松花粉外用联合复方芩柏颗粒坐浴对湿热下注型肛瘘患者术后创面愈合相关生长因子及肛肠动力学的影响  

Effects of Songhuafen (Pine Pollen) External Application Combined with Qinbai Granule (芩柏颗粒) Sitz Bath on Postoperative Wound Healing Related Growth Factors and Anorectal Dynamics in Patients with Anal Fistula of Damp-Heat Descending Syndrome

作　　者：罗雯鹏 李克亚[1] 王真权[1] LUO Wen-peng;LI Ke-ya;WANG Zhen-quan(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha Hunan,410005,China)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005

出　　处：《中医药导报》2021年第4期100-104,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：湖南省中医药管理局一般项目(201786);湖南省中医药管理局中医药防治肛肠疾病重点研究室(湘中医药涵[2020]51号)。

摘　　要：目的:探讨松花粉外用联合复方芩柏颗粒坐浴对湿热下注型肛瘘患者术后创面愈合相关生长因子及肛肠动力学的影响。方法:纳入78例湿热下注型低位单纯性肛瘘患者,均行肛瘘切扩术,将患者随机分为治疗组和对照组各39例,对照组患者术后采用高锰酸钾溶液坐浴+凡士林纱条换药,治疗组患者术后采用复方芩柏颗粒坐浴+松花粉纱条换药。治疗14 d后,对临床疗效进行评价,观察患者疼痛、创面渗液、肉芽形态情况,采用酶联免疫法检测患者血清中生长因子EGF、VEGF、bFGF、TGF-β1的水平,比较两组患者肛肠动力学变化情况。计算治疗后7 d、14 d创面愈合率,统计创面完全上皮化的时间,记录患者创面愈合时间并记录研究中出现的不良反应。结果:治疗后14 d,治疗组总有效率为92.31%(36/39),对照组总有效率为74.36%(29/39),治疗组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后14 d,两组患者疼痛评分、创面渗液评分、肉芽形态评分均明显低于治疗前,且治疗组患者疼痛评分、创面渗液评分、肉芽形态评分均明显低于对照组(P<0.05)。治疗后7 d、14 d治疗组患者创面愈合率均显著高于对照组,治疗组患者创面愈合时间显著短于对照组,差异均有统计学意义(P<0.05)。治疗后14 d,两组患者血清EGF、VEGF、bFGF、TGF-β1水平均高于治疗前,且治疗组患者血清EGF、VEGF、bFGF、TGF-β1水平均高于对照组(P<0.05)。治疗后14 d,两组患者ALCT、AMCP较术前无明显变化(P>0.05),RRP、ARP均低于术前(P<0.05),且治疗后治疗组患者RRP、ARP均高于对照组(P<0.05)。研究过程中未见明显不良反应。结论:松花粉外用联合复方芩柏颗粒坐浴用于湿热下注型肛瘘患者的术后治疗,可减轻患者疼痛、渗出等临床症状,缩短创面愈合时间,提高血清中EGF、VEGF、bFGF及TGF-β1相关生长因子的水平,促进术后肛门功能的恢复。Objective: To investigate the effects of Songhuafen(Pine Pollen) external application combined with Qinbai granule sitz bath on postoperative wound healing related growth factors and anorectal dynamics in patients with anal fistula of damp-heat descending syndrome. Methods: Totally 78 patients with low simple anal fistulas of damp-heat descending syndrome were included, all underwent anal fistula incision and expansion, and the patients were randomly divided into treatment and control groups(39 cases in each group). Patients were treated with potassium permanganate solution sitting bath and vaseline gauze dressing change in the control group, and compound Qinbai granule sitz bath and Songhuafen(Pine Pollen) gauze dressing change in treatment group. After 14 days of treatment, the clinical efficacy was evaluated. Pain, wound exudation and granulation morphology were observed. The serum levels of growth factors EGF, VEGF, b FGF and TGF-β1 were detected by enzyme-linked immunoassay. The changes of anorectal dynamics were compared between the two groups. The wound healing rate was calculated in 7 and 14 days, and the days of complete epithelialization of the wound were counted. The wound healing time of the patients was recorded and the adverse reactions occurred were recorded. Results: The total effective rate was 92.31%(36/39) in treatment group and 74.36%(29/39) in control group, in 14 days. The treatment group showed better clinical efficacy than control group, and the difference was statistically significant(P <0.05). The pain score, wound exudate score and granulation morphological score decreased in the two groups 14 days, and the treatment group showed lower pain score, wound exudate score and granulation morphological score than control group(P<0.05). The treatment group showed higher wound healing rate than control group, while shorter wound healing than control group in 7 and 14 days, with statistical significance(P<0.05). The levels of EGF, VEGF, b FGF and TGF-β1 increased in the two groups, and the tre

关 键 词：肛瘘 湿热下注证 肛瘘术后 松花粉 复方芩柏颗粒 创面愈合生长因子 肛肠动力学 

分 类 号：R266[医药卫生—中医外科学]