黄柏苦参汤坐浴熏洗联合挂线疗法对肛瘘患者术后创面疼痛及愈合程度的影响  

The Influence of Cortex Phellodendri Chinensis and Radix Sophorae Flavescentis Decoction for Sitting Bath Fumigation Combined with Thread-Drawing Therapy on Postoperative Wound Pain and Healing of Patients with Anal Fistula

作　　者：于建云 吴秀丽 孙宏普 YU Jian-yun;WU Xiu-li;SUN Hong-pu(Jianxi District of Luoyang Hospital of Traditional Chinese Medicine,Luoyang,Henan,China,471000;Luoyang First People's Hospital,Luoyang,Henan,China,471000)

机构地区：[1]洛阳市中医院涧西院区,河南洛阳471000 [2]洛阳市第一人民医院,河南洛阳471000

出　　处：《河南中医》2022年第12期1872-1875,共4页Henan Traditional Chinese Medicine

基　　金：河南省医学科技攻关计划项目(202002293)。

摘　　要：目的:观察黄柏苦参汤坐浴熏洗联合挂线疗法对肛瘘患者术后创面疼痛及愈合程度的影响。方法:将80例肛瘘患者按照随机数字表法分为对照组和观察组,每组各40例。两组患者均行低位切开挂线术,对照组术后采用高锰酸钾坐浴熏洗治疗,观察组给予黄柏苦参汤坐浴熏洗治疗。比较两组患者的临床疗效、创面愈合情况(创面愈合时间、愈合率、创面最大纵径和横径)及治疗前后视觉模拟评分(visual analogue score,VAS)变化情况,检测两组患者治疗前后血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)、转化生长因子-β1((transforming growth factor-β1,TGF-β1)水平。结果:对照组有效率为80.00%,观察组有效率为95.00%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后VAS评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。观察组创面愈合时间、创面最大纵径和横径小于对照组,创面愈合率高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后VEGF、bFGF、TGF-β1水平高于本组治疗前,治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。结论:黄柏苦参汤坐浴熏洗有利于缓解肛瘘患者术后创面疼痛,且能有效促进创面愈合,同时也能提高患者血清VEGF、bFGF、TGF-β1表达水平。Objective:To observe the influence of Cortex Phellodendri Chinensis and Radix Sophorae Flavescentis Decoction for sitting bath fumigation combined with thread-drawing therapy on postoperative wound pain and healing of patients with anal fistula.Methods:A total of 80 patients with anal fistula were divided into the control group and the observation group according to random number table,with 40 cases in each group.Both groups were first treated with low incision and thread-drawing operation.The control group was then treated with potassium permanganate for sitting bath fumigation after operation,and the observation group was then treated with Phellodendri Chinensis and Radix Sophorae Flavescentis Decoction for sitting bath fumigation.The clinical efficacy,the changes of wound healing(such as wound healing time,healing rate,maximum longitudinal and transverse diameter of the wound)and visual analog score(VAS)before and after treatment were compared between the two groups.The changes of the levels of the serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),and transforming growth factor-β1(TGF-β1)were detected before and after treatment.Results:The effective rate was 80.00%in the control group and 95.00%in the observation group.The difference between the two groups was statistically significant(P<0.05).The VAS score of the two groups after treatment was lower than that of the same group before treatment,and the score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the wound healing time,the maximum longitudinal and transverse diameters of the wound in the observation group were smaller than those in the control group,and the wound healing rate was higher than that in the control group,and all the differences were statistically significant(P<0.05).The levels of VEGF,bFGF and TGF-β1 after treatment were higher than those before the treatment.The above indexes of the observation group were higher

关 键 词：肛瘘 黄柏苦参汤 低位切开挂线术 高锰酸钾 坐浴熏洗 

分 类 号：R266[医药卫生—中医外科学]