止痛如神汤对肛瘘术后创面愈合效果及血清纤维连接蛋白、表皮生长因子水平的影响  

Effect of Zhitong-Rusheng Decoction on wound healing and serum fibronectin andepidermal growth factor levels after anal fistula operation

作　　者：张承岳 刘远成 张劲远 Zhang Chengyue;Liu Yuancheng;Zhang Jinyuan(Department of Anorectal,the First People’s Hospital of Hefei,Hefei 230061,China)

机构地区：[1]安徽省合肥市第一人民医院肛肠科,230061

出　　处：《国际中医中药杂志》2021年第7期653-657,共5页International Journal of Traditional Chinese Medicine

基　　金：安徽省卫生计生委中医药科研课题(2016zy110)。

摘　　要：目的探讨止痛如神汤对肛瘘术后创面愈合效果及血清纤维连接蛋白(fibronectin, FN)、表皮生长因子(epidermal growth factor, EGF)的影响。方法将符合入选标准的2018年3月-2020年3月本院患者102例,采用随机数字表法分为2组,每组51例。对照组采用西医常规疗法治疗,观察组在对照组基础上联合止痛如神汤治疗,2组均连续治疗3周。分别于治疗前后进行临床症状评分,采用ELISA法检测血清FN、EGF水平,观察治疗期间创面愈合时间和便血消失时间,以及治疗前后创面纵径和创面面积,评价临床疗效。结果观察组总有效率为98.0%(50/51)、对照组为72.6%(37/51),2组比较差异有统计学意义(χ2=13.209,P<0.01)。观察组治疗后疼痛程度评分、创面渗液评分及肉芽形态评分均低于对照组(t值分别为15.448、21.424、28.641,P值均<0.001)。观察组治疗后创面愈合时间[(6.04±1.20)d比(9.42±1.58)d,t=12.166]和便血消失时间[(15.72±2.86)d比(19.95±4.33)d,t=6.862]均较对照组缩短(P<0.01)。治疗后,观察组创面纵径[(1.89±0.31)cm比(2.82±0.54)cm,t=10.666]和创面面积[(3.26±0.54)cm2比(4.98±1.10)cm2,t=10.024]均小于对照组(P<0.01);观察组血清FN[(2.92± 0.50)mg/L比(2.45±0.39)mg/L,t=5.293]、EGF[(7.03±1.44)μg/L比(5.47±1.03)μg/L,t=6.293]水平高于对照组(P<0.01)。结论在西医常规治疗基础上联合应用止痛如神汤有助于肛瘘术后患者创面的愈合,可减轻患者的临床症状,提高血清FN、EGF水平及临床疗效。Objective To investigate the effect of Zhitong-Rusheng Decoction on wound healing and serum fibronectin(FN)and epidermal growth factor(EGF)levels after anal fistula operation.Methods A total of 102 patients after anal fistula operation in our hospital from March 2018 to March 2020 were randomly divided into control group(51 cases)and observation group(51 cases)according to the random number table method.The control group was treated with conventional western treatment,while the observation group was treated with Zhitong-Rusheng Decoction on the basis of control group.The two groups were treated for 3 weeks.The clinical symptoms were scored before and after treatment,and the levels of serum FN and EGF were detected by ELISA.The wound healing time,hematochezia disappearance time,wound longitudinal diameter and wound area before and after treatment were observed.The clinical efficacy was evaluated after treatment.Results The total effective rate was 98.0%(50/51)in the observation group and 72.6%(37/51)in the control group,with significant difference between the two groups(χ^(2)=13.209,P<0.01).After treatment,the pain degree score, wound exudation score and granulation morphology score of the observation group were significantlylower than those in the control group (t=15.448, 21.424, 28.641, P<0.001). After treatment, the wound healingtime [(6. 04 ± 1.20) d vs. (9.42 ± 1.58) d, t=12.166] and the disappearance time of hematochezia [(15.72 ± 2.86) dvs. (19.95 ± 4.33) d, t=6.862] of the observation group were significantly shorter than thosse of the control group(P<0.01). After treatment, the wound longitudinal diameter [(1.89 ± 0.31) cm vs. (2.82 ± 0.54) cm, t=10.666]and wound area [(3.26 ± 0.54) cm^(2)vs. (4.98 ± 1.10) cm^(2), t=10. 024] of the observation group were significantlyless than those in the control group (P<0.01). The serum FN [(2.92 ± 0.50) mg/L vs. (2.45 ± 0.39) mg/L,t=5.293], EGF [(7.03 ± 1.44) mg/L vs. (5.47 ± 1.03) mg/L, t=6.293] of the observation group were significantlyhigher than thos

关 键 词：肛门疾病 肛瘘 手术后并发症 止痛如神汤 疼痛 手术后 伤口愈合 

分 类 号：R657.16[医药卫生—外科学]