止痛如神汤对肛瘘术后伤口愈合及疼痛程度的影响
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摘要
目的探讨止痛如神汤对肛瘘术后伤口愈合及疼痛程度的影响。方法选取贵阳中医学院第一附属医院2015年12月～2018年6月肛瘘术后患者60例,随机数字表法分为对照组(n=30)与研究组(n=30)。对照组采用地奥司明及高锰酸钾坐浴,研究组在对照组基础上采用止痛如神汤,两组均治疗3周。统计比较两组临床疗效、创面愈合时间及便血消失时间,治疗前后血清表皮生长因子(EGF)与纤维连接蛋白(FN)水平、创面纵径及创面面积、症状(疼痛程度、肉芽形态、创面渗液)积分。结果研究组总有效率高于对照组(P <0.05)。研究组创面愈合时间及便血消失时间均短于对照组(P <0.01)。两组治疗后血清EGF与FN水平均高于本组治疗前(P <0.01),且研究组高于对照组(P <0.05)。治疗后两组创面纵径及创面面积较本组治疗前缩小(P <0.01),且研究组小于对照组(P <0.01)。治疗后两组疼痛程度、肉芽形态、创面渗液分值较本组治疗前降低(P <0.01),且研究组低于对照组(P <0.01)。结论采取止痛如神汤治疗肛瘘术后患者,可有效缩短创面愈合及便血消失时间,促使创面消失,减轻患者疼痛感,缓解患者临床症状,增加血清EGF与FN水平,提高疾病治疗效果。
Objective To investigate the effect of Zhitong Rushen Decoction on wound healing and pain degree after anal fistula operation. Methods Sixty patients with anal fistula from December 2015 to June 2018 in the First Affiliated Hospital to Guiyang College of Traditional Chinese Medicine were selected. By the random number table method all the patients were divided into control group(n = 30) and study group(n = 30). The control group was treated with Diosmin and Potassium Permanganate. The study group was treated with Zhitong Rushen Decoction on the basis of the control group, and the two groups were treated for 3 weeks. The clinical efficacy, wound healing time and disappearance time of blood in the stool, serum epidermal growth factor(EGF) and fibronectin(FN) levels, wound longitudinal diameter and wound area, symptoms(pain level, granulation morphology), wound surface exudate) integral were measured and comparedy between the two groups. Results The total effective rate of the study group was higher than that of the control group(P < 0.05). The healing time of the wound in the study group and the disappearance time of blood in stool in the study group were shorter than those in the control group(P < 0.05). After treatment, serum EGF and FN levels in the two groups were higher than those before treatment(P < 0.01), and those in the study group were higher than those in the control group(P < 0.05). After treatment, the longitudinal diameter and wound area of the two groups were smaller than those before treatment(P < 0.01), and those in the study group were smaller than those in the control group(P < 0.01).After treatment, scores of the pain level, granulation morphology and wound exudate in the two groups were lower than those before treatment(P < 0.01), and those in the study group were lower than those in the control group(P < 0.01).Conclusion The treatment of anal fistula with Zhitong Rushen Decoction can effectively shorten the healing time of wound healing and blood in the stool, promote the disappearance of wounds, reduce the pain of patients, relieve the clinical symptoms, increase the levels of serum EGF and FN, and improve the therapeutic effect of the disease.
Objective To investigate the effect of Zhitong Rushen Decoction on wound healing and pain degree after anal fistula operation. Methods Sixty patients with anal fistula from December 2015 to June 2018 in the First Affiliated Hospital to Guiyang College of Traditional Chinese Medicine were selected. By the random number table method all the patients were divided into control group(n = 30) and study group(n = 30). The control group was treated with Diosmin and Potassium Permanganate. The study group was treated with Zhitong Rushen Decoction on the basis of the control group, and the two groups were treated for 3 weeks. The clinical efficacy, wound healing time and disappearance time of blood in the stool, serum epidermal growth factor(EGF) and fibronectin(FN) levels, wound longitudinal diameter and wound area, symptoms(pain level, granulation morphology), wound surface exudate) integral were measured and comparedy between the two groups. Results The total effective rate of the study group was higher than that of the control group(P < 0.05). The healing time of the wound in the study group and the disappearance time of blood in stool in the study group were shorter than those in the control group(P < 0.05). After treatment, serum EGF and FN levels in the two groups were higher than those before treatment(P < 0.01), and those in the study group were higher than those in the control group(P < 0.05). After treatment, the longitudinal diameter and wound area of the two groups were smaller than those before treatment(P < 0.01), and those in the study group were smaller than those in the control group(P < 0.01).After treatment, scores of the pain level, granulation morphology and wound exudate in the two groups were lower than those before treatment(P < 0.01), and those in the study group were lower than those in the control group(P < 0.01).Conclusion The treatment of anal fistula with Zhitong Rushen Decoction can effectively shorten the healing time of wound healing and blood in the stool, promote the disappearance of wounds, reduce the pain of patients, relieve the clinical symptoms, increase the levels of serum EGF and FN, and improve the therapeutic effect of the disease.
