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随机临床试验显示包扎对奶牛指皮炎M2期病变的治疗效果。

Randomised clinical trial showing the curative effect of bandaging on M2-stage lesions of digital dermatitis in dairy cows.

作者信息

Klawitter Marcus, Döpfer Dörte, Braden Theo Broderick, Amene Ermias, Mueller Kerstin Elisabeth

机构信息

Faculty of Veterinary Medicine, Clinic for Ruminants and Swine, Freie Universität Berlin, Berlin, Germany.

Department of Medical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.

出版信息

Vet Rec Open. 2019 May 22;6(1):e000264. doi: 10.1136/vetreco-2017-000264. eCollection 2019.

Abstract

OBJECTIVES AND DESIGN

This trial evaluated the effect of bandaging of acute painful ulcerative bovine digital dermatitis (DD) lesion (stage M2) in dairy cows, tested using two different topical treatments.

DESIGN

Randomised clinical trial.

SETTING

This study was conducted using Holstein-Friesian cows ranging in age from heifers to fourth lactation in a single dairy herd and diagnosed with acute ulcerative DD lesions (stage M2) on the first examination (week 0). Cows were randomly assigned into either a non-bandaged or bandaged group across two treatment conditions: topical chlortetracycline spray (CTC) and Intra Hoof-Fit Gel (IHF). Lesions received standardised bandaging and treatment on a weekly basis. Unhealed lesions could receive up to five repeated treatments, at weekly intervals, within a four-week period. Both M-stage and locomotion were also evaluated and scored weekly. Cows with healthily formed skin (stage M0) were deemed healed and subsequently released from the study.

RESULTS

In total, 163 M2 lesions were diagnosed at week 0. Bandaged M2 lesions had a significantly higher probability of cure than non-bandaged lesions regardless of treatment type (HR: 4.1; P<0.001; 95 per cent CI: 2.5 to 6.8). Most healing occurred within the first three weeks of trial. Furthermore, bandaged lesions (group 2 and group 4) were significantly less likely to progress into the chronic hyperkeratotic or proliferative stage (M4) than non-bandaged lesions in group 1 and group 3 (HR: 0.10; P<0.001; 95 per cent CI: 0.04 to 0.22). Out of concern for the cow's wellbeing, this study investigated the effects of bandaging on locomotion. Bandaging had no effect on locomotion for either cows treated with CTC (group 1: median Sprecher score, 2; IQR=1-2; group 2: median Sprecher score, 2; IQR=1-3; P=0.3) or IHF (group 3: median Sprecher score, 2; IQR=1-2; group 4: median Sprecher score, 2; IQR=1-3; P=0.3).

摘要

目的与设计

本试验评估了对奶牛急性疼痛性溃疡性牛指皮炎(DD)病变(M2期)进行包扎的效果,采用两种不同的局部治疗方法进行测试。

设计

随机临床试验。

背景

本研究使用了荷斯坦-弗里生奶牛,年龄从初产母牛到第四胎泌乳期,来自单一奶牛群,在首次检查(第0周)时被诊断为急性溃疡性DD病变(M2期)。奶牛被随机分为非包扎组或包扎组,分为两种治疗条件:局部用金霉素喷雾(CTC)和蹄内凝胶(IHF)。病变每周接受标准化包扎和治疗。未愈合的病变在四周内可每隔一周接受多达五次重复治疗。每周还对M期和运动能力进行评估和评分。皮肤健康形成(M0期)的奶牛被视为治愈,随后退出研究。

结果

在第0周共诊断出163个M2期病变。无论治疗类型如何,包扎的M2期病变治愈的可能性明显高于未包扎的病变(风险比:4.1;P<0.001;95%置信区间:2.5至6.8)。大多数愈合发生在试验的前三周内。此外,与第1组和第3组的未包扎病变相比,包扎的病变(第2组和第4组)发展为慢性角化过度或增殖期(M4)的可能性明显较小(风险比:0.10;P<0.001;95%置信区间:0.04至0.22)。出于对奶牛健康的考虑,本研究调查了包扎对运动能力的影响。对于接受CTC治疗的奶牛(第1组:Sprecher评分中位数,2;四分位间距=1-2;第2组:Sprecher评分中位数,2;四分位间距=1-3;P=0.3)或IHF治疗的奶牛(第3组:Sprecher评分中位数,2;四分位间距=1-2;第4组:Sprecher评分中位数,2;四分位间距=1-3;P=0.3),包扎对运动能力均无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d319/6541101/d69ce945d497/vetreco-2017-000264f01.jpg

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