Effects of hydrotherapy with traditional Chinese medicine and magnetotherapy on treatment of scars after healing of deep partial-thickness burn wounds in children
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摘要: 目的 研究中药水疗+磁疗对治疗小儿深Ⅱ度烧伤创面愈合后瘢痕的效果。 方法 2016年1—12月,空军总医院烧伤科收治的48例深Ⅱ度烧伤创面愈合后形成瘢痕患儿符合本研究入选标准,回顾性分析其病历资料。在创面完全愈合后1个月以内,根据患儿及其家属意愿,24例患儿瘢痕处外用硅酮霜2次/d且全天佩戴弹力套,设为常规治疗组;另24例患儿在采用常规治疗组治疗方法的基础上,每2天采用复春散2号进行30 min中药水疗1次,每天早晚各采用脉冲磁疗仪进行30~60 min磁疗1次,设为水疗+磁疗组。治疗前及治疗12周后,采用温哥华瘢痕量表评定患儿瘢痕情况,采用Wong-Baker面部表情量表评定患儿瘢痕疼痛程度,采用数字评价量表评定患儿瘢痕瘙痒程度,采用改良Barthel指数评定患儿日常生活活动能力(ADL),采用运动功能评定量表评价患儿瘢痕所在四肢的功能障碍情况。治疗12周后,计算患儿畸形的发生率。对数据行
t 检验、χ 2检验。 结果 治疗前,常规治疗组、水疗+磁疗组患儿瘢痕情况评分相近(t =0.517,P =0.721);治疗12周后,水疗+磁疗组患儿的瘢痕情况评分为(2.8±0.8)分,明显低于常规治疗组的(3.9±0.8)分(t =5.725,P <0.01)。治疗前,常规治疗组、水疗+磁疗组患儿瘢痕疼痛、瘙痒程度评分相近(t =0.373、0.241,P =0.712、0.631);治疗12周后,水疗+磁疗组患儿瘢痕疼痛、瘙痒程度评分分别为(0.52±0.21)、(0.7±0.4)分,明显低于常规治疗组的(1.13±0.32)、(1.3±0.4)分(t =6.057、5.259,P <0.01)。治疗前,常规治疗组、水疗+磁疗组患儿ADL评分相近(t =0.082,P =0.964);治疗12周后,水疗+磁疗组患儿的ADL评分为(67±13)分,明显高于常规治疗组的(48±10)分(t =5.378,P <0.01)。治疗前,常规治疗组、水疗+磁疗组患儿瘢痕所在四肢功能障碍评分相近(t =0.261,P =0.720);治疗12周后,水疗+磁疗组患儿瘢痕所在四肢功能障碍评分为(62±9)分,明显高于常规治疗组的(47±8)分(t =14.463,P <0.05)。治疗12周后,水疗+磁疗组患儿的畸形发生率为8.3%(2/24),明显低于常规治疗组的37.5%(9/24),χ 2=4.25,P <0.05。 结论 在外用抗瘢痕药物及压迫治疗的基础上,辅以中药水疗+磁疗可明显减轻小儿深Ⅱ度烧伤创面愈合后瘢痕增生程度、疼痛程度、瘙痒程度,改善患儿ADL,促进其功能恢复,降低其畸形发生率。Abstract: Objective To study the effects of hydrotherapy with traditional Chinese medicine combined with magnetotherapy on treatment of scars after healing of deep partial-thickness burn wounds in children. Methods Forty-eight children with scars after healing of deep partial-thickness burn wounds admitted to the Burn Department of Air Force General Hospital from January to December in 2016 met the criteria for inclusion in this study, and their medical records were analyzed retrospectively. Within one month after the wound was completely healed, 24 children were treated with silicone cream for 2 times per day and wore elastic sleeves all day long according to the wishes of the children and their families, and they were enrolled in routine treatment group. The other 24 children were treated by hydrotherapy with traditional Chinese medicine Fuchunsan No. 2 once every 2 days for 30 min each time on the basis of treatment methods of routine treatment group, plus magnetotherapy using pulse magnetotherapy apparatus in the morning and evening of each day for 30-60 min each time, and they were enrolled in hydrotherapy+ magnetotherapy group. Before treatment and 12 weeks after treatment, the Vancouver Scar Scale was used to assess the scar condition of children, the Wong-Baker Facial Expression Scale was used to assess the degree of scar pain of children, the Numerical Rating Scale was used to assess the degree of scar itching of children, the modified Barthel Index was used to assess the activity of daily living (ADL) of children, and the Motor Function Evaluation Scale was used to assess the dysfunction condition of limbs with scar. After 12 weeks of treatment, the incidence of deformity of children was calculated. Data were processed witht test and chi-square test. Results Before treatment, the scores of scar condition of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t =0.517,P =0.721). After 12 weeks of treatment, the score of scar condition of children in hydrotherapy+ magnetotherapy group was (2.8±0.8) points, which was significantly lower than (3.9±0.8) points of routine treatment group (t =5.725,P <0.01). Before treatment, the scores of scar pain and itching degree of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t =0.373, 0.241,P =0.712, 0.631). After 12 weeks of treatment, the scores of scar pain and itching degree of children in hydrotherapy+ magnetotherapy group were (0.52±0.21) and (0.7±0.4) points, respectively, which were obviously lower than (1.13±0.32) and (1.3±0.4) points of routine treatment group (t =6.057, 5.259,P <0.01). Before treatment, the ADL scores of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t =0.082,P =0.964). After 12 weeks of treatment, the ADL score of children in hydrotherapy+ magnetotherapy group was (67±13) points, which was significantly higher than (48±10) points of routine treatment group (t =5.378,P <0.01). Before treatment, the dysfunction scores of limbs with scar of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t =0.261,P =0.720). After 12 weeks of treatment, the dysfunction score of limbs with scar of children in hydrotherapy+ magnetotherapy group was (62±9) points, which was significantly higher than (47±8) points of routine treatment group (t =14.463,P <0.05). After 12 weeks of treatment, the incidence of deformity of children in hydrotherapy+ magnetotherapy group was 8.3% (2/24), which was significantly lower than 37.5% (9/24) of routine treatment group (χ 2=4.25,P <0.05). Conclusions On the basis of topical anti-scarring drugs and compression therapy, supplementing hydrotherapy with traditional Chinese medicine and magnetotherapy can significantly reduce the hyperplasia degree, pain degree, itching degree of scars formed after healing of deep partial-thickness burn wounds in children, improve the ADL, promote functional recovery, and reduce the incidence of deformity of children.-
Key words:
- Burns /
- Rehabilitation /
- Child /
- Hydrotherapy with traditional Chinese medicine /
- Magnetotherapy
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