清热燥湿方熏洗对陈旧性肛裂术后创面愈合及炎症因子水平的影响  

Effect Qingrezaoshi decoction fumigation on wound healing and inflammatory factors in patients with anal fissure undergoing surgery

作　　者：陆文强[1] 

机构地区：[1]上海市普陀区人民医院中医科,上海200060

出　　处：《结直肠肛门外科》2018年第1期64-67,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨清热燥湿方熏洗对陈旧性肛裂术后创面愈合及炎症因子水平的影响。方法将本院116例经手术治疗的陈旧性肛裂患者随机为分观察组(清热燥湿方熏洗)与对照组(高锰酸钾溶液坐浴),每组各58例。记录两组术后1 d、3 d、7 d创面分泌物、创面疼痛、创面肉芽生长积分、创面愈合时间及炎症因子变化,比较两组术后肛门功能并观察不良反应。结果观察组创面愈合时间(11.26±1.35)d,显著短于对照组的(14.30±1.42)d,差异有统计学意义(P<0.05)。两组术后1 d、3 d、7 d创面分泌物、创面疼痛、创面肉芽生长积分均呈降低趋势(均P<0.05);且观察组术后3 d、7 d创面分泌物、创面疼痛、创面肉芽生长积分均显著低于对照组(均P<0.05)。观察组术后3 d、7 d IL-6、TNF-α水平低于对照组(均P<0.05)。两组术后1 d、术后1个月肛管静息压、肛管最大收缩压差异均无统计学意义(均P>0.05)。两组术后1个月Wexner评分均低于术后1 d,且观察组显著低于对照组(均P<0.05)。两组均未发生不良反应。结论清热燥湿方熏洗可缩短陈旧性肛裂术后创面愈合时间,促进肛门功能恢复,加速术后康复进程,无明显不良反应,其作用机制可能与降低机体炎症因子水平有关。Objective To investigate the effect of Qingrezaoshi decoction fumigation on wound healing and inflammatory factors in patients with anal fissure undergoing surgery. Methods 116 patients with anal fissure treated in our hospital were randomly assigned to treatment group（Qingrezaoshi decoction fumigation） and control group（conventional potassium permanganate solution）, with 58 patients in each group. 1 d, 3 d and 7 d after the surgery, wound secretion, wound pain, wound granulation growth score, time to wound healing, and change of inflammatory factors were recorded in two groups. Postoperative anal function and adverse reactions were compared between the two groups. Results The time to wound healing in the treatment group（11.26 ± 1.35） d was significantly shorter than that in the control group（14.30 ± 1.42） d（P〈0.05）. 1 d, 3 d, and 7 d after operation, wound secretion, wound pain, and wound granulation growth score in both groups decreased（P〈0.05）. 1 d and 3 d after operation, the scores of wound secretion, wound pain and wound granulation growth were significantly lower in the treatment group than those in the control group（P〈0.05）. 3 d and 7 d after operation, the levels of IL-6 and TNF-α were lower in the treatment group than those in the control group（P〈0.05）. 1 d and 1 month after operation, there was no significant difference in anal rest pressure and anal maximum systolic pressure between the two groups（P〉0.05）. The Wexner scores 1 month after operation decreased in both group, with lower score in the treatment group than in the control group（P〈0.05）. There were no adverse reactions in either group. Conclusion Qingrezaoshi Decoction fumigation can shorten the time to wound healing after operation in anal fissure, promote the recovery of anal function, which can accelerate postoperative rehabilitation process and has high safety. The mechanism of action may be related to lowering the level of inflammatory factors.

关 键 词：清热燥湿方熏洗 陈旧性肛裂术 康复效果 

分 类 号：R657.1[医药卫生—外科学]