祛毒促愈汤联合非甾体抗炎药对肛瘘术后创面愈合速度及肛肠动力学的影响  

Effect of Qudu Cuyu decoction combined with non-steroidal anti-inflammatory drugs on wound healing and anorectal dynamics after anal fistula surgery

作　　者：王兰 张宁[1] WANG Lan;ZHANG Ning(Department of Proctology,Sichuan Integrated Traditional Chinese and Western Medicine Hospital,Chengdu 610042,China)

机构地区：[1]四川省中西医结合医院肛肠科,成都610042

出　　处：《中国中西医结合外科杂志》2025年第2期254-258,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：四川省中医药管理局科研项目(2020LC0188)。

摘　　要：目的:分析祛毒促愈汤联合非甾体抗炎药对肛瘘术后创面愈合速度及肛肠动力学的影响。方法:选取2022年5月-2024年3月在本院行肛瘘术的140例患者,依据随机数字表法分为对照组(n=70)及观察组(n=70),对照组给予非甾体抗炎药治疗,观察组在上述基础联合祛毒促愈汤治疗,两组均连续治疗14 d,对比两组临床疗效、术后疼痛视觉模拟评分(VAS)、创面愈合指标及肛肠动力学指标[肛管收缩压(AMCP)、肛管最长收缩时间(ALCT)、肛管静息压(ARP)和直肠静息压(RRP)],并比较两组不良反应发生情况。结果:观察组治疗总有效率(91.43%)较对照组(72.86%)增高(P<0.05)。相较于术后1 d,两组术后2 d、3 d的VAS评分更低(P<0.05),且观察组术后2 d、3 d的VAS评分相较于对照组更低(P<0.05)。治疗后,观察组创面愈合时间较对照组更短,创面愈合率较对照组更高(P<0.05)。相较于治疗前,两组治疗后AMCP、ALCT均无明显差异(P>0.05),两组ARP、RRP更低,且观察组ARP、RRP较对照组更低(P<0.05)。两组患者均未出现明显不良反应。结论:肛瘘术后应用祛毒促愈汤联合非甾体抗炎药治疗效果确切,可减轻术后疼痛,促进创面愈合,并加快肛肠动力学恢复,且安全性较高。Objective To analyze the effect of Qudu Cuyu decoction combined with non-steroidal anti-inflammatory drugs on wound healing and anorectal dynamics after anal fistula surgery.Methods From May 2022 to March 2024,140 patients who underwent anal fistula surgery in the hospital were selected as the study subjects.Using a table of random numbers,the subjects were randomly assigned to the control group(n=70)and the observation group(n=70),receiving treatment with non-steroidal anti-inflammatory drugs and combined treatment with Qudu Cuyu decoction and non-steroidal anti-inflammatory drugs,respectively.Both groups were treated for 14 d.Clinical efficacy,postoperative Visual Analogue Scale(VAS)score for pain,wound healing indicators and anorectal dynamic indicators[anal maximal contraction pressure(AMCP),anal longest contraction time(ALCT),anal rest pressure(ARP)and rectal rest pressure(RRP)]were compared between the groups.The incidence of adverse reactions was analyzed.Results The total effective rate of the observation group reached 91.43%,significantly higher than 72.86%of the control group(P<0.05).VAS scores of the two groups were significantly lower on day 2 and day 3 after surgery than on day 1 after surgery.Compared with the control group,the observation group had lower scores(P<0.05).After treatment,the observation group had shorter wound healing time and a higher wound healing rate(P<0.05).There was no significant change in AMCP or ALCT of the two groups after treatment(P>0.05).ARP and RRP of both groups were significantly reduced,and the observation group had lower ARP and RRP(P<0.05).No adverse reaction was observed in either group.Conclusion The combined treatment with Qudu Cuyu decoction and non-steroidal anti-inflammatory drugs is effective after anal fistula surgery.It can alleviate postoperative pain,promote wound healing,and accelerate the recovery of anorectal dynamics,with high safety.

关 键 词：肛瘘 祛毒促愈汤 非甾体抗炎药 创面愈合 肛肠动力学 

分 类 号：R657.1[医药卫生—外科学]