仙方活命饮加减联合中药及复方多黏菌素B软膏外敷 对儿童肛周脓肿术后创面愈合的影响  

Effects of oral administration of modified Xianfang Huoming drink combined with external application of traditional Chinese medicine and external application of compound polymyxin B ointment on wound healing in children after perianal abscess surgery

作　　者：闫骁春 陈显韬 宋小平 YAN Xiaochun;CHEN Xiantao;SONG Xiaoping(Department of Anorectal Surgery,West China Guang’an Hospital,Sichuan University,Guang’an 638099,China)

机构地区：[1]四川大学华西广安医院肛肠科,四川广安638099

出　　处：《陕西中医》2022年第11期1571-1575,1579,共6页Shaanxi Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科研课题(2020LC0120)。

摘　　要：目的:观察分析仙方活命饮加减口服联合中药及复方多黏菌素B软膏外敷对儿童肛周脓肿(PA)术后创面愈合的影响。方法:选取120例行手术治疗的儿童低位PA为观察对象,采用随机数字表法分为仙方活命饮组和软膏外敷组各60例,两组均常规行切开引流术,软膏外敷组术后给予自制中药及复方多黏菌素B软膏外敷,仙方活命饮组在软膏外敷组基础上联合仙方活命饮加减口服,比较两组术后2周临床症状评分、炎症相关指标[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平、血清疼痛因子[去甲肾上腺素(NE)、5-羟色胺(5-HT)、P物质(SP)]水平、创面愈合情况、临床疗效及术后随访复发情况。结果:术后2周,两组创面疼痛、创面分泌物、创面水肿、肉芽组织评分均显著降低(P<0.05),且仙方活命饮组症状评分明显低于软膏外敷组(P<0.05);两组血清IL-6、IL-10、TNF-α及CRP水平均显著降低(P<0.05),且仙方活命饮组各指标水平明显低于软膏外敷组(P<0.05);术后2周,两组血清NE、5-HT、SP水平均显著降低(P<0.05),且仙方活命饮组各因子水平明显低于软膏外敷组(P<0.05);仙方活命饮组腐肉脱落时间、新生上皮出现时间和创面愈合时间均明显短于软膏外敷组(P<0.05);仙方活命饮组临床总有效率显著高于软膏外敷组(P<0.05);术后随访6个月,仙方活命饮组复发1例,复发率为2.44%;软膏外敷组复发3例,复发率为9.38%,两组比较差异无统计学意义(P>0.05)。结论:仙方活命饮加减口服联合自制中药及复方多黏菌素B软膏外敷可有效减轻儿童PA术后临床症状、炎症反应和疼痛,促进创面愈合,临床疗效显著。Objective:To observe and analyze the effects of oral administration of modified Xianfang Huoming drink combined with external application of self-made traditional Chinese medicine and external application of compound polymyxin B ointment on wound healing in children after perianal abscess(PA)surgery.Methods:120 cases of children with low PA who underwent surgical treatment were selected as the observation subjects,and they were divided into Xianfang Huoming drink group and ointment external application group by the random number table method,with 60 cases in each group.Both groups routinely underwent incision and drainage and received postoperative nursing,and ointment external application group was given external application of self-made traditional Chinese medicine and compound polymyxin B ointment after surgery while Xianfang Huoming drink group was combined with oral administration of modified Xianfang Huoming drink on the basis of ointment external application group.The clinical symptoms scores,levels of inflammation-related indicators[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],levels of serum pain factors[norepinephrine(NE),5-hydroxy tryptamine(5-HT),substance P(SP)]wound healing and clinical efficacy at 2 weeks after surgery and postoperative follow-up recurrence were compared between Xianfang Huoming drink group and ointment external application group.Results:At 2 weeks after surgery,the scores of wound pain,wound secretion,wound edema and granulation tissue in the two groups were significantly decreased(P<0.05),and the scores of symptoms in Xianfang Huoming drink group were significantly lower than those in ointment external application group(P<0.05).The levels of serum IL-6,IL-10,TNF-αand CRP were significantly reduced in both groups(P<0.05),and the levels were significantly lower in Xianfang Huoming drink group than those in ointment external application group(P<0.05).The levels of serum NE,5-HT and SP in Xianfang Huoming drink group and ointmen

关 键 词：肛周脓肿 儿童 仙方活命饮 中药外敷 复方多黏菌素B软膏 创面愈合 炎症反应 

分 类 号：R657.15[医药卫生—外科学]