医用三氧气浴治疗糖尿病足溃疡感染创面

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秦新愿，王雷，王江宁. 医用三氧气浴治疗糖尿病足溃疡感染创面[J]. 中国组织工程研究，2020，24(17):2735-2741. DOI:10.3969/j.issn.2095-4344.2676
wounds such as caries. OBJECTIVE: To explore the clinical effect of ozone bath on the control of diabetic foot ulcer’s infection and the promotion of wound healing. METHODS: According to the treatment methods, 100 patients with type 2 diabetic foot ulcer who met the inclusion criteria were divided into two groups randomly. In the experimental group, ozone bath was applied to the wound for 30 minutes after cleaning the wound with local normal saline; in the control group, air bath was applied to the wound for 30 minutes after cleaning the wound with local normal saline, once a day. Three weeks later, the bacterial control (quantitative analysis of bacteria, distribution of pathogenic bacteria), the degree of decline of inflammation index, the reduction of ulcer wound, the rate of wound healing and the visual analogue scale score of wound pain were counted in both groups. The expression levels of vascular endothelial growth factor, transforming growth factor-β and platelet-derived growth factor in wound tissues were measured before and after treatment. The protocols were approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated to Capital Medical University. Patients and their family member signed the informed consent. RESULTS AND CONCLUSION: After 3 weeks of treatment, bacteria were still detected in 46 patients in the control group and 5 patients in the experimental group. The number of pathogenic bacteria was 73 before treatment and 66 after treatment in the control group, 74 before treatment and 7 after treatment in the experimental group. Bacterial quantitative analysis was significantly higher in the control group than in the experimental group after treatment. The indexes of ulcer healing, including the reduction of ulcer wound, the visual analogue scale score of wound pain, and the degree of decline of inflammation index, were better in the experimental group than those in the control group (P < 0.05). (4) The expression levels of vascular endothelial growth factor, transforming growth factor-β and platelet-derived growth factor in local wound tissues were significantly higher in the experimental group than in the control group (P < 0.05). The percentage of wound healing in the experimental group was significantly higher than that in the control group (P < 0.05). To conclude, ozone bath can significantly control the local infection of diabetic foot, reduce the distribution of pathogenic bacteria on the wound surface, relieve the inflammatory pain of the wound, stimulate the secretion of growth factor in wound, and improve the wound healing rate. Key words: ozone; air bath; diabetic foot; ulcer; infection; wound Funding: the Capital Clinical Characteristic Application Research and Achievement Promotion, No. Z171100001017070 (to WJN)
