Robson Val, Dodd Susanna, Thomas Stephen
Leg Ulcer Care, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.
J Adv Nurs. 2009 Mar;65(3):565-75. doi: 10.1111/j.1365-2648.2008.04923.x.
This paper is a report of a study to compare a medical grade honey with conventional treatments on the healing rates of wounds healing by secondary intention.
There is an increasing body of evidence to support the use of honey to treat wounds, but there is a lack of robust randomized trials on which clinicians can base their clinical judgement.
A sample of 105 patients were involved in a single centre, open-label randomized controlled trial in which patients received either a conventional wound dressing or honey. Data were collected between September 2004 and May 2007.
The median time to healing in the honey group was 100 days compared with 140 days in the control group. The healing rate at 12 weeks was equal to 46.2% in the honey group compared with 34.0% in the conventional group, and the difference in the healing rates (95% confidence interval, CI) at 12 weeks between the two groups was 12.2% (-13.6%, 37.9%). The unadjusted hazard ratio (95% CI) from a Cox regression was equal to 1.30 (0.77, 2.19), P = 0.321. When the treatment effect was adjusted for confounding factors (sex, wound type, age and wound area at start of treatment), the hazard ratio increased to 1.51 but was again not statistically significant.
Wound area at start of treatment and sex are both highly statistically significant predictors of time to healing. These results support the proposition that there are clinical benefits from using honey in wound care, but further research is needed.
本文报告一项研究,比较医用级蜂蜜与传统治疗方法对二期愈合伤口愈合率的影响。
越来越多的证据支持使用蜂蜜治疗伤口,但缺乏有力的随机试验供临床医生作为临床判断的依据。
105名患者参与了一项单中心、开放标签的随机对照试验,患者分别接受传统伤口敷料或蜂蜜治疗。数据收集于2004年9月至2007年5月期间。
蜂蜜组的中位愈合时间为100天,而对照组为140天。蜂蜜组12周时的愈合率为46.2%,传统组为34.0%,两组12周时愈合率的差异(95%置信区间,CI)为12.2%(-13.6%,37.9%)。Cox回归得出的未调整风险比(95%CI)为1.30(0.77,2.19),P = 0.321。当对治疗效果进行混杂因素(性别、伤口类型、年龄和治疗开始时的伤口面积)调整后,风险比增至1.51,但仍无统计学意义。
治疗开始时的伤口面积和性别都是愈合时间的高度统计学显著预测因素。这些结果支持在伤口护理中使用蜂蜜具有临床益处这一观点,但仍需进一步研究。