祛腐生肌液熏洗坐浴联合红光照射改善老年低位单纯性肛瘘患者术后创面的临床观察  

Clinical observation on the effects of fumigation and sitz bath with Qufu Shengji solution combined with red light irradiation on postoperative wound of elderly patients with low⁃level simple anal fistula

作　　者：张志刚 付红燕 陈卓 Zhang Zhigang;Fu Hongyan;Chen Zhuo∗(Department of Proctology,Traditional Chinese Medicine Hospital of Huangshi City,Huangshi,Hubei,435001,P.R.China)

机构地区：[1]黄石市中医医院肛肠科,湖北黄石435001

出　　处：《老年医学与保健》2023年第2期384-389,共6页Geriatrics & Health Care

基　　金：湖北省黄石市医疗卫生科技计划项目(2019A29)。

摘　　要：目的 探讨祛腐生肌液熏洗坐浴联合红光照射对低位单纯性肛瘘创面愈合的治疗效果,以及对血清PGE2、 SP、 IL-1水平的影响。方法 选取2020年1月—2022年8月黄石市中医医院肛肠科收治的老年肛瘘患者80例,采取数字表法随机分为试验组和对照组,每组40例。对照组应用复方黄柏液熏洗坐浴治疗,试验组应用祛腐生肌液熏洗坐浴联合红光照射治疗。观察并比较2组治疗前(即术后第1天)、治疗后5、10 d各症状(创缘水肿、创面渗出、瘙痒、疼痛、肉芽组织生长)评分、创面愈合时间、不良反应发生率;评估并比较2组治疗前、治疗后10 d血清学炎症因子(PGE2、 SP、 IL-1)水平;比较2组临床疗效和不良反应。结果 治疗10 d后,试验组总有效率(100%)高于对照组(95%),但差异无统计学意义(P>0.05);治疗前,2组各症状评分及各血清学炎症因子水平差异均无统计学意义(P>0.05);经组内比较,2组各症状评分(治疗后5、 10 d)及各血清学炎症因子水平(治疗后10 d)均低于同组治疗前(P<0.05);经组间比较,试验组症状评分(治疗后5、 10 d)及血清炎症因子水平(治疗后10 d)改善情况均优于对照组(P<0.05);2组创面愈合时间比较,试验组少于对照组(P<0.05);试验组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论 应用祛腐生肌液熏洗坐浴联合红光照射可显著促进老年低位单纯性肛瘘患者术后创面愈合,促进肉芽生长,减轻术后水肿、渗出、瘙痒、疼痛不适症状,降低血清学炎症因子表达水平,不良反应发生率低,且临床效果优于复方黄柏液熏洗坐浴治疗。Objective To investigate the therapeutic effect of fumigation and sitz bath with Qufu Shengji solution com⁃bined with red light irradiation on wound healing of low⁃level simple anal fistula,as well as its effect on the levels of serum PGE2,SP and IL⁃1β.Methods A total of 80 elderly patients with low⁃level simple anal fistula admitted to Department of Proctology,Traditional Chinese Medicine Hospital of Huangshi City from January 2020 to August 2022 were selected and ran⁃domly divided into experimental group and control group by digital table method,with 40 cases in each group.The control group was treated with fumigation and sitz bath with compound Huangbai solution,while the experimental group was treated with fumigation and sitz bath with Qufu Shengji solution combined with red light irradiation.The symptom(wound margin ede⁃ma,wound exudation,itching,pain and granulation tissue growth)scores were compared between the two groups before treat⁃ment(the 1st day after surgery)and 5,10 d after treatment.The wound healing time and the incidence of adverse reactions were compared between the two groups.The levels of serum inflammatory factors(PGE2,SP,and IL⁃1)were compared be⁃tween the two groups before treatment and 10 days after treatment,and the clinical efficacy of the two groups was compared.Results After 10 days of treatment,the total effective rate of the experimental group(100%)was higher than that of the con⁃trol group(95%),but the difference was not statistically significant(P>0.05).Before treatment,there was no significant difference in the symptom scores and levels of serum inflammatory factors between the two groups(P>0.05).Intra⁃group comparison showed that the symptom scores(5,10 days after treatment)and levels of serum inflammatory factors(10 days af⁃ter treatment)of both groups were lower than those of the same group before treatment(P<0.05).Comparison between the two groups showed that the improvement of symptom scores(5,10 days after treatment)and levels of serum inflammatory

关 键 词：老年 肛瘘 祛腐生肌液 熏洗坐浴 红光 创面愈合 白介素-1 前列腺素E2 P物质 

分 类 号：R657.16[医药卫生—外科学]