加味黄连解毒汤对低位肛瘘术后湿热下注型患者创面愈合的影响  

Effects of Modified Huanglian Jiedu Decoction on Wound Healing in Patients with Damp-Heat Downward Syndrome after Low Fistula-in-Ano Surgery

作　　者：范俊龙 贵照旺 吴媛媛 FAN Junlong;GUI Zhaowang;WU Yuanyuan(Hebi Coal(Group)Co.,Ltd.General Hospital,Hebi 458000,China;Puyang City Hospital of Traditional Chinese Medicine,Puyang 457000,China)

机构地区：[1]鹤壁煤业(集团)有限责任公司总医院,河南鹤壁458000 [2]濮阳市中医医院,河南濮阳457000

出　　处：《中医药信息》2025年第2期58-64,共7页Information on Traditional Chinese Medicine

摘　　要：目的:探讨加味黄连解毒汤对低位肛瘘术后湿热下注型患者创面愈合的影响,并从抗炎、免疫调节及营养改善等方面分析其作用机制。方法:采用随机对照试验设计,将符合纳入标准的100例低位肛瘘术后湿热下注型患者随机分为试验组和对照组,每组各50例。对照组接受常规治疗,试验组在对照组治疗基础上口服加味黄连解毒汤。观察两组患者治疗前后炎症标志物(CRP、WBC)、免疫细胞功能(CD3^(+)、CD4^(+))及生活质量(SF-36评分)的变化情况,同时比较创面愈合时间。结果:试验组的创面愈合时间显著短于对照组(P<0.001)。术后第7、14天,试验组的CRP、WBC、NEUT%水平显著低于对照组(P<0.05)。术后第14天,试验组的CD3^(+)、CD4^(+)、CD8^(+)、NK细胞及B细胞比例显著高于对照组(P<0.05)。术后第1、3、7、14、21天,试验组的VAS疼痛评分显著低于对照组(P<0.05),且止痛药使用频率和剂量也显著低于对照组(P<0.05)。术后第14、30天,试验组SF-36生活质量各维度评分均高于对照组(P<0.05)。术后第14天,试验组血清白蛋白、前白蛋白、转铁蛋白含量显著高于对照组(P<0.05),IL-6、TNF-α、IFN-γ含量显著低于对照组(P<0.05),但肝肾功能相关指标未见明显变化(P>0.05)。结论:加味黄连解毒汤可以通过抗炎、免疫调节及改善营养状态,促进低位肛瘘术后创面愈合,减轻术后疼痛,改善生活质量。Objective:To investigate the effects of Modified Huanglian Jiedu Decoction(MHJD)on wound healing in patients with damp-heat downward syndrome after low fistula-in-ano surgery and to analyze its mechanism from the perspectives of anti-inflammation,immune modulation,and nutritional improvement.Methods:A randomized controlled trial was conducted on 100 eligible patients with damp-heat downward syndrome after low fistula-in-ano surgery.Patients were randomly divided into an experimental group and a control group,with 50 patients in each group.The control group received conventional treatment,while the experimental group was additionally treated with oral MHJD.Changes in inflammatory markers(CRP,WBC),immune cell function(CD3^(+),CD4^(+)),and quality of life(SF-36 score)were observed before and after treatment,and wound healing time was compared between groups.Results:The experimental group showed significantly shorter wound healing times than the control group(P<0.001).On postoperative days 7 and 14,CRP,WBC,and NEUT%levels were significantly lower in the experimental group compared to the control group(P<0.05).On day 14,CD3^(+),CD4^(+),CD8^(+),NK cells,and B cell ratios were significantly higher in the experimental group(P<0.05).VAS pain scores on days 1,3,7,14,and 21 were significantly lower in the experimental group(P<0.05),and the frequency and dosage of analgesics used were also significantly lower (P < 0. 05). On days 14 and 30, the SF-36 quality of life scores were significantly higher in the experimental group across all dimensions (P < 0. 05). On day 14, serum albumin, prealbumin, and transferrin levels were significantly higher, while IL-6, TNF- α, and IFN- γ levels were significantly lower in the experimental group (P < 0. 05), with no significant changes in liver and kidney function indicators (P > 0. 05). Conclusion: Modified Huanglian Jiedu Decoction promotes wound healing, reduces postoperative pain, and improves quality of life in patients with damp-heat downward syndrome after low fistula-in-ano surg

关 键 词：加味黄连解毒汤 低位肛瘘术后 创面愈合 抗炎 湿热下注 

分 类 号：R65[医药卫生—外科学]