湿热毒清汤熏洗坐浴联合柴芩承气方内服治疗复杂性肛瘘术后患者的临床效果  

Clinical Effect of Damp-Heat Toxin-Clearing Decoction Fumigation and Sitz Bath Combined with Chaiqin Chengqi Formula Oral Administration in Treating Patients with Complex Anal Fistula Post-Surgery

作　　者：李丹丹[1] 杨海荣 刘嫕 张海燕 LI Dandan;YANG Hairong;LIU Yi;ZHANG Haiyan(Department of Traditional Chinese Medicine Proctology,Huai an First Hospital Affiliated to Nanjing Medical University,Huai an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院中医肛肠科,江苏淮安223300

出　　处：《中医药学报》2024年第8期67-72,共6页Acta Chinese Medicine and Pharmacology

基　　金：江苏省卫生健康委员会科研项目(Z2020024)。

摘　　要：目的:研究湿热毒清汤熏洗坐浴联合柴芩承气方内服治疗复杂性肛瘘术后的临床效果。方法:选取2020年6月—2023年5月南京医科大学附属淮安第一医院中医肛肠科收治的复杂性肛瘘术后患者118例,采用随机数字表法分为对照组、研究1组、研究2组。对照组术后行温水坐浴,研究1组行湿热毒清汤熏洗坐浴,研究2组行湿热毒清汤熏洗坐浴+柴芩承气方内服。观察3组的临床疗效、术后并发症、术后创面恢复情况及6个月内的复发率,并统计治疗前、治疗2周后的中医证候积分及血清炎性因子(hs-CRP、IL-2、IL-4、TNF-α、INF-γ)、相关生长因子(VEGF、EGF、bFGF、TGF-β)的变化。结果:总有效率比较,研究2组>研究1组>对照组(P<0.05);复发率、创面愈合时间比较,研究2组<研究1组<对照组(P<0.05,P<0.01);中医证候积分、创面疼痛、分泌物渗出、创缘水肿评分及hs-CRP、IL-4、TNF-α水平比较,研究2组<研究1组<对照组(P<0.05);IL-2、INF-γ、VEGF、EGF、bFGF、TGF-β水平比较,研究2组>研究1组>对照组(P<0.05)。3组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:湿热毒清汤熏洗坐浴联合柴芩承气方内服可促进复杂性肛瘘术后创面的恢复,改善炎症反应,提高疗效,降低复发率,且不会增加并发症。Objective:To study the clinical effect of damp-heat toxin-clearing decoction fumigation and sitz bath combined with oral administration of Chaiqin chengqi formula in treating patients post complex anal fistula surgery.Methods:From June 2020 to May 2023,118 patients who underwent surgery for complex anal fistulas at the Department of Traditional Chinese Medicine Proctology,Huai an First Hospital Affiliated to Nanjing Medical University,were randomly divided into a control group,study group 1,and study group 2.The control group received warm water sitz baths post-surgery,study group 1 received damp-heat toxin-clearing decoction fumigation sitz baths,and study group 2 received both damp-heat toxin-clearing decoction fumigation sitz baths and oral Chaiqin chengqi formula.Clinical effect,postoperative complications,wound healing,and recurrence rates within 6 months were observed.Changes in Traditional Chinese Medicine(TCM)syndrome scores and serum inflammatory markers(hs-CRP,IL-2,IL-4,TNF-α,INF-γ)and growth factors(VEGF,EGF,bFGF,TGF-β)at baseline and after 2 weeks of treatment were also assessed.Results:The total effective rate comparison showed that study group 2>study group 1>control group(P<0.05).Recurrence rate and wound healing time were lowest in study group 2,followed by Study Group 1,and highest in the control group(P<0.05).TCM syndrome scores,wound pain,secretion exudation,and wound edema scores,as well as levels of hs-CRP,IL-4,and TNF-αwere lowest in study group 2(P<0.05).Levels of IL-2,INF-γ,VEGF,EGF,bFGF,and TGF-βwere highest in study group 2(P<0.05).There were no significant differences in the rate of postoperative complications among the three groups(P>0.05).Conclusion:Damp-heat toxin-clearing decoction fumigation sitz bath combined with Chaiqin chengqi formula oral administration can promote wound recovery,improve inflammatory response,enhance treatment effect,and reduce recurrence rates in patients with complex anal fistulas post-surgery,without increasing the incidence of complications.

关 键 词：湿热毒清汤 熏洗疗法 坐浴 柴芩承气方 肛瘘 手术疗法 

分 类 号：R266[医药卫生—中医外科学]