目的：观察紫归长皮膏联合银离子藻酸盐敷料治疗乳腺癌术后伤口不愈的临床疗效，初步探讨作用机制。方法：将80例乳腺癌术后伤口不愈患者随机分为2组，对照组40例采用银离子藻酸盐外敷，治疗组40例用紫归长皮膏联合银离子藻酸盐外敷；2组疗程均为6周，治疗6周后评价疗效；6周未愈者重新评估伤口，更改方案治疗直至创面愈合；比较2组临床疗效、创面愈合率、创面肉芽组织中血管内皮生长因子表达。结果：对照组痊愈率为68.42％，总有效率为81.58％；治疗组分别为86.49％、94.59％；组间比较，P＜0.05；治疗组VEGF面积（1447.64±240.18）μm2，对照组为（1117.95±373.54）μm2，治疗组明显优于对照组（P＜0.01）。结论：紫归长皮膏联合银离子藻酸盐敷料治疗乳腺癌术后伤口不愈，能提高创面愈合率、临床疗效；促进创面血管内皮生长因子表达，从而促进创面愈合；治疗期间未出现不良反应，值得临床推广。%Objective:To observe the curative effects of Ziguizhangpi Ointment(ZG)combined with silver alginate in the treatment of unhealed wounds after breast cancer operation and explore the mechanism.Methods:Eighty patients were randomly divided into control group and treatment group (n=40).Patients in control group were treated by silver alginate,while patients in treatment group were treated by ZG combined with silver alginate.After 6 weeks of treatment,the clinical effects,on wound healing,and expression of vascular endothelial growth factor (VEGF)were evaluated.Results:In the control group,the curative rate and total effective rate were 68.42% and 81 .58%,and they were 86.49%and 94.59%respectively in treatment group (P<0.05);Im-munohistochemistry showed that VEGF expression in control group was(1117.95 ±373.54)μm2,and it was(1447.64 ±240.18)μm2 in treatment group(P<0.01 ).Conclusion:Combined application of ZG and silver alginate can improve wound healing rate and upregulate the expression of VEGF.It shows no noticeable adverse effect,therefore it is worth of clinical application.
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