机构地区:[1]浙江中医药大学附属嘉兴中医院肛肠科,浙江嘉兴314001 [2]浙江中医药大学附属嘉兴中医院病理科,浙江嘉兴314001
出 处:《中国中西医结合外科杂志》2020年第5期930-935,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基 金:浙江省中医药科学研究基金项目(2020ZB256);浙江省嘉兴市科技局科研项目(2018AD32146);浙江嘉兴卫生健康实用新技术和适宜技术培育推广项目(2018-TP-10)。
摘 要:目的:探讨基于创面新血管生成的郭氏苦柏方对肛瘘术后恢复的影响。方法:将106例肛瘘患者随机分为观察组(54例)和对照组(52例)。所有患者均行肛瘘切除术,观察组术后用郭氏苦柏方熏洗坐浴,对照组用高锰酸钾外用片稀释后坐浴,观察两组术后第7、14、21天的创面疼痛评分、愈合率、肉芽评分,术后第7、14天显微镜下创面毛细血管含量、创面血管内皮生长因子(VEGF)的表达,并评估肛门功能,观察治愈率及创面愈合时间。结果:观察组术后第7、14天的疼痛VAS评分分别为(2.78±0.49)分、(1.79±0.36)分,均低于对照组的(3.07±0.61)分和(2.01±0.41)分;观察组术后第7、14、21天创面肉芽评分分别为(1.52±0.51)分、(0.98±0.44)分、(0.57±0.23)分,均低于对照组的(1.86±0.68)分、(1.25±0.46)分、(0.76±0.48)分;创面愈合率分别为(25.34±4.68)%、(60.21±7.92)%、(88.39±9.65)%,均高于对照组的(22.89±4.01)%、(54.91±8.33)%、(83.95±8.43)%;观察组术后第7、14天镜下创面毛细血管数量分别为32.78±8.72、97.04±11.58,高于对照组的27.69±7.37、89.54±7.03;观察组的VEGF阳性表达强度高于对照组(P<0.05);观察组总有效率与对照组相当;治愈患者中,观察组创面愈合时间为(24.72±3.89)d,少于对照组的(27.34±4.25)d。结论:郭氏苦柏方能减轻肛瘘患者术后疼痛,提高创面VEGF的表达强度,增加创面毛细血管数量,从而加快肉芽生长,促进术后创面愈合,且无明显的不良反应。Objective To explore the effect of Guoshikubai Recipe on the recovery of anal fistula after wound neovascularization.Methods 106 patients were randomly divided into observation group and control group,which 54 cases in observation group and 52 cases in control group.All patients underwent anal fistula resection.The observation group was treated with Guoshikubai Recipe.Sitting in the bath,the control group was diluted with potassium permanganate topical tablets.The wound pain score,healing rate,granulation score and microscopic observation of wounds were observed on the 7th,14th and 21st day after operation.Capillary content,expression of VEGF in the wound were observed on the 7thand 14th day after operation.The postoperative anal function was evaluated.The cure rate and wound healing time were observed.Results The pain VAS scores of patients in the observation group on the 7th and 14th days after operation were(2.78±0.49)and(1.79±0.36),which were lower than those in the control group(3.07±0.61)and(2.01±0.41).The wound granulation scores on the 7th,14th and 21st days after operation were(1.52±0.51),(0.98±0.44)and(0.57±0.23),which were all lower than those in the control group(1.86±0.68)and(1.25±0.46)and(0.76±0.48).The wound healing rates were(25.34±4.68),(60.21±7.92)and(88.39±9.65),which were higher than those of the control group(22.89±4.01),(54.91±8.33)and(83.95±8.43).The number of capillaries under the microscope on the 7th and 14th days of the observation group were(32.78±8.72)and(97.04±11.58),which were higher than those of the control group(27.69±7.37),(89.54±7.03),the VEGF positive expression intensity was higher than that of the control group(P<0.05).The observation group was cured in 51 cases and improved in 3 cases.The total effective rate was 100%,which was equivalent to the control group.Among the cured patients,the wound healing time of the observation group was(24.72±3.89),which was less than that of the control group(27.34±4.25).Conclusion Guoshikubai Recipe can alleviate posto
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