对照组：创面局部应用空 气套袋气浴做对照。
3 周后检测：
(1)创面细菌控制情况; (2)炎症指标; (3)溃疡创面创面愈合率; (4)创面疼痛目测类比评分; (4)创面组织中血管内皮生长因子、转化生长因
子 β 和血小板衍生生长因子的表达水平。
秦新愿，男，1987 年生， 河南省信阳市人，汉族， 2014 年首都医科大学毕 业，硕士，医师，主要从 事骨科、修复重建与创面 外科研究。
通讯作者：王江宁，博士， 主任医师，教授，首都医 科大学附属北京世纪坛医 院矫形外科，北京市 100038
文题释义： 三氧：又称臭氧，是一种由三个氧原子组成的强氧化剂，常温下半衰期为 20 min，易分解和溶于水，所以 只能即时制备，即时应用。三氧因其具有氧化、抗炎、镇痛的作用，被广泛应用于临床治疗，尤其在治疗 疼痛类疾病方面，有着显著的疗效。 降钙素原(PCT)：是一种蛋白质，当严重细菌、真菌、寄生虫感染以及脓毒症和多脏器功能衰竭时它在血浆 中的水平升高；自身免疫、过敏和病毒感染时降钙素原不会升高；局部有限的细菌感染、轻微的感染和慢 性炎症不会导致其升高。细菌内毒素在诱导过程中担任了至关重要的作用。
Ozone bath in the treatment of diabetic foot ulcer infection
Qin Xinyuan, Master, Physician, Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
Qin Xinyuan1, Wang Lei2, Wang Jiangning1 (1Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China; 2Emergency Medicine Center, The Second Hospital of Shandong University, Jinan 250000, Shandong Province, China)
Corresponding author: Wang Jiangning, MD, Chief physician, Professor, Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
Abstract BACKGROUND: Medical ozone is a strong oxidant, can kill bacteria, resist inflammation, improve circulation, relieve pain and promote regeneration. It has been reported that medical ozone has a positive effect on ulcer
ORCID: 0000-0003-3566-8900(秦新愿)
100038；2山速阅读：
文章描述— 医用三氧气浴能够显著控制糖尿病足的局部感染，减少创面病原菌分布，缓解创面炎症疼痛，刺 激创面分泌生长因子，提高创面愈合率。
2 型糖尿病性 足溃疡患者
实验组：创面局部应用医 用三氧套袋气浴治疗。
《中国组织工程研究》 Chinese Journal of Tissue Engineering Research
医用三氧气浴治疗糖尿病足溃疡感染创面
·研究原著·
秦新愿1，王 雷2，王江宁1 (1首都医科大学附属北京世纪坛医院矫形外科，北京市
省济南市 250000)
DOI:10.3969/j.issn.2095-4344.2676
文献标识码:B 投稿日期：2019-12-06 送审日期：2019-12-12 采用日期：2020-01-17 在线日期：2020-02-29
摘要 背景：医用三氧是一种强氧化剂，具有杀菌抗炎、改善循环、缓解疼痛和促进再生的作用，有报道验证了 医用三氧在龋齿等溃疡创面的积极作用。 目的：探讨医用三氧气浴对控制糖尿病足溃疡局部感染和促进创面愈合的临床效果。 方法：根据入组治疗方式，将符合入选标准的 100 例 2 型糖尿病性足溃疡患者分为 2 组。实验组给予创面 局部生理盐水清洁后应用医用三氧套袋气浴 30 min；对照组给予创面局部生理盐水清洁后应用空气套袋气 浴 30 min，1 次 d，3 周后统计 2 组患者创面细菌控制情况(细菌定量分析、病原菌分布情况)、炎症指标下 降程度、溃疡创面缩小情况、创面愈合率及创面疼痛目测类比评分情况；检测治疗前后创面组织中血管内 皮生长因子、转化生长因子 β 和血小板衍生生长因子的表达水平。研究方案通过首都医科大学附属北京世 纪坛医院伦理委员会审核批准。患者及家属对治疗过程完全知情同意。 结果与结论：①经 3 周治疗后对照组有 46 例患者创面细菌培养仍检出细菌，实验组有 5 例患者仍检出细菌； 病原菌株数对照组治疗前 73 株，治疗后 66 株；实验组治疗前 74 株，治疗后 7 株；②细菌定量分析对照 组治疗后显著高于实验组治疗后；③实验组的各项溃疡愈合指标(创面缩小面积，创面疼痛目测类比评分， 炎症指标下降程度)均优于对照组(P < 0.05)；④实验组局部组织中血管内皮生长因子、转化生长因子 β 和 血小板衍生生长因子的水平明显升高且优于对照组(P < 0.05)；⑤实验组患者的创面愈合百分率显著高于对 照组(P < 0.05)；⑥结果说明，医用三氧气浴能够显著控制糖尿病足的局部感染，减少创面病原菌分布，缓 解创面炎症疼痛，刺激创面分泌生长因子，提高创面愈合率。 关键词： 医用三氧；气浴；糖尿病足；溃疡；感染；创面 中图分类号：R459.9；R496；R318 基金资助： 首都临床特色应用研究与成果推广(Z171100001017070)，项目负责人：王江宁