引文
[1]孔淑娟,何德贤,罗文婷,等.中药液冲洗结合压迫法对肛瘘拖线术后伤口愈合的影响[J].中国实用护理杂志,2016,32(19):1441-1444.
[2]Alasari S,Kim NK.Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract(LIFT)[J].Tech Coloproctol,2014,18(1):13-22.
[3]陈红梅,赵海波.康复新液联合重组人酸性成纤维细胞生长因子对湿热下注型肛瘘术后创面愈合的影响[J].现代中西医结合杂志,2017,26(13):1420-1422.
[4]Sirany AM,Nygaard RM,Morken JJ.The ligation of the intersphincteric fistula tract procedure for anal fistula:a mixed bag of results[J].Dis Colon Rectum,2015,58(6):604-612.
[5]杨会举,周鹏飞,刘翔,等.龙珠软膏、肛泰软膏、复方角菜酸酯乳膏对肛瘘术后创面愈合的临床观察[J].世界中西医结合杂志,2016,11(12):1710-1713.
[6]余克强,伍静,吕长遥,等.中医外治法在肛瘘术后切口愈合中的应用[J].天津中医药,2018,35(7):557-560.
[7]王昱,陈倚,高凌卉,等.柏氏虎杖油膏对低位肛瘘术后创面愈合影响的临床研究[J].上海中医药杂志,2016,50(9):63-66.
[8]中华医学会外科学分会,中华中医药学会,中国中西医结合学会.肛瘘临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(5):461-462.
[9]刘伟志.自拟消毒汤内服与灌肠联用对肛瘘患者术后免疫球蛋白A表皮生长因子及创面恢复的影响[J].四川中医,2017,35(1):132-135.
[10]孙凤伟.加味苦参汤坐浴熏洗对缓解肛瘘术后创面疼痛及促进愈合的效果观察[J].现代中西医结合杂志,2015,24(36):4076-4078.
[11]Amato A,Bottini C,Nardi PD,et al.Evaluation and management of perianal abscess and anal fistula:a consensus statement developed by the Italian Society of Colorectal Surgery(SICCR)[J].Tech Coloproctol,2015,19(10):595-606.
[12]刘益峰,林雨冬,林梅英.微波联合德赛恩液体敷料促进低位肛瘘术后切口愈合效果观察[J].人民军医,2017,60(4):358-360.
[13]许国辉.瘘管旷置术联合传统切开挂线疗法对高位复杂性肛瘘患者术后切口愈合及复发率的影响[J].首都食品与医药,2018,25(14):14-34.
[14]Adamina M,Ross T,Guenin MO,et al.Anal fistula plug:a prospective evaluation of success,continence and quality of life in the treatment of complex fistulae[J].Colorectal Dis,2014,16(7):547-554.
[15]夏泽华,张雅明,沈菲菲.自拟促愈汤对湿热下注型低位肛瘘术后止痛促愈作用[J].长春中医药大学学报,2016,32(2):350-351.
[16]闻永,李俊,易艺.止痛如神油纱对低位肛瘘术后患者疼痛及创面愈合的影响[J].中医药导报,2016,22(10):81-83.
[17]唐勤富,曾伟,黄琪.自拟益气祛毒方促进低位肛瘘术后创面愈合的临床观察[J].四川中医,2017,35(3):127-129.
[18]王健.复方黄柏液联合中药坐浴方治疗肛瘘术后患者临床研究[J].陕西中医,2017,38(8):1022-1023.
[19]肖迪飞.加减止痛如神汤坐浴促进肛瘘术后创面愈合45例[J].湖南中医杂志,2010,26(1):54-55.
[20]黄高玮.止痛如神汤联合藻酸盐医用膜在肛瘘术后缓解疼痛的临床观察[J].光明中医,2017,32(15):2172-2174.
[21]季顺祥.四季止痛汤坐浴对痔瘘术后伤口愈合与止痛效果的观察[J].中医外治杂志,2017,26(5):5.
[22]林春燕.肛瘘术后伤口愈合应用苦参汤熏洗剂的价值探析[J].内蒙古中医药,2016,35(10):75.
