拔毒生肌散用于肛肠疾病术后换药的临床观察
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摘要
目的:探索拔毒生肌散用于肛肠疾病术后换药的疗效与安全性。方法:共纳入肛瘘、肛周脓肿术后患者19例,包括迁延1个月不愈者7例(A组),感染性创面者12例(B组)。2组患者均采用拔毒生肌散与凡士林1:9混匀,涂抹于无菌纱条,在常规消毒清创后,进行填塞或外敷,1次/d,连续7 d。观察2组有效率,对比治疗前后创面面积、脓性分泌物、局部疼痛瘙痒,监测不良反应。结果:2组患者均取得了较理想的疗效,总有效率95.7%,其中A组(86.7%)有优于B组(100.0%)的趋势(P>0.05);治疗后创面面积显著缩小(P<0.05),脓腐评分显著降低(P<0.05),局部疼痛评分、瘙痒评分未显著降低(P>0.05)。未发现药物不良反应。结论:拔毒生肌散用于肛肠疾病术后难愈性创面和感染性创面的换药有效安全,值得进一步研究。
Objective: To explore the efficacy and safety of Badu Shengji powder for dressing replacement after anorectal diseases.Methods: A total of 19 patients with anal fistula and perianal abscess in our hospital from April 2017 to August 2017 were included and divided into group A or group B according to their different conditions.There were 7 cases who delayed wound healing for one month assigned to group A,and 12 cases with infected wounds were assigned to group B.All of the patients were stuffed or covered with the sterilized gauze which infiltrationed with Badu Shengji powder and Vaseline mixed in ratio of 1:9.After routine disinfection and removal of the clinging skin,padding or external application was performed,once a day for 7 days.The effective rate,the wound area,the score of pus secretion,the score of local pain and itch,the liver and kidney function and the side effects were observed before and after treatment in the two groups.Results: Both groups had an ideal curative effect,and the total effective rate was 95.7%.The group A( 86.7%) had a tendency to had superior curative effect than group B( 100%)( P > 0.05); the area of wound surface decreased significantly( P < 0.05),The purulent rot score was significantly reduced( P < 0.05),and the local pain and pruritus score did not decrease significantly( P > 0.05).No adverse reactions were found,and liver and kidney functions were not founded abnormal.Conclusion: It is effective and safe for the dressing replacement of the refractory wounds and infected wounds after the operation of anorectal diseases.It is worth to expand the sample size,prolong the observation time,and conduct the randomized controlled trial further more.
Objective: To explore the efficacy and safety of Badu Shengji powder for dressing replacement after anorectal diseases.Methods: A total of 19 patients with anal fistula and perianal abscess in our hospital from April 2017 to August 2017 were included and divided into group A or group B according to their different conditions.There were 7 cases who delayed wound healing for one month assigned to group A,and 12 cases with infected wounds were assigned to group B.All of the patients were stuffed or covered with the sterilized gauze which infiltrationed with Badu Shengji powder and Vaseline mixed in ratio of 1:9.After routine disinfection and removal of the clinging skin,padding or external application was performed,once a day for 7 days.The effective rate,the wound area,the score of pus secretion,the score of local pain and itch,the liver and kidney function and the side effects were observed before and after treatment in the two groups.Results: Both groups had an ideal curative effect,and the total effective rate was 95.7%.The group A( 86.7%) had a tendency to had superior curative effect than group B( 100%)( P > 0.05); the area of wound surface decreased significantly( P < 0.05),The purulent rot score was significantly reduced( P < 0.05),and the local pain and pruritus score did not decrease significantly( P > 0.05).No adverse reactions were found,and liver and kidney functions were not founded abnormal.Conclusion: It is effective and safe for the dressing replacement of the refractory wounds and infected wounds after the operation of anorectal diseases.It is worth to expand the sample size,prolong the observation time,and conduct the randomized controlled trial further more.
引文
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[5]朱赟,鲁林源.痔疾洗液应用于肛肠疾病术后的临床观察[J].中国医药,2013,8(5):689-690.
[6]杨润华,程明.拔毒生肌散的研制及临床应用[J].中国卫生产业,2011,8(7):76-77.
