祛瘀生肌散对湿热下注型肛瘘患者术后创面愈合的影响  

Influence of Quyu Shengji powder on postoperative wound healing in patients with anal fistula of damp-heat downward flow

作　　者：彭彪 鲍虎豹 高晓楠 吴剑箫[1] 张亚滨[1] PENG Biao;BAO Hubao;GAO Xiaonan;WU Jianxiao;ZHANG Yabin(Department of Anal and Intestinal Medicine,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China)

机构地区：[1]石家庄市中医院肛肠一科,河北石家庄050051

出　　处：《陕西中医》2024年第12期1644-1648,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研项目(2023375)。

摘　　要：目的:探究祛瘀生肌散对湿热下注型肛瘘患者术后创面愈合、创面组织Ⅰ型胶原蛋白(COLⅠ)、Ⅲ型胶原蛋白(COLⅢ)表达的影响。方法:选取120例肛瘘手术患者为研究对象,随机数表法分为参照组和中药组,每组60例,参照组给予伤口常规换药,中药组给予祛瘀生肌散外敷换药。比较两组治疗21 d后的临床疗效、术后创面愈合情况[创面愈合率、COLⅠ、COLⅢ、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)]、创口评分、炎性因子水平、肛门功能[大便失禁严重程度(Wexner)量表、肛管静息压、最大收缩压]。结果:治疗21 d后,中药组临床疗效高于参照组(P<0.05)。中药组创面愈合率显著高于参照组(P<0.05)。两组COLⅠ、COLⅢ、TGF-β1、VEGF水平、肛管静息压、最大收缩压显著升高,且中药组高于参照组(均P<0.05)。两组分泌物评分、水肿评分、肉芽评分、炎性因子水平、Wexner评分显著降低,且中药组低于参照组(均P<0.05)。结论:祛瘀生肌散能够加快湿热下注型肛瘘患者术后创面愈合,上调COLⅠ、COLⅢ因子水平。Objective:To explore the influence of Quyu Shengji powder on postoperative wound healing and expression of wound tissue collagen typeⅠ(COLⅠ)and collagen typeⅢ(COLⅢ)in patients with anal fistula of damp-heat downward flow.Methods:120 patients with anal fistula surgery were selected as the research subjects,and were divided into reference group and traditional Chinese medicine group,with 60 cases in each group.The reference group was given routine wound dressing change,while the traditional Chinese medicine group was given Quyu Shengji powder for external application.The clinical efficacy and postoperative wound healing status[wound healing rate,COLⅠ,COLⅢ,transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)],wound score,inflammatory factors,and anal function[fecal incontinence severity scale(Wexner),anal resting pressure,maximum systolic pressure]were compared between groups after 21 days of treatment.Results:After 21 days of treatment,the clinical efficacy in traditional Chinese medicine group was significantly higher than that in reference group(P<0.05).The wound healing rate in traditional Chinese medicine group with(94.27±2.16)%was significantly higher than(85.37±1.24)%in reference group(P<0.05).The levels of COLⅠ,COLⅢ,TGF-β1 and VEGF,anal resting pressure and maximum systolic pressure in the two groups were significantly increased,and the indicators in traditional Chinese medicine group were higher than those in reference group(all P<0.05).The secretion score,edema score,granulation score,inflammatory factors levels and Wexner score were significantly decreased in both groups,and the scores and levels in traditional Chinese medicine group were lower(all P<0.05).Conclusion:Quyu Shengji powder can accelerate postoperative wound healing in patients with anal fistula of damp-heat downward flow,and up-regulate COLⅠand COLⅢlevels.

关 键 词：肛瘘 祛瘀生肌散 创面愈合 胶原蛋白 肛门功能 炎性因子 

分 类 号：R657.1[医药卫生—外科学]