中医护场理论指导下如意金黄散外敷对肛周脓肿术后创面的影响分析  

Influence of external application of Ruyi Jinhuang powder under guidance of traditional Chinese medicine nursing field theory on wounds after perianal abscess surgery

作　　者：李晓洁[1] 杨会举[2] LI Xiao-jie;YANG Hui-ju(Department of Anorectal Surgery,the Fifth Clinical College of Henan University of Chinese Medicine,Zhengzhou People's Hospital,Zhengzhou 450000,China;Department of Anorectology,the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院肛肠外科,郑州450000 [2]河南中医药大学第三附属医院肛肠科,郑州450000

出　　处：《医药论坛杂志》2024年第23期2546-2550,共5页Journal of Medical Forum

基　　金：河南省中医药拔尖人才专项课题(2022ZYBJ16);河南省中医药科学研究专项课题(2023ZY2116)。

摘　　要：目的分析探究中医护场理论指导下如意金黄散外敷对肛周脓肿术后创面愈合的影响。方法选择2021年8月至2023年8月河南中医药大学第五临床医学院(郑州人民医院)收治的160例肛周脓肿患者,按入院的先后次序编号并通过随机数字表法分为常规组(n=80)和调查组(n=80)。常规组给予凡士林外敷治疗,调查组给予中医护场理论指导下如意金黄散外敷治疗。比较两组治疗效果,术后创面视觉模拟量表(visual analogue scale,VAS)评分、创面分泌物评分、血清白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-1β(nterleukin-1β,IL-1β)水平以及创面组织血管内皮生长因子(vascular endothelial growth factor,VEGF)、表皮生长因子受体(epidermal growth factor receptor,EGFR)、碱性成纤维细胞生长因子(asic fibroblast growth factor,bFGF)表达量,并记录两组创面愈合时间。结果调查组总有效率高于常规组,差异有统计学意义(P<0.05);调查组术后3 d、术后7 d和术后14 d的创面VAS评分、创面分泌物评分以及血清IL-6、TNF-α、IL-1β水平低于常规组,差异有统计学意义(P<0.05),创面组织VEGF、EGFR、bFGF表达量高于常规组,差异有统计学意义(P<0.05);调查组创面愈合时间短于常规组,差异有统计学意义(P<0.05)。结论中医护场理论指导下如意金黄散外敷有利于减轻肛周脓肿术后创面疼痛,减少创面分泌物渗出,并抑制炎症反应,进而促进创面愈合,其机制可能与上调创面组织VEGF、EGFR、bFGF表达有关。Objective To analyze and explore the influence of external application of Ruyi Jinhuang powder on wound healing after perianal abscess surgery under the guidance of traditional Chinese medicine nursing field theory.Methods Totally 160 patients with perianal abscess in the hospital from August 2021 to August 2023 were selected and numbered according to the order of admission and divided into regular group(n=80)and investigation group(n=80)by adopting the random number table method.The regular group was treated with vaseline for external application,while the investigation groupwas given Ruyi Jinhuang powder for external application under the guidance of traditional Chinese medicine nursing field theory.The therapeutic effect,postoperative wound visual analogue scale(VAS)score,wound secretion score,levels of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)and expression levels of of vascular endothelial growth factor(VEGF),epidermal growth factor receptor(EGFR)and basic fibroblast growth factor(bFGF)in wound tissue were compared.The wound healing time in both groups was recorded.Results The total effective rate in investigation groupwas higher than that in regular group(P<0.05).The wound VAS score,wound secretion score,serum IL-6,TNF-αand IL-1βlevels in investigation groupwere lower than those in regular group at 3,7 and 14 days after surgery(P<0.05),while the expression levels of VEGF,EGFR and bFGF in wound tissue were higher compared to regular group(P<0.05).The wound healing time was shorter in investigation groupthan that in regular group(P<0.05).Conclusion External application of Ruyi Jinhuang powder under the guidance of traditional Chinese medicine nursing field theory is beneficial to relieving wound pain after perianal abscess surgery,reducing wound secretion exudation,inhibiting inflammatory response,and promoting wound healing.Its mechanism may be related to the up-regulations of expressions of VEGF,EGFR and bFGF in wound tissue.

关 键 词：肛周脓肿 中医护场理论 如意金黄散 外敷 创面愈合 

分 类 号：R574.8[医药卫生—消化系统]