三黄膏、止痛膏治疗脓肿溃疡型淋巴结核的疗效观察

郭小玲 等

[摘要] 目的 探讨三黄膏、止痛膏治疗脓肿、溃疡型淋巴结核的疗效。 方法 抗痨基础上将190例行病灶清除术后的脓肿、溃疡型淋巴结核患者，按照配对研究原则分为2组，实验组采用三黄膏、止痛膏分阶段换药，对照组采用异烟肼纱条换药。统计两组的治愈率、治愈时间和随访1年的复发率。 结果 实验组在第1、2、3周及1月时的治愈率均高于对照组，差异有统计学意义（P <0.05）；其中脓肿型淋巴结核在1、2、3周时实验组的治愈率高于对照组，差异有统计学意义（P<0.05），但在1月时的治愈率差异无统计学意义（P=0.079）；溃疡型淋巴结核在第2周时出现治愈者，在第2、3周和1月时实验组的治愈率均高于对照组，差异有统计学意义（P<0.05））。实验组创口愈合（15.69±6.974）d，对照组（24.63±10.085）d，差异有统计学意义（P=0.00）；随访1年，两组病人淋巴结局部均无复发。 结论 在规范抗痨并病灶清除术基础上使用三黄膏、止痛膏分阶段换药治疗脓肿、溃疡型淋巴结核治愈率高，疗程短。

[关键词] 淋巴结核； 脓肿型； 溃疡型； 病灶清除术；中药外治

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）09（a）-0182-03

Effect Observation of San Huang Plaster and Analgesic Plaster on Abscess and Ulcer Scrofula

GUO Xiao-ling1， WANG Yong-bin1， WANG Kun2， ZHAO Chun-ling3

1.Department of internal medicine， Lanzhou pulmonary hospital，Lanzhou， Gansu Province， 730046 China；2.Department of imaging， Lanzhou pulmonary hospital，Lanzhou， Gansu Province， 730046 China； 3. Department of general surgery， Lanzhou pulmonary hospital，Lanzhou， Gansu Province， 73000 China

[Abstract] Objective To observe the effect of San Huang plaster and analgesic plaster on abscess and ulcer scrofula. Methods This is a 1：1 matched case-control study. All patients were undergone focal cleaning and regularly anti-tuberculosis treatment， 95 patients used San Huang plaster and analgesic plaster at different stages in case group and the same number of peoples used isoniazide sliver in control group for comparative study. To observe the cure rate and the healing-time， the relapse rate were observed after 1 year. Results The cure rate in the case group was significantly higher than that of the control group in the first， second， third week and the first month（P<0.05）. The cure rate of abscess scrofula in the case group was significantly higher than that of in the control group in the first， second，and third（P<0.05） week， with statistical significance. However， that was not statistically significant in the first month（P>0.05）.Ulcer scrofula began to be cured in the second week， the cure rate in the case group was significantly higher than that of in the control group in the second， third week and the first month （P<0.05），with statistical significance. The time required for wound-healing in the case group was （15.69±6.974）days， that of control group is（24.63±10.085）days， with statistical significance（P=0）. The patients of two groups have been followed up 1 year， there was no replace. Conclusion San Huang plaster and Analgesic plaster on abscess and ulcer scrofula at different stages has higher cure rate and shorter healing-time which based on anti-tuberculosis treatment and focal cleaning.

[Key words] Scrofula； Abscess； Ulcer； Focal cleaning； External treatment by Chinese herbal

作为肺外结核中最常见的浅表淋巴结核，其局部易坏死、液化、破溃形成溃疡或瘘管，一旦形成，脓液不断，溃疡经久不愈。目前多采用内科抗痨联合外科手术，但手术范围有限，故临床很难I期愈合。该研究在抗痨及手术基础上根据创口情况给予三黄膏及止痛膏油砂条分阶段换药，与异烟肼纱条换药的手术后病人做对照，现报道如下。

1 资料与方法

1.1 一般资料

整群选择2009年2月—2013年10月确诊的脓肿、溃疡型淋巴结核术后患者190例，诊断标准为：①分泌物涂片或培养查到结核菌；② 结核菌检查阴性但病理涂片有干酪样坏死或有散在上皮样成分和郎罕细胞；具备其中一项且患者知情同意即可入组；但同时需排外：①合并糖尿病或心、肝肾、血液系统疾病者；②严重营养不良者；③有精神病史及其他慢性传染性疾病者；④使用免疫抑制剂及激素类药物者；⑤妊娠或需要哺乳的妇女。将患者按照1：1配对研究原则分为实验组和对照组，每组95例。……