vessels in the scar tissue. 3, immunohistochemical observation: two groups before treatment, CK19 and P63 expression was very few. The expression of CK19 and P63 in treatment group increased third days after treatment and reached peak at seventh days. After third days of treatment, the expression of CK19 and P63 reached a peak and decreased in seventh days. The positive expression rate of CK19 and P63 in the treatment group (80%, 73.33%) was significantly higher than that in the control group (33.33%, 26.67%), and the difference between the groups was statistically significant (P0.05). 4, the final wound healing time: wound healing time in the treatment group (8.23 + 2.78) d was significantly better than that in the control group (10.55 + 2.98) d, the difference between the two groups was statistically significant (P0.05). 5, Vancouver scar scale score: there was no statistically significant difference in scar score between the two groups before treatment (P0.05). After treatment, the treatment group was lower than that in the control group at the same time (P0.05). 6, the total effective rate of the treatment group was 86.67% significantly higher than that of the control group (46.67%), and there was a significant difference (P0.05). 7, pigmentation occurred in the two groups after 3 months of treatment, and the incidence of 6.67% in the treatment group was significantly lower than that of the control group (46.67%). There was a significant difference (P0.05). Conclusion: hypertrophic scar lattice of carbon dioxide (CO_2) laser wound after treatment with baicalin ointment, medical technology, not only can promote wound healing, accelerate healing, also can reduce the pain of the laser treatment, can improve the appearance, reduce pigmentation, obvious curative effect, worthy of promotion.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R622

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