曹延广　王君杰　　范佳俊　　陈烽　　董黎强

[摘要] 目的 探討应用补肾生肌中药结合“标本配穴”电针治疗肾阳虚型高龄患者骶尾部压疮的临床疗效观察。 方法 选取2016年1月至2020年6月我院就诊的肾阳虚型高龄骶尾部压疮患者60例，随机分两组，治疗组30例，对照组30例。压疮行清创处理后，对照组应用凡士林纱布换药，治疗组应用补肾生肌中药结合“标本配穴”电针治疗。两组治疗过程中，以7 d、14 d、28 d为时间点，进行McGill疼痛评分，测算创面愈合率，免疫组化法检测创面组织转化生长因子-β1（TGF-β1）、促红细胞生成素（EPO）的表达，组内及组间比较，并评估其临床疗效。 结果 两组患者经过7 d、14 d、28 d的治疗，组内比较，McGill疼痛评分逐渐降低，创面愈合率、TGF-β1和EPO的表达逐渐升高（P<0.05）;组间比较，在各个时间点上，治疗组均优于对照组，差异有统计学意义（P<0.05）。 结论 采用补肾生肌中药结合“标本配穴”电针治疗肾阳虚型高龄患者骶尾部压疮，补肾助阳，祛腐生肌，可有效缓解疼痛，促进压疮创面的愈合，效果满意。

[关键词] 补肾生肌;标本配穴;压疮;转化生长因子-β1;促红细胞生成素

[中图分类号] R632.1          [文献标识码] B          [文章编号] 1673-9701（2021）11-0125-04

Observation on the curative effect of Chinese medicine for Bushen Shengji combined with the combination of Biao-Ben acupoints electroacupuncture in the treatment of pressure ulcers of kidney-yang deficiency type

CAO Yanguang1   WANG Junjie1   FAN Jiajun2   CHEN Feng2   DONG Liqiang1

1.Department of Orthopedics， The Second Affiliated Hospital of Zhejiang Chinese Medicine University， Hangzhou 310005， China; 2.Zhejiang Chinese Medicine University， Hangzhou   310053， China

[Abstract] Objective To investigate the clinical efficacy of Chinese medicine for Bushen Shengji combined with the combination of Biao-Ben acupoints electroacupuncture in the treatment of sacral pressure ulcers in elderly patients with kidney-yang deficiency. Methods A total of 60 elderly patients with sacrococcygeal pressure ulcer of kidney-yang deficiency type from January 2016 to June 2020 were selected and randomly divided into two groups， with 30 cases in the treatment group and 30 cases in the control group. After debridement of the pressure ulcers， the control group was treated with petrolatum gauze， and the treatment group was treated with Chinese medicine for Bushen Shengji combined with the combination of Biao-Ben acupoints electroacupuncture. In the two groups during the treatment， with 7 d， 14 d， 28 d as time points， the McGill pain score was performed， the wound healing rate was measured. The immunohistochemical method was used to detect the expression of transforming growth factor-β1（TGF-β1） and erythropoiesis（EPO） of the wound tissue. The results were compared within and between groups. Its clinical efficacy was evaluated. Results After seven days， 14 days， and 28 days of treatment， the McGill pain scores of the two groups of patients gradually decreased， and the wound healing rate， TGF-β1， and EPO expressions gradually increased （P<0.05）. At each time point， the treatment group was better than the control group， and the difference was statistically significant（P<0.05）. Conclusion The use of Chinese medicine for Bushen Shengji combined with the combination of Biao-Ben acupoints electroacupuncture for the treatment of sacrococcygeal pressure ulcers in elderly patients with kidney yang deficiency can invigorate the kidney and promote yang， dispel decay and promote muscle growth. It also can effectively relieve pain and promote the healing of pressure ulcer wounds with satisfactory results.

[Key words] Bushen Shengji; Combination of Biao-Ben acupoints; Pressure ulcers; Transforming growth factor-β1; Erythropoietin

近年来，随着人口老龄化，高龄患者因外伤骨折、脑血管疾患、老年痴呆等致使长期卧床，骶尾部皮肤受到压力刺激，继而缺血坏死溃烂，引起难愈性压疮[1-2]。压疮创面难以愈合，其机制可能与创面受到炎症刺激，炎症细胞因子的过度表达有关[3]。在创面愈合的过程中，发现多个细胞生长因子参与损伤组织重建，促进创面愈合[4-5]。转化生长因子-β1（transforming growth factor-β1，TGF-β1）是细胞生长、分化过程中重要的调节因子，促进细胞增殖及胶原蛋白的合成与堆积，从而促进创面肉芽的形成[5-6]。促红细胞生成素（erythropoietin，EPO）具有抑制炎性因子，减少脂质过氧化损伤等特性，有助于促进创面的愈合[7]。……