自拟中药熏洗方对合并糖尿病的肛周脓肿患者术后的临床疗效观察  

Clinical Effects of Homemade Herbal Fumigation among Perianal Abscess Postoperative Patients Complicated with Diabetes Mellitus

作　　者：林丽娟 杨屿晴[2] 谢守勇[2] LIN Li-juan;YANG Yu-qing;XIE Shou-yong(Anorectal Department of TCM,The Fourth People's Hospital of Yibin,Yibin(644000),China)

机构地区：[1]宜宾市第四人民医院中医肛肠科,四川宜宾644000 [2]宜宾市第一人民医院中西医结合科,四川宜宾644000

出　　处：《中国中西医结合外科杂志》2020年第6期1115-1119,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：宜宾市技术创新项目(2018YJ117)。

摘　　要：目的:探讨自拟中药熏洗方对合并糖尿病的肛周脓肿术后患者疼痛、伤口愈合和生活质量的影响。方法:抽取手术治疗的合并糖尿病的肛周脓肿患者44例,随机均分为对照组和观察组,行一次性脓肿根治术后,对照组采用1:5000高锰酸钾溶液坐浴,观察组采用自拟中药方煎水熏洗,两组其余治疗护理措施相同,治疗2周后,观察两组患者疼痛数字评分(NRS)、伤口愈合情况和生活质量。结果:两组患者术后第1天疼痛NRS评分差异无统计学意义,术后1周和术后2周,观察组疼痛程度低于对照组[术后1周:排便时(4.7±0.9)vs(5.4±1.0);走动时(4.4±0.8)vs(5.0±1.1);平时(4.0±0.8)vs(4.7±0.9)。术后2周:排便时(3.1±0.8)vs(4.0±0.9);走动时(2.8±0.7)vs(3.7±0.8);平时(2.4±0.6)vs(3.4±0.9),P<0.05];观察组腐肉脱落时间、上皮新生时间和创口愈合时间均短于对照组[腐肉脱落时间:(5.4±1.5)vs(7.2±1.8)d;上皮新生时间(6.4±1.3)vs(8.5±1.9)d;创口愈合时间:(19.9±3.5)d vs(23.8±4.9)d,P<0.05],术后1周两组患者创面分泌物和肉芽组织评分差异有统计学意义(P<0.05);两组患者术后第1天生活质量评分差异无统计学意义(P>0.05),术后1周和术后2周,观察组的生活质量评分显著低于对照组[术后1周:(41.6±6.7)分vs(46.8±7.6)分;术后2周:(26.9±5.5)分vs(34.4±6.4)分],差异均有统计学意义(P<0.05)。结论:本自拟中药方熏洗有利于合并糖尿病的肛周脓肿患者缓解疼痛、促进伤口愈合、减少不良反应,从而提高患者生活质量。Objective To explore the effects of homemade herbal fumigation on pain,wound healing and quality of life among perianal abscess postoperative patients complicated with diabetes mellitus.Methods From January to December 2019,forty-four perianal abscess postoperative patients complicated with diabetes mellitus(DM)had been selected from the fourth People's hospital and divided into control group and observation group randomly.All patients were conducted.The patients in control group and observation group were treated with a hip bath of 200 ppm potassium permanganate solution and homemade herbal fumigation respectively for two weeks after the same radical operation of one-off abscess and other nursing measures.Finally pain numberical rating scale(NRS),wound healing and quality of life were assessed.Results There was no statistical difference of pain NRS score between two groups after operation for one day(P>0.05),pain NRS score of patients in observation group was significantly lower than those in control group after operation for one or two weeks whenever defecation,walking and normal conditions[After operation for one week:defecation(4.7±0.9)vs(5.4±1.0);walking(4.4±0.8)vs(5.0±1.1);normal condition(4.0±0.8)vs(4.7±0.9).After operation for two weeks:defecation(3.1±0.8)vs(4.0±0.9);walking(2.8±0.7)vs(3.7±0.8);normal condition(2.4±0.6)vs(3.4±0.9).P<0.05].The length of wound slough decaying[(5.4±1.5)vs(7.2±1.8)days],epithelial neogenesis[(6.4±1.3)vs(8.5±1.9)days]and wound healing[(19.9±3.5)vs(23.8±4.9)days]in observation group were statistically shorter than those of control group(P<0.05),which the differences of score of wound secretion and wound granulation tissue were found between two groups after operation for one week(P<0.05).The difference of quality of life was not observed between two groups after operation for one day(P>0.05),which found after operation for one or two weeks in observation group was lower than that of control group[After operation for one week:(41.6±6.7)vs(46.8±7.6);After oper

关 键 词：中药熏洗 肛周脓肿 糖尿病 伤口愈合 生活质量 

分 类 号：R657.1+5[医药卫生—外科学] R285.6[医药卫生—临床医学]