止痛如神汤定向透药联合湿润烧伤膏改善肛瘘术后创面愈合的疗效及对细胞生长因子和疼痛应激的影响  

Effect of Zhitong Rushen Decoction Directional Penetration Medication Combine with Moist Burn Ointment on Wound Healing after Anal Fistula Operation and its Effect on Cell Growth Factor and Pain Stress

作　　者：何盛伊 陈仙霞 林奕[1] 刘贝贝 罗芙蓉 袁畅 HE Sheng-yi;CHEN Xian-xia;LIN Yi;LIU Bei-bei;LUO Fu-rong;YUAN Chang(Department of Anorectal,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan,410007,China;Department of Integrated Traditional Chinese and Western Medicine,Changsha Third Hospital,Changsha,Hunan,410035,China)

机构地区：[1]湖南中医药大学第一附属医院肛肠科,湖南长沙410007 [2]长沙市第三医院中西医结合科,湖南长沙410035

出　　处：《现代生物医学进展》2024年第8期1516-1519,1565,共5页Progress in Modern Biomedicine

基　　金：湖南省卫生健康委科研立项课题(20200338)。

摘　　要：目的:探讨止痛如神汤定向透药联合湿润烧伤膏改善肛瘘术后创面愈合的疗效及对细胞生长因子和疼痛应激的影响。方法:采用随机数字表法将2020年5月~2022年6月期间在湖南中医药大学第一附属医院接受治疗的116例肛瘘患者分为对照组(58例,接受湿润烧伤膏治疗)和研究组(58例,对照组的基础上结合止痛如神汤定向透药)。治疗30天后,对比两组疗效、临床指标[创面愈合率、疼痛视觉模拟(VAS)评分、创面渗液评分、创面水肿评分、肉芽生长评分、创面愈合时间]、细胞生长因子[血管内皮生长因子(VEGF)、血清表皮生长因子(EGF)、成纤维细胞生长因子(bFGF)]和疼痛应激指标[β-内啡肽(β-EP)、P物质(SP)]变化情况。结果:研究组的临床总有效率、创面愈合率高于对照组,VAS评分、创面渗液评分、创面水肿评分、肉芽生长评分小于对照组,创面愈合时间短于对照组(P<0.05)。治疗后,研究组血清EGF、VEGF、bFGF水平高于对照组(P<0.05)。治疗后,研究组血清β-EP、SP水平低于对照组(P<0.05)。结论:止痛如神汤定向透药联合湿润烧伤膏可促进肛瘘术后创面愈合,可能与调节血清细胞生长因子、减轻疼痛应激有关。Objective:To explore the therapeutic effect of pain-alleviating formula combined with moist burn ointment on healing of postoperative anal fistula wounds and its influence on cell growth factors and pain stress.Methods:A total of 116 patients with anal fistula admitted to The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from May 2020 to June 2022 were divided into control group(58 cases,treated with moist burn ointment)and study group(58 cases,combined with pain-alleviating formula directed drug delivery)by random number table method.After 30 days of treatment,the changes in clinical efficacy,clinical indicators[wound healing rate,visual analogue scale(VAS)score,wound exudate score,wound edema score,granulation growth score],cell growth factors[vascular endothelial growth factor(VEGF),serum epidermal growth factor(EGF),fibroblast growth factor(bFGF)]and pain stress indicators[beta-endorphin(β-EP),substance P(SP)]were compared between the two groups.Results:The clinical total efficiency and wound healing rate of the study group were higher than those of the control group,while the VAS score,wound exudate score,wound edema score,granulation growth score of the study group were lower than those of the control group.The wound healing time of the study group was shorter than that of the control group(P<0.05).After treatment,the serum levels of EGF,VEGF,bFGF in the study group were higher than those in the control group(P<0.05).After treatment,the serum levels ofβ-EP and SP in the study group were lower than those in the control group(P<0.05).Conclusion:Pain-alleviating formula combined with moist burn ointment can promote wound healing after anal fistula surgery,which may be related to regulating serum cell growth factors and reducing pain stress.

关 键 词：止痛如神汤 定向透药 湿润烧伤膏 肛瘘 细胞生长因子 

分 类 号：R657.16[医药卫生—外科学]