[23]葛广德.解毒化瘀中药内服外洗对肛瘘术后治疗效果及EGF、sIgA水平的影响[J].现代中西医结合杂志,2017,26(31):3524-3526.
[24]蔡丽霞,王业皇.肛瘘的微创治疗研究[J].长春中医药大学学报,2013,29(1):105-107.
[2]Alasari S,Kim NK.Overview of anal fistula and systematic review of ligation of the intersphincteric fistula tract(LIFT)[J].Tech Coloproctol,2014,18(1):13-22.
[3]陈红梅,赵海波.康复新液联合重组人酸性成纤维细胞生长因子对湿热下注型肛瘘术后创面愈合的影响[J].现代中西医结合杂志,2017,26(13):1420-1422.
[4]Sirany AM,Nygaard RM,Morken JJ.The ligation of the intersphincteric fistula tract procedure for anal fistula:a mixed bag of results[J].Dis Colon Rectum,2015,58(6):604-612.
[5]杨会举,周鹏飞,刘翔,等.龙珠软膏、肛泰软膏、复方角菜酸酯乳膏对肛瘘术后创面愈合的临床观察[J].世界中西医结合杂志,2016,11(12):1710-1713.
[6]余克强,伍静,吕长遥,等.中医外治法在肛瘘术后切口愈合中的应用[J].天津中医药,2018,35(7):557-560.
[7]王昱,陈倚,高凌卉,等.柏氏虎杖油膏对低位肛瘘术后创面愈合影响的临床研究[J].上海中医药杂志,2016,50(9):63-66.
[8]中华医学会外科学分会,中华中医药学会,中国中西医结合学会.肛瘘临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(5):461-462.
[9]刘伟志.自拟消毒汤内服与灌肠联用对肛瘘患者术后免疫球蛋白A表皮生长因子及创面恢复的影响[J].四川中医,2017,35(1):132-135.
[10]孙凤伟.加味苦参汤坐浴熏洗对缓解肛瘘术后创面疼痛及促进愈合的效果观察[J].现代中西医结合杂志,2015,24(36):4076-4078.
[11]Amato A,Bottini C,Nardi PD,et al.Evaluation and management of perianal abscess and anal fistula:a consensus statement developed by the Italian Society of Colorectal Surgery(SICCR)[J].Tech Coloproctol,2015,19(10):595-606.
[12]刘益峰,林雨冬,林梅英.微波联合德赛恩液体敷料促进低位肛瘘术后切口愈合效果观察[J].人民军医,2017,60(4):358-360.
[13]许国辉.瘘管旷置术联合传统切开挂线疗法对高位复杂性肛瘘患者术后切口愈合及复发率的影响[J].首都食品与医药,2018,25(14):14-34.
[14]Adamina M,Ross T,Guenin MO,et al.Anal fistula plug:a prospective evaluation of success,continence and quality of life in the treatment of complex fistulae[J].Colorectal Dis,2014,16(7):547-554.
[15]夏泽华,张雅明,沈菲菲.自拟促愈汤对湿热下注型低位肛瘘术后止痛促愈作用[J].长春中医药大学学报,2016,32(2):350-351.
[16]闻永,李俊,易艺.止痛如神油纱对低位肛瘘术后患者疼痛及创面愈合的影响[J].中医药导报,2016,22(10):81-83.
[17]唐勤富,曾伟,黄琪.自拟益气祛毒方促进低位肛瘘术后创面愈合的临床观察[J].四川中医,2017,35(3):127-129.
[18]王健.复方黄柏液联合中药坐浴方治疗肛瘘术后患者临床研究[J].陕西中医,2017,38(8):1022-1023.
[19]肖迪飞.加减止痛如神汤坐浴促进肛瘘术后创面愈合45例[J].湖南中医杂志,2010,26(1):54-55.
[20]黄高玮.止痛如神汤联合藻酸盐医用膜在肛瘘术后缓解疼痛的临床观察[J].光明中医,2017,32(15):2172-2174.
[21]季顺祥.四季止痛汤坐浴对痔瘘术后伤口愈合与止痛效果的观察[J].中医外治杂志,2017,26(5):5.
[22]林春燕.肛瘘术后伤口愈合应用苦参汤熏洗剂的价值探析[J].内蒙古中医药,2016,35(10):75.
[23]葛广德.解毒化瘀中药内服外洗对肛瘘术后治疗效果及EGF、sIgA水平的影响[J].现代中西医结合杂志,2017,26(31):3524-3526.
[24]蔡丽霞,王业皇.肛瘘的微创治疗研究[J].长春中医药大学学报,2013,29(1):105-107.