肛痈促愈汤在促进肛周脓肿术后创面愈合的作用及对血管内皮因子的影响  

Effect of Anal Carbuncle Promoting Healing Decoction on Postoperative Wound Healing in Patients with Perianal Abscess and Its Effect on Vascular Endothelial Factors

作　　者：柳春生 李积良 王继宁[1] LIU Chunsheng;Li Jiliang;WANG Jining(Department of Anorectal Medicine,Qinghai Hospital of Traditional Chinese Medicine,Xining 810000,Qinghai,China)

机构地区：[1]青海省中医院肛肠科,青海西宁810000

出　　处：《中华中医药学刊》2020年第12期205-208,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：青海省重点实验室专项(2017-ZJ-Y08)。

摘　　要：目的观察肛痈促愈汤在促进肛周脓肿患者术后创面愈合的作用及对血管内皮因子的影响。方法选择2018年1月—2019年8月医院收治的肛周脓肿患者83例,依照治疗方案的不同分为观察组(42例)和对照组(41例)。两组患者均采用一次性肛周脓肿根治术治疗。对照组采用高猛酸钾坐浴,患者大便后清洗创面,观察组采用肛痈促愈汤辅助治疗,直至创面愈合。比较两组治疗疗效,两组患者术后不同时间点症状及体征评分;比较两组腐肉完全脱离时间、创面愈合时间和创面缩小率;比较血清VEGF、IL-1β、TNF-α和IL-6含量;比较两组不同时段肛门功能。结果观察组总有效率为90.48%(38/42),对照组治疗总有效率为73.17%(30/41),观察组治疗总有效率高于对照组(P<0.05);观察组术后7 d和术后14 d肛门疼痛、肛门周围组织水肿、分泌物和肉芽形态的评分低于对照组(P<0.05);观察组患者腐肉完全脱离时间、创面愈合时间和创面缩小率均低于对照组(P<0.05);观察组术后14 d VEGF水平高于对照组,炎性细胞因子IL-6、IL-8和TNF-α水平低于对照组(P<0.05);观察组术后1个月和术后3个月肛管静息压和肛管最大收缩压均高于对照组(P<0.05)。结论肛痈促愈汤可促进肛周脓肿患者一次性根治术后创面愈合和肉芽生长,提高血清VEGF水平,降低炎症反应,有效恢复肛门收缩功能,提高临床总有效率。Objective To observe the effect of Anal Carbuncle Promoting Healing Decoction on promoting wound healing of patients with perianal abscess and its effect on vascular endothelial factors. Methods Eighty-three patients with perianal abscess admitted to our hospital from January 2018 to August 2019 were selected and divided into the observation group(n=42) and the control group(n=41) according to different treatment regimens. The two groups were treated with one-time radical resection of perianal abscess. The control group was treated with sitting bath of high mensurate potassium and the patients were cleaned after defecating. The observation group was treated with sitting bath of Anal Carbuncle Promoting Healing Decoction until the wound heals. The therapeutic effect of the two groups was compared, and the symptom and sign scores of the two groups at different time points after the operation were compared. The time of complete release of carrion, wound healing time and wound reduction rate were compared between the two groups. Serum levels of VEGF, IL-1β, TNF-α and IL-6 were compared. Anal function was compared between the two groups at different time periods. Results The total effective rate of the observation group was 90.48%(38/42), while the total effective rate of the control group was 73.17%(30/41). The total effective rate of the observation group was higher than that of the control group(P<0.05). The scores of postoperative pain, perianal tissue edema, secretion and granulation morphology in the observation group were lower than those in the control group(P<0.05). The level of VEGF on 14 d in the observation group was higher than that in the control group, and the levels of inflammatory cytokines IL-6, IL-8 and TNF-α in the observation group were lower than those in the control group(P<0.05). The anorectal resting pressure and maximal systolic pressure were higher in the observation group than those in the control group at 1 and 3 months after operation(P<0.05). Conclusion Anal Carbuncle Promoting Healin

关 键 词：肛痈促愈汤 肛周脓肿 术后 血管内皮生长因子 影响 

分 类 号：R269.571.5[医药卫生—中西医结合]