Efficacy and safety of Zhang's Qingre Xiaoyu decoction combined with vacuum sealing drainage in the treatment of open tibia and fibula fracture wound infection patients
Objective To study the effectiveness and safety of Zhang's Qingre Xiaoyu decoction combined with vacuum sealing drainage(VSD)in treatment of open tibia and fibula fracture wound infection.Methods A total of 70 patients with open tibia and fibula fracture wound infection who received treatment in Hangzhou Fuyang Traditional Chinese Medicine Orthopedic Hospital from January 2020 to January 2024 were selected,and they were divided into control group(VSD treatment)and observation group(Zhang's Qingre Xiaoyu decoction combined with VSD treatment)according to the random number table method,35 cases in each group.Compared the morphologies and proliferation abilities of wound fibroblasts between two groups of patients after treatment;compared the wound healing rates,calf swelling disappearance times and other effectiveness indicators between the two groups of patients;Compared the incidence of complications between two groups of patients.At the same time,the levels of inflammatory factors and T lymphocytes of two groups of patients before the start of treatment(before treatment)and 1 day after the end of treatment(after treatment)were compared;the inflammatory responses,immune functions and other related indicators of two groups of patients before and after treatment were compared.Differences in fibrillar collagen synthesis between two groups of patients before and after treatment.Results The morphologies and proliferation abilities of wound fibroblasts in observation group were significantly better than those in control group(P<0.05);The wound healing rates and wound granulation tissue growth scores of the patients in observation group were significantly higher than those in control group(P<0.05).The pathogen positive rates,calf swelling disappearance times and visual analogue scale(VAS)scores were significantly lower than those in control group(P<0.05).There was no statistical difference in the incidences of complications such as liver and kidney damages between two groups(P>0.05).After treatment,the levels of procalcitonin,tumor necrosis factor-α,interleukin(IL)-1β,IL-6,IL-8,CD3+,and CD8+in observation group were significantly lower than those in control group,The CD4+level of observation group was significantly higher than that of control group(P<0.05).The CD64,C-reactive protein(CRP),albumin(ALB)levels and CRP/ALB of the patients in observation group after treatment were significantly lower than those in control group,and significantly lower than before treatment of this group(P<0.05).The levels of type Ⅰ collagen,type Ⅲ collagen,type Ⅴ collagen and type Ⅺ collagen in observation group were significantly higher than those in control group,and was significantly higher than that before treatment of this group(P<0.05).Conclusion Zhang's Qingre Xiaoyu decoction combined with VSD can significantly promote the proliferation of fibroblasts in patients with open tibia and fibula fracture wound infection,promote the synthesis of fibrous collagen,and reduce inflammatory reactions.Its efficacy is better than VSD alone,and it has highly efficient and effective.
Open tibia and fibula fractureWound infectionZhang's Qingre Xiaoyu decoctionVacuum sealing drainageEfficacySafety
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