中药洗剂对难治性甲沟炎术后感染及复发的影响  

Effect of traditional Chinese medicine lotion on incidence of postoperative infection and recurrence of refractory paronychia

作　　者：刘小金[1] 王海明[1] 宫赟正[1] Liu Xiaojin;Wang Haiming;Gong Yunzheng(Department of Surgery,Hangzhou Third People's Hospital,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]杭州市第三人民医院外科,杭州310000

出　　处：《中国基层医药》2024年第9期1346-1351,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察中药洗剂对难治性甲沟炎术后感染及复发的影响。方法选择杭州市第三人民医院2019年1月至2022年11月收治的难治性甲沟炎患者78例为研究对象,采用随机对照临床研究方法,根据随机数字表法分为聚维酮碘组(39例)和中药洗剂组(39例)。两组均采用侧方切口甲基质切除梭形切皮整形术进行治疗,术前聚维酮碘组进行5%聚维酮碘溶液治疗,中药洗剂组采用中药洗剂(成分:半枝莲、马鞭草、金银花、紫花地丁、大黄、苍术、芒硝、黄柏、赤芍、生甘草、厚朴)治疗,两组均治疗至满足手术指征,术后随访6个月。统计两组术后1个月临床疗效,比较两组术前红肿、脓液、肉芽肿、疼痛消失时间,术后创面与敷料粘连程度、创面恢复情况、术后1、3 d疼痛情况及术后1周感染发生情况、术后1、6个月复发情况。结果术后1个月,中药洗剂组总有效率[92.31%(36/39)]高于聚维酮碘组[71.79%(28/39)](χ ^(2)=4.26,P<0.05);中药洗剂组红肿、脓液、肉芽肿及疼痛消失时间[(5.66±0.58)d、(3.64±0.55)d、(8.42±1.58)d、(3.36±0.32)d]均短于聚维酮碘组[(6.73±0.65)d、(4.56±0.48)d、(9.77±2.56)d、(3.89±0.48)d](t=7.67、7.87、2.80、5.73,均P<0.05);中药洗剂组术后创面与敷料轻度粘连占比高于聚维酮碘组,重度粘连占比低于聚维酮碘组(Z=4.64,P<0.05);中药洗剂组术后疼痛持续时间、红肿消失时间、创面愈合时间[(4.22±1.73)d、(3.02±1.16)d、(11.84±2.50)d]均短于聚维酮碘组[(8.53±2.48)d、(5.20±2.31)d、(13.32±2.86)d](t=8.90、5.26、2.43,均P<0.001);两组术后3 d疼痛评分均低于术后1 d,中药洗剂组术后1、3 d疼痛评分[(3.30±0.18)分、(2.28±0.23)分]均低于聚维酮碘组[(3.61±0.29)分、(2.52±0.33)分](t=5.67、3.72,均P<0.05);两组术后1周感染率及术后1、6个月复发率差异均无统计学意义(均P>0.05)。结论中药洗剂联合侧方切口甲基质切除梭形切皮整形术治疗难治性�Objective To investigate the effect of traditional Chinese medicine(TCM)lotion on incidence of postoperative infection and recurrence of refractory paronychia.Methods Seventy-eight patients with intractable paronychia who received treatment at Hangzhou Third People's Hospital from January 2019 to November 2022 were included in this study.The patients were randomly divided into the povidone-iodine group(n=39)and the TCM lotion group(n=39)using the random number table method.Both groups underwent matrixectomy via a lateral incision and rhomboid flap excision surgery.Prior to the procedure,the povidone-iodine group received treatment with a 5%povidone-iodine solution,whereas the TCM lotion group was administered a TCM lotion containing Scutellaria barbata,Verbena,Lonicera japonica,Viola,Rheum palmatum,Atractylodes,Glauber's salt,Phellodendron,red peony root,Glycyrrhiza uralensis,and Magnolia officinalis.Both groups underwent treatment until the patients fulfilled the surgical indications and were subsequently observed for a period of 6 months post-surgery.The clinical efficacy was evaluated 1 month after the surgical intervention.A comparative analysis was conducted to assess the postoperative duration of redness and swelling,pus discharge,granulation,and pain resolution between the two groups.Additionally,the postoperative occurrence of wound-dressing adhesion,the status of wound healing,pain intensity at 1 and 3 days post-surgery,the incidence of infection at 1 week post-surgery,and the recurrence rates at 1 and 6 months post-surgery,were compared between the two groups.Results At 1 month post-surgery,the total effective rate in the TCM lotion group was 92.31%(36/39),which was significantly higher than that in the povidone-iodine group[71.79%(28/39),χ ^(2)=4.26,P<0.05].The postoperative durations of redness and swelling,pus discharge,granulation,and pain resolution in the TCM lotion group were(5.66±0.58)days,(3.64±0.55)days,(8.42±1.58)days,and(3.36±0.32)days,respectively,which were significantly shorter than

关 键 词：甲沟炎 中药洗剂 外科伤口感染 复发 疼痛 手术后 

分 类 号：R269[医药卫生—中西医结合]