摘要
目的观察罂粟碱注射液联合重组牛碱性成纤维细胞生长因子(rb-bFGF)治疗深度烧伤残余创面的临床疗效。方法回顾性选取2019年1月至2023年6月入中国人民解放军联勤保障部队第九一〇医院治疗的深度烧伤患者80例作为研究对象,参考用药不同分为联合用药组(n=40)与单独用药组(n=40)。联合用药组采用rb-bFGF与罂粟碱注射液联合治疗,于5 cm×5 cm无菌纱布上涂抹300 IU/cm^(2)rb-bFGF之后将其于创面上覆盖,每日换药1次,肌肉注射罂粟碱注射液每日30 mg,每日2次。单独用药组单用rb-bFGF,用法同联合用药组。两组均持续治疗14 d。比较两组患者的治疗前及治疗后14 d的血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-10、IL-6、IL-4、IL-1β]水平,治疗后3、7、10、14 d的创面分泌物评分和创缘反应评分,创面愈合时间,总有效率及不良反应发生率。结果联合用药组患者治疗后14 d的血清TNF-α、IL-6、L-1β水平分别为(65.27±8.77)、(105.21±9.14)、(20.21±1.18)μg/L,均明显低于单独用药组[(89.26±9.32)、(128.32±8.21)、(29.36±1.28)μg/L],IL-10、IL-4水平分别为(537.75±22.92)、(162.42±17.79)μg/L,均明显高于单独用药组[(497.41±22.63)、(137.27±17.41)μg/L],差异均有统计学意义(P<0.05)。联合用药组患者治疗后3、7、10、14 d创面分泌物评分分别为(1.64±0.25)、(0.97±0.24)、(0.78±0.20)、(0.38±0.11)分,均低于单独用药组[(1.82±0.29)、(1.28±0.26)、(1.04±0.24)、(0.65±0.14)分],差异均有统计学意义(P<0.05)。联合用药组患者治疗后3、7、10、14 d创缘反应评分分别为(0.82±0.13)、(0.39±0.09)、(0.20±0.04)、(0.04±0.02)分,均低于单独用药组[(1.19±0.21)、(0.68±0.11)、(0.49±0.10)、(0.21±0.04)分],差异均有统计学意义(P<0.05)。联合用药组患者治疗后创面愈合时间为(22.84±3.02)d,明显短于单独用药组[(27.94±3.14)d],差异有统计学意义(P<0.05)。联合用药组患者的治疗后总有效率为97.50%,明显高于单独用药组(80.00%),差异有统计学意义(P<0.05)。两组均未发生皮肤刺痛及红痒等不良反应。结论深度烧伤残余创面治疗中,与单用rb-bFGF治疗相比,罂粟碱注射液联合rb-bFGF的临床疗效明显提高,可进一步减轻炎症反应,加速创面愈合,且无明显不良反应。
Objective To observe the clinical efficacy of papaverine injection combined with recombinant bovine basic fibroblast growth factor(rb-bFGF)in the treatment of deep burn residual wounds.Methods A total of 80 patients with deep burns who were admitted to the 910th Hospital,Chinese People's Liberation Army Joint Logistic Support Force from January 2019 to June 2023 were retrospectively selected as the research objects.According to different medications,they were divided into the combined treatment group(n=40)and the separate treatment group(n=40).The combined treatment group was treated with rb-bFGF combined with papaverine injection,after 300 IU/cm^(2) rb-bFGF was smeared on 5 cm×5 cm sterile gauze,it was covered on the wound,the dressing was changed once a day,and 30 mg of papaverine injection was injected intramuscularly twice a day.The separate treatment group was treated with rb-bFGF alone,and the usage was the same as that of the combined treatment group.Both groups were treated for 14 d.The levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-10,IL-6,IL-4 and IL-1β]between the two groups before treatment and 14 days after treatment,the wound secretion score and wound edge reaction score at 3,7,10 and 14 days after treatment,wound healing time,total effective rate and incidence of adverse reactions between the two groups were compared.Results The levels of serum TNF-α,IL-6 and IL-1βin the combined treatment group at 14 days after treatment were(65.27±8.77),(105.21±9.14)and(20.21±1.18)μg/L,respectively,which were significantly lower than those in the separate treatment group[(89.26±9.32),(128.32±8.21)and(29.36±1.28)μg/L],and the levels of IL-10 and IL-4 in the combined treatment group were(537.75±22.92)and(162.42±17.79)μg/L,respectively,which were significantly higher than those in the separate treatment group[(497.41±22.63),(137.27±17.41)μg/L],and the differences were statistically significant(P<0.05).The levels of TNF-α,IL-6 and L-1βin the combination treatment group were significantly lower than those in the separate treatment group,the levels of IL-10 and IL-4 were significantly higher than those in the separate treatment group,and the differences were statistically significant(P<0.05).The wound secretion scores in the combined treatment group at 3,7,10 and 14 days after treatment were(1.64±0.25),(0.97±0.24),(0.78±0.20)and(0.38±0.11)points,respectively,which were lower than those in the separate treatment group[(1.82±0.29),(1.28±0.26),(1.04±0.24)and(0.65±0.14)points],and the differences were statistically significant(P<0.05).The scores of wound edge reaction in the combination treatment group at 3,7,10 and 14 days after treatment were(0.82±0.13),(0.39±0.09),(0.20±0.04)and(0.04±0.02)points,respectively,which were lower than those in the separate treatment group[(1.19±0.21),(0.68±0.11),(0.49±0.10)and(0.21±0.04)points],and the differences were statistically significant(P<0.05).The wound healing time of the combination treatment group was(22.84±3.02)d,which was significantly shorter than that of the separate treatment group[(27.94±3.14)d],and the difference was statistically significant(P<0.05).The post-treatment total response rate of the combination treatment group was 97.50%,which was significantly higher than that of the separate treatment group(80.00%),and the difference was statistically significant(P<0.05).There were no adverse reactions such as skin tingling and red itching occurred in both groups.Conclusion In the treatment of deep burn residual wounds,compared with rb-bF GF alone,papaverine injection combined with rb-bF GF is significantly improved,which can further reduce inflammatory response and accelerate wound healing without obvious adverse effects.
作者
林冠
王佳坤
戴立
林淑瑜
欧阳容兰
刘江涛
LIN Guan;WANG Jia-kun;DAI Li(Department of Pharmacy,910th Hospital,Chinese People's Liberation Army Joint Logistic Support Force,Quanzhou Fujian 362000,China)
出处
《临床和实验医学杂志》
2024年第20期2223-2227,共5页
Journal of Clinical and Experimental Medicine
基金
福建省自然科学基金计划(编号:2023J01241)。