[7]李层,涂扬茂.拔毒生肌散外用治疗跟骨骨折术后伤口不愈合临床观察[J].内蒙古中医药,2014,33(17):38-39.
[8]梅启元,刘鹏.拔毒生肌散治疗四肢感染伤口的应用[J].特别健康,2014,2(2):350-350.
[9]查丽春.拔毒生肌散治疗糖尿病足感染性溃疡的临床观察[J].湖北中医杂志,2013,35(4):50-51.
[10]黄春莲.红光照射联合拔毒生肌散外敷治疗慢性皮肤溃疡临床治疗与护理观察[J].中国实用医药,2015,10(26):229-230.
[11]方园园,叶煜婉.拔毒生肌散与黄连膏纱条用于混合痔术后伤口换药的疗效观察[J].中西医结合研究,2013,5(4):194-195.
[12]中华医学会创伤学分会组织修复专业委员会.慢性伤口诊疗指导意见[S].北京:人民卫生出版社,2011.
[13]王正国.创伤基础研究进展[J].中华创伤杂志,2005,21(1):6-10.
[14]郑春菊,王业皇.肛瘘术后创面愈合的中医学研究进展[J].世界中西医结合杂志,2014,9(2):207-209.
[15]李明安.肛肠手术术后创面愈合缓慢的原因分析[J].世界最新医学信息文摘,2017,17(30):43-47.
[16]贺蓉,彭博,路艳丽,等.拔毒生肌散及其拆方对大鼠破损皮肤组织形态学的影响观察[J].中国中药杂志,2012,37(6):715-718.
[17]路艳丽,贺蓉,彭博,等.拔毒生肌散中配伍药味对汞、铅成分毒性的影响[J].中国中药杂志,2011,36(15):2118-2123.
[2]游冬阁,杨艳霞,裴学军,等.拔毒生肌散临床应用[J].世界中医药,2016,11(7):1381-1383.
[3]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:132-133.
[4]陶晓春,梁宏涛,曹永清,等.中医内治法促进肛瘘术后创面愈合的研究进展[J].中国肛肠病杂志,2015,35(5):61-63.
[5]朱赟,鲁林源.痔疾洗液应用于肛肠疾病术后的临床观察[J].中国医药,2013,8(5):689-690.
[6]杨润华,程明.拔毒生肌散的研制及临床应用[J].中国卫生产业,2011,8(7):76-77.
[7]李层,涂扬茂.拔毒生肌散外用治疗跟骨骨折术后伤口不愈合临床观察[J].内蒙古中医药,2014,33(17):38-39.
[8]梅启元,刘鹏.拔毒生肌散治疗四肢感染伤口的应用[J].特别健康,2014,2(2):350-350.
[9]查丽春.拔毒生肌散治疗糖尿病足感染性溃疡的临床观察[J].湖北中医杂志,2013,35(4):50-51.
[10]黄春莲.红光照射联合拔毒生肌散外敷治疗慢性皮肤溃疡临床治疗与护理观察[J].中国实用医药,2015,10(26):229-230.
[11]方园园,叶煜婉.拔毒生肌散与黄连膏纱条用于混合痔术后伤口换药的疗效观察[J].中西医结合研究,2013,5(4):194-195.
[12]中华医学会创伤学分会组织修复专业委员会.慢性伤口诊疗指导意见[S].北京:人民卫生出版社,2011.
[13]王正国.创伤基础研究进展[J].中华创伤杂志,2005,21(1):6-10.
[14]郑春菊,王业皇.肛瘘术后创面愈合的中医学研究进展[J].世界中西医结合杂志,2014,9(2):207-209.
[15]李明安.肛肠手术术后创面愈合缓慢的原因分析[J].世界最新医学信息文摘,2017,17(30):43-47.
[16]贺蓉,彭博,路艳丽,等.拔毒生肌散及其拆方对大鼠破损皮肤组织形态学的影响观察[J].中国中药杂志,2012,37(6):715-718.
[17]路艳丽,贺蓉,彭博,等.拔毒生肌散中配伍药味对汞、铅成分毒性的影响[J].中国中药杂志,2011,36(15):2118-2123.