消肿生肌汤辅助LIFT对高位单纯性肛瘘术后疼痛与康复进程的影响  

Effect of Xiaozhong Shengji Decoction Assisted LIFT on Postoperative Pain and Rehabilitation Progress of High Simple Anal Fistula

作　　者：孔二波 郭宗战 贾宝新 Kong Er-bo;Guo Zong-zhan;Jia Bao-xin(Department of Surgery,The Affiliated Hospital of Jiyuan Vocational and Technical College,Jiyuan 459000,Henan,China)

机构地区：[1]济源市职业技术学院附属医院,河南济源459000

出　　处：《四川生理科学杂志》2024年第3期551-554,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:研究消肿生肌汤辅助经括约肌间瘘管结扎术(Ligation of intersphincteric fistula tract,LIFT)对高位单纯性肛瘘术后疼痛(Visual analogue scale,VAS)评分、康复进程的影响.方法:选取2020年8月至2022年8月于我院确诊的94例肛瘘患者作为研究对象,依随机对照法分为研究组和对照组,各47例.对照组采用LIFT术治疗,研究组在对照组基础上联合消肿生肌汤治疗.比较两组临床疗效、治疗后恢复情况及住院时间、治疗前后视觉模拟评分(VAS)、大便失禁严重性指数(Fecal incontinence severity index,FISI)、Wexner肛门失禁评分(Wexner)、肛肠动力学、相关血清指标水平.结果:研究组总有效率高于对照组(P<0.05);治疗后,研究组VAS、FISI、Wexner评分均低于对照组(P<0.05);研究组直肠静息压(Rectal resting pressure,RRP)、肛管最大收缩压(Analmaximal contraction pressure,AMCP)、肛管静息压(Anal tube resting pressure,ARP)、肛管最长收缩时间(Anal longest contraction,ALCT)水平高于对照组(P<0.05);研究组血清转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、纤维连接蛋白(Fibronectin,FN)高于对照组,淀粉样蛋白A(Serum amyloid A,SAA)、趋化因子5(Chemokine ligand 5,CCL5)低于对照组(P>0.05);研究组恢复情况及住院时间短于对照组(P<0.05).结论:消肿生肌汤辅助LIFT对高位单纯性肛瘘患者术后效果显著,可有效促进患者创口愈合,减少炎症反应,降低肛肠疼痛度,缩短临床康复进程.Objective:To investigate the effect of XiaozhongShengji decoction assisted Ligation of intersphincteric fistula(LIFT)on Visual analogue scale(VAS)score and rehabilitation process of postoperative high simple anal fistula.Methods:Ninety-four patients with anal fistula diagnosed in our hospital from August 2020 to August 2022 were selected as study subjects and divided into study group and control group according to randomized control method,with 47 cases each.The control group was treated with LIFT,and the study group was treated with XiaozhongShengji decoction based on the control group.The clinical efficacy,recovery after treatment,length of stay,visual analogue score(VAS),Fecal incontinence severity index(FISI),Wexner anal incontinence score(Wexner),anorectal dynamics,and related serum index levels were compared between the two groups.Results:The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,VAS,FISI and Wexner scores in the study group were lower than those in the control group(P<0.05).Rectal resting pressure(RRP),Analmaximal contraction pressure(AMCP),Anal tube resting pressure(RRP),The levels of ARP and Anal longest contraction(ALCT)were higher than those of control group,and were close to the level before treatment(P<0.05).The serum transforming growth factor-β1(TGF-β1)and fibronectin(FN)in the study group were higher than the control group,and the serum amyloid A(SAA)and chemokine ligand 5(CCL5)were lower than the control group(P<0.05).CCL5 were lower than those in the control group(P>0.05),the recovery and hospital stay in the study group were shorter than the control group(P<0.05).Conclusion:XiaozhongShengji Decoction assisted LIFT has significant postoperative effect on patients with high simple anal fistula,which can effectively promote wound healing,reduce inflammatory response,reduce anorectal pain,and shorten clinical rehabilitation process.

关 键 词：消肿生肌汤 LIFT 高位单纯性肛瘘 

分 类 号：R657.16[医药卫生—外科学]