托里透毒汤口服联合紫草纱条引流促进肛周脓肿术后创面愈合的研究  

Effect of Oral Administration of Tuoli Toudu Decoction(托里透毒汤)Combined with Shikonin Gauze Drainage on Postoperative Wound Healing and Inflammatory Factor Expression in Patients with Perianal Abscess

作　　者：王燕燕[1] 梁想 李玲玲[1] 马玉超 刘红振 位艳赏 WANG Yanyan;LIANG Xiang;LI Lingling;MA Yuchao;LIU Hongzhen;WEI Yanshang(Hebei Province Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,Hebei,China;Hebei Yiling Hospital,Shijiazhuang 050000,Hebei,China;Zhangjiakou Guyuan County Hospital of Traditional Chinese Medicine,Zhangjiakou 076550,Hebei,China;Shijiazhuang Huayao Hospital of North China Medical Health Group,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北省中医院,河北石家庄050000 [2]河北以岭医院,河北石家庄050000 [3]张家口市沽源县中医医院,河北张家口076550 [4]华北医疗健康集团石家庄华药医院,河北石家庄050000

出　　处：《中华中医药学刊》2024年第4期243-247,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2019015)。

摘　　要：目的探讨托里透毒汤方口服联合紫草纱条创面引流促进肛周脓肿患者术后创面愈合和影响炎性因子表达研究。方法选取医院2019年6月—2022年1月收治的174例肛周脓肿术的患者为研究对象,随机分为观察组(58例)、对照组A(58例)和对照组B(58例),术后所有患者给予常规处理,对照组A增加紫草纱条创面引流治疗,对照组B增加凡士林纱条创面引流治疗,观察组增加托里透毒汤方口服与紫草纱条创面引流联合治疗。比较3组患者术后第1、7、14天时疼痛程度、创面症状评分、创面愈合情况、炎性因子水平及治疗效果。结果术后第7、14天观察组血清P物质(Substance P,SP)、五羟色胺(5-Hydroxytryptamine,5-HT)水平均低于对照组A与对照组B(P<0.05),对照组A第7、14天各水平均低于对照组B(P<0.05);术后第7、14天观察组分泌物评分、水肿评分均低于对照组A与对照组B(P<0.05),对照组A7 d、14 d各评分均低于对照组B(P<0.05);观察组第7、14天创面缩小率高于对照组A与对照组B(P<0.05),对照组A第7、14天缩小率均高于对照组B,治疗后观察组创面腐肉全部脱落时间与创面愈合时间均短于对照组A与对照组B(P<0.05),对照组A各时间均低于对照组B(P<0.05);术后第7、14天观察组血清肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、C反应蛋白(C-reactive Protein,CRP)及白细胞介素-6(Interleukin-6,IL-6)炎性因子水平均低于对照组A与对照组B(P<0.05),对照组A第7天、14天各水平均低于对照组B(P<0.05);治疗后观察组患者总有效58例(100.00%)显著比对照组A患者54例(93.10%)和对照组B患者50例(86.21%)高(P<0.05),对照组A总有效率比对照组B高,但两组比较差异不存在统计学意义(P>0.05)。结论托里透毒汤口服联合紫草纱条创面引流可以促进术后创面愈合,降低炎性因子水平,缩短康复进程,值得推广。Objective To discuss the effect of oral administration of Tuoli Toudu Decoction(托里透毒汤)combined with shikonin gauze drainage on postoperative wound healing and inflammatory factor expression in patients with perianal abscess.Methods One hundred and seventy-four patients with perianal abscess underwent surgery in the hospital from June 2019 to January 2022 were selected and randomly divided into three groups,each with 58 cases.All patients received routine treatment after surgery.After that,the control group A received shikonin gauze drainage,the control group B received vaseline gauze drainage,while the observation group received oral administration of Tuoli Toudu Decoction combined with shikonin gauze drainage.Then the pain degree,wound symptom score,wound healing,inflammatory factor level and therapeutic effect were compared among three groups on the 1st,7th and 14th day after surgery.Results The serum levels of substance P(SP)and 5-hydroxytryptamine(5-HT)on the 7th and 14th day after operation in the observation group were lower than those in two control groups(P<0.05),and the serum levels of two indicators on the 7th and 14th day after operation in the control group A were lower than those of the control group B(P<0.05).The secretion score and edema score in the observation group were lower than those in two control groups on the 7th and 14th~day after operation(P<0.05),and the control group A had lower secretion score and edema score on the 7th and 14th day after operation(P<0.05).The wound reduction rate in the observation group was higher than that in two control groups on the 7th and 14th day after operation(P<0.05),and the reduction rate of the control group A was higher than that of the control group B(P<0.05).The time leading to complete cure including wound slough shedding and wound healing was notably decreased in the observation group compared with that of the two control groups(P<0.05),and the cure time of the control group A was shorter than that of the control group B(P<0.05).The serum l

关 键 词：托里透毒汤 中药口服 紫草纱条 肛周脓肿 创面愈合 炎性因子 

分 类 号：R266[医药卫生—中医外科学]