锡类散熏洗剂对Ⅰ、Ⅱ期肛裂术后局部水肿、创面修复的影响及其机制研究  

Study on Effect of Xilei Powder Fumigation Wash on Postoperative Local Edema and Wound Healing of Anal Fissure in Stage Ⅰ and Ⅱ and Its Mechanism

作　　者：刘忠磊 罗高宏 LIU Zhonglei;LUO Gaohong

机构地区：[1]浙江中医药大学研究生院,浙江杭州310053 [2]遂昌县中医院,浙江遂昌323300

出　　处：《新中医》2023年第8期105-110,共6页New Chinese Medicine

基　　金：浙江省自然科学基金面上项目(LH19H290001);浙江中医药大学校级科研课题(2021A034)。

摘　　要：目的:观察锡类散熏洗剂对Ⅰ、Ⅱ期肛裂术后局部水肿、创面修复及临床疗效,并探讨其作用机制。方法:选取104例Ⅰ、Ⅱ期肛裂术后患者随机分为2组各52例,对照组予Ⅰ、Ⅱ期肛裂术后常规治疗,观察组在对照组治疗方案的基础上给予锡类散熏洗剂治疗,均连续治疗14 d。观察并比较治疗前后2组临床疗效、临床症状积分、局部水肿消退时间、创面修复时间、疼痛视觉模拟评分法(VAS)评分、免疫指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、炎症指标[C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、干扰素-γ(IFN-γ)],并如实记录不良反应发生情况。结果:临床疗效总有效率观察组98.08%,对照组84.62%,2组总有效率比较,差异有统计学意义(P<0.05)。治疗后,2组临床症状积分、疼痛VAS评分均下降,且观察组临床症状积分、疼痛VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组局部水肿消退时间、创面修复时间低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组免疫指标均升高,且观察组高于对照组,差异均有统计学意义(P<0.05);治疗后,2组炎症指标均降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:锡类散熏洗剂可有效改善Ⅰ、Ⅱ期肛裂术后患者局部水肿情况,促进术后创面修复,缓解相关症状及局部疼痛,具有较好的安全性,其可能通过局部抗炎性作用、提升机体免疫等多环节发挥疗效。Objective:To observe the clinical effect of Xilei Powder Fumigation Wash on postoperative local edema and wound healing of anal fissure in stageⅠand Ⅱand discuss its mechanism.Methods:A total of 104 patients after surgery of anal fissure in stageⅠand Ⅱwere randomly divided into two groups,with 52 cases in each group.The control group was given routine treatment after surgery of anal fissure in stageⅠand Ⅱ,and the observation group was treated with Xilei Powder Fumigation Lotion based on the treatment of the control group.The two groups were treated for 14 days.Before and after treatment,the clinical effects,scores of clinical symptoms,regression time of local edema,wound healing time,scores of Visual Analogue Scale(VAS)for pain,immune indexes including CD3^(+),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin-A(IgA),and immunoglobulin-G(IgG),inflammatory indicators,including C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(CRP),and interferon-γ(IFN-γ)in the two groups were observed and compared,and the incidence of adverse reactions was accurately recorded.Results:The total clinical effective rate was 98.08%in the observation group,and 84.62%in the control group,the difference being significant(P<0.05).After treatment,the scores of clinical symptoms and VAS scores for pain in both groups were decreased,and the above two scores in the observation group were lower than those in the control group,differences being significant(P<0.05).The regression time of local edema and wound healing time in the observation group were less than those in the control group,differences being significant(P<0.05).After treatment,the levels of immune indexes in the two groups were increased,and the levels of immune indexes in the observation group were higher than those in the control group,differences being significant(P<0.05);after treatment,the levels of inflammatory indicators in both groups were decreased,and the levels of inflammatory indicators in the observation gr

关 键 词：肛裂 锡类散熏洗剂 创面修复 疗效评价 作用机制 

分 类 号：R657.14[医药卫生—外科学]