中药坐浴联合红外线照射在肛瘘术后患者中的应用观察  

Observation onApplication of Traditional Chinese Medicine Decoction in Sitz Bath Combined with Infrared Radiation in Patients with Anal Fistula after Operation

作　　者：王彦苍 刘永海 王娟 王为松 李升平 WANG Yancang;LIU Yonghai;WANG Juan;WANG Weisong;LI Shengping(Hefei Eighth People′s Hospital,Hefei 230011,Anhui,China)

机构地区：[1]合肥市第八人民医院,安徽合肥230011

出　　处：《辽宁中医杂志》2025年第3期56-60,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨加味苦参汤坐浴联合红外线照射在肛瘘术后患者中的应用效果。方法选取2020年5月—2022年9月94例合肥市第八人民医院收治的行肛瘘手术的患者,采用随机数字表法分为对照组(47例)和观察组(47例)。对照组术后接受高锰酸钾液熏洗坐浴联合红外线照射治疗,观察组术后接受加味苦参汤坐浴联合红外线照射治疗,两组患者治疗10 d,并随访6个月。比较两组创面愈合时间,治疗后临床疗效,治疗前后创面疼痛、渗液、水肿及肉芽形态评分、肛肠动力学指标及创面肉芽组织中表皮生长因子(epidermal growth factor,EGF)、血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)、血管内皮细胞生长因子受体2(vascular endothelial growth factor receptor 2,VEGFR-2)、酸性成纤维细胞生长因子(acidic fibroblast growth factor,FGF-1)、碱性成纤维细胞生长因子(basic fibroblast growth factor,FGF-2)水平,治疗与随访期间的安全性及复发情况。结果治疗后,观察组总有效率高于对照组;与治疗前比较,两组创面疼痛、渗液、水肿及肉芽形态评分、直肠静息压(rectal resting pressure,RRP)水平降低,两组间治疗后比较,观察组更低;观察组创面愈合时间短于对照组;与治疗前比较,治疗后两组直肠最大耐受容量(maximum tolerated volume,MTV)、肛管最大收缩压(maximum squeeze pressure,MSP)、肛管静息压(anal resting pressure,ARP)、高压区(high pressure zone,HPZ)长度及创面肉芽组织中EGF、VEGF、VEGFR-2、FGF-1、FGF-2水平升高,两组间治疗后比较,观察组水平更高;随访期间观察组肛瘘复发率低于对照组,差异有统计学意义(P<0.05)。治疗及随访期间两组并发症总发生率经比较,数据差异无统计学意义(P>0.05)。结论加味苦参汤坐浴联合红外线照射治疗肛瘘术后患者可有助于缓解其临床症状,优化肛肠动力学指标,加快创面肉芽组织形成及血管生成,提高临床疗效Objective To explore the application effect of Jiawei Kushen Decoction(加味苦参汤)in sitz bath combined with infrared radiation in patients with anal fistula after operation.Methods Ninety-four patients from May 2020 to September 2022 who underwent anal fistula surgery in Hefei Eighth People′s Hospital were selected and divided into the control group(47 cases)and the observation group(47 cases)by the random number table method.The control group was treated with potassium permanganate solution fumigation combined with infrared radiation,while the observation group was treated with Jiawei Kushen Decoction in sitz bath combined with infrared radiation.The patients in both groups were treated for 10 days and followed up for 6 months.The wound healing time,clinical efficacy after treatment,scores of wound pain,exudation,edema and granulation morphology,anorectal dynamic indexes and epidermal growth factor(EGF),vascular endothelial growth factor(VEGF),vascular endothelial growth factor receptor 2(VEGFR-2),acidic fibroblast growth factor(FGF-1)and basic fibroblast growth factor(FGF-1)in wound granulation tissue before and after treatment,safety and recurrence during treatment and follow-up were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control group.After treatment,compared with those before treatment,the scores of wound pain,exudation,edema,granulation morphology and the level of rectal resting pressure(RRP)of the two groups decreased,and those of the observation group were lower.The wound healing time of the observation group was shorter than that of the control group.After treatment,the values of maximum tolerated volume(MTV),the maximum squeeze pressure(MSP)and the anal resting pressure(ARP),the length of high pressure zone(HPZ)and the levels of EGF,VEGF,VEGFR-2,FGF-1 and FGF-2 in wound granulation tissue of the two groupsincreased,and those of the observation group were higher.During the follow-up period,the recurrenc

关 键 词：肛瘘 加味苦参汤 红外线 肛肠动力学 安全性 复发 

分 类 号：R266[医药卫生—中医外科学]