摘要
目的:观察中药口服联合灌肠治疗单纯性肛瘘切除术后湿热下注证的疗效。方法:将单纯性肛瘘切除术后湿热下注证患者120例随机分为试验组与对照组,每组60例。对照组予常规术后管理,试验组在对照组基础上加用仙方活命饮内服联合五味消毒饮灌肠治疗,两组疗程均为14天。观察术后第1天、7天、14天患者创面面积,术后第1天、14天患者疼痛、瘙痒、渗出、肿胀、中医证候及Wexner评分以及术前、术后第14天患者直肠静息压(rectal resting pressure,RRP)、肛管静息压(anal resting pressure,ARP)、肛管最长收缩时间(anal longest contraction time,ALCT)、肛管最大收缩压(anal maximum contraction pressure,AMCP);观察术后第1天、14天肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素1β(interleukin-1β,IL-1β)及血管内皮生长因子(vascular endothelial growth factor,VEGF)、表皮细胞生长因子(epidermal growth factor,EGF)、转化生长因子β_(1)(transforming growth factor-β_(1),TGF-β_(1))表达水平,评估临床疗效。结果:术后第7、14天患者创面面积与疼痛、瘙痒、渗出、肿胀、中医证候、Wexner评分及炎症因子TNF-α、IL-1β试验组均低于对照组(P<0.01),RRP、ARP、AMCP及创面愈合生长因子VEGF、EGF、TGF-β_(1)试验组均高于对照组(P<0.01),ALCT试验组高于对照组(P<0.05);试验组临床疗效优于对照组(P<0.05)。结论:仙方活命饮内服联合五味消毒饮灌肠能有效促进单纯性肛瘘切除术后湿热下注证患者创面愈合,改善患者术后疼痛、瘙痒、渗出、肿胀等症状,有利于患者术后肛门功能恢复。
Objective:To observe clinical effects of oral administration of herbs combined with herbal enema in the treatment of low simple anal fistula of damp-heat downward pouring pattern after resection.Methods:All 120 patients after the operation were randomized into the experiment group and the control group with 60 cases in each group.The control group accepted conventional postoperative management,and the experiment group was treated by oral Xianfang Huoming drink and Wuwei Xiaodu drink enema based on the control group,the course of the treatment was 14 weeks.To observe the wound areas one day,seven and fourteen days after the surgery,pain,pruritus,exudation,swelling,TCM syndrome and Wexner scores one day and fourteen days after the surgery,RRP,ARP,ALCT and AMCP before the surgery and fourteen days after the surgery;to detect the expressions of TNF-α,IL-1β,VEGF,EGF and TGF-β_(1) one day and fourteen days after the surgery,and assess clinical effects.Results:Wound area,pain,pruritus,exudation,swelling,TCM syndrome and Wexner scores,and the levels of TNF-αand IL-1βone day and fourteen days after the surgery of the experiment group were lower than these of the control group(P<0.01),RRP,ARP,AMCP and the levels of VEGF,EGF and TGF-β_(1) of the experiment group were higher than these of the control group(P<0.01),ALCT of the experiment group was longer than that of the control group(P<0.05);clinical effects of the experiment group were superior to these of the control group(P<0.05).Conclusion:Oral Xianfang Huoming drink and Wuwei Xiaodu drink enema could effectively promote the wound healing,improve the patients'symptoms including postoperative pain,pruritus,exudation,swelling and others,and accelerate the recovery of anal function of the patients after the operation.
作者
李凤
吴东升
林奕
曹晖
LI Feng;WU Dongsheng;LIN Yi;CAO Hui(The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)
出处
《西部中医药》
2024年第9期131-135,共5页
Western Journal of Traditional Chinese Medicine
基金
湖南省教育厅科学研究重点项目(19A373)
湖南省中医药科研计划项目(2021022)
长沙市自然科学基金项目(kq2014221)。
关键词
肛瘘
术后
湿热下注证
仙方活命饮
五味消毒饮
灌肠
anal fistula
postoperative
damp-heat downward pouring pattern
Xianfang Huoming drink
Wuwei Xiaodu drink
enema
