Stüwe U
Fortschr Med. 1983 Nov 3;101(41):1883-8.
In a randomized single-blind trial 44 patients of the Unfallchir. Klinik of Wiesbaden with purulent exudates and/or necrotic substrates in wounds had been enzymatically debrided with preparation A or B (22 patients each group). The solutions had been applied topically in a wet-to-dry technique. Dressings were changed two times a day, until the area became clean and showed granulations. In the group treated with preparation A excellent and good results could be obtained in 16 patients, in the comparison group in 14 patients. Three patients in the group treated with preparation A remained unchanged; in the comparison group five patients remained unchanged or showed deterioration. Due to inefficiency or to side effects treatment was interrupted in four patients of the preparation A-group and in eight patients of the comparison group. The more satisfactory results with preparation A can be interpreted in regard to the action of the enzymes: Fibrinolysin immediately attacks the fibrin of blood clots and fibrinous exudates. Desoxyribonuclease assails desoxyribonucleic acid structures. Streptokinase and streptodornase however are needing plasminogen for transforming it into the effective enzyme of plasmin, as they themselves are uneffective. And the amounts of plasminogen in the treated wounds possibly are not sufficient.
在一项随机单盲试验中，威斯巴登事故外科诊所的44例伤口有脓性渗出物和/或坏死组织的患者，分别用制剂A或制剂B进行酶清创治疗（每组22例患者）。采用湿-干技术局部应用溶液。每天更换两次敷料，直到伤口区域清洁并出现肉芽组织。使用制剂A治疗的组中，16例患者获得了优和良的效果，对照组中有14例患者。使用制剂A治疗的组中有3例患者病情未改善；对照组中有5例患者病情未改善或恶化。由于无效或出现副作用，制剂A组有4例患者和对照组有8例患者中断了治疗。制剂A取得更满意的结果可从酶的作用方面来解释：纤维蛋白溶酶立即作用于血凝块和纤维蛋白渗出物中的纤维蛋白。脱氧核糖核酸酶攻击脱氧核糖核酸结构。然而，链激酶和链道酶需要纤溶酶原才能将其转化为有效的纤溶酶，因为它们本身是无效的。而且在接受治疗的伤口中纤溶酶原的量可能不足。
