濕潤燒傷膏與蜂蜜敷料在Ⅱ度燒傷創(chuàng)面治療中的隨機對照試驗

摘要： 目的當(dāng)今有很多局部外用產(chǎn)品可用于Ⅱ度燒傷創(chuàng)面的治療,筆者從天然抗菌性、抗炎性及創(chuàng)面愈合3方面對濕潤燒傷膏(MEBO)及蜂蜜進行了比較。在燒傷創(chuàng)面治療中,此兩種藥物已被證明均優(yōu)于磺胺嘧啶銀。方法本實驗為隨機對照試驗,為期6個月,研究樣本均為30%TBSA以下的急性Ⅱ度燒傷患者。本試驗共有34名患者被隨機編入MEBO組及蜂蜜組(蜂蜜為印尼當(dāng)?shù)厣a(chǎn)),創(chuàng)面每日換藥1次,并給予相應(yīng)處理措施。入院時評估創(chuàng)面深度及燒傷面積,此后2周內(nèi)每周再評估1次;使用視覺模擬量表(VAS)評估患者疼痛水平;每周進行創(chuàng)面拭子分泌物培養(yǎng)獲得創(chuàng)面微生物情況;同時,記錄各組的每日治療成本。結(jié)果相比于蜂蜜組,MEBO組的Ⅱ度燒傷創(chuàng)面愈合較快,VAS疼痛評分較低;兩組在創(chuàng)面拭子分泌物培養(yǎng)的細菌類型中無差異,但MEBO在細菌繁殖方面具有更有效地抑制作用;MEBO組的全程治療費用亦低于蜂蜜組。結(jié)論作為治療Ⅱ度燒傷的外用藥,MEBO在愈合速度,疼痛緩解程度,細菌繁殖率及成本-效益率4個方面均優(yōu)于當(dāng)?shù)厣a(chǎn)的蜂蜜。
Objective Many topical agents are available for the treatment of partial thickness bum.We examined Moist Exposed Burn Ointment(MEBO) and honey regarding their natural antibacterial,antiinflammatory,and wound healing properties.They were also have been proven to be superior than silver sulphadiazine in treating burn wound.Methods This study is a randomized clinical trial study during 6 months.All patients with acute partial thicknes burn with < 30%of total body surface burn area were included.A total of 34 patients were randomly allocated into MEBO group and Indonesian local honey group.The wounds are changed daily,with corresponding interventions applied.The depth and extent of injury were assessed upon patient' s admission and once a week for two weeks.Pain level was evaluated using the Visual Analogue Scale(VAS).The wound swabs were cultured weekly to obtain microoganisms profile.The cost-per-day of each group were counted.Results Acute partial thickness burn in MEBO group showed faster healing compared to honey group.VAS score for pain was also lower in MEBO group.There was no difference in bacterial type between two groups,but MEBO was found to be more effective in decreasing bacterial colonization.Cost of treating wound using MEBO until complete healing was also lesser than local honey.Conclusions As topical agent to treat partial thickness bum,MEBO is superior compared to local honey regarding faster healing,better pain relief,fewer bacterial colonization and the more cost -effective usage.