萆薢渗湿汤加减内服对单纯性低位肛瘘术后创面愈合的影响  

Effect of Bexie Sshenshi Decoction on wound healing after simple low anal fistula

作　　者：王立波 郭旭琴 刘翠珠 任卫宁 牛玉凤 李洪超 WANG Libo;GUO Xuqin;LIU Cuizhu;REN Weining;NIU Yufeng;LI Hongchao(Department of Anorectal,the Second Affiliated Hospital of Hebei University of Chinese Medicine,Hebei Province,Dingzhou073000,China;Department of Ultrasound,Dingzhou Traditional Chinese Medicine Hospital,Hebei Province,Dingzhou073000,China;Department of Medicine Anorectal,Hebei Provincial Hospital of Traditional Chinese,Hebei Province,Shijiazhuang050013,China)

机构地区：[1]河北中医药大学第二附属医院肛肠科,河北定州073000 [2]河北省定州市中医医院超声科,河北定州073000 [3]河北省中医院肛肠科,河北石家庄050013

出　　处：《中国医药导报》2025年第7期129-133,共5页China Medical Herald

基　　金：河北省中医药管理局中医药科研计划项目(2022399)。

摘　　要：目的 探讨萆薢渗湿汤加减内服对单纯性低位肛瘘术后创面愈合的影响。方法 选择于河北中医药大学第二附属医院2023年1月至2024年2月接受手术治疗的96例单纯性低位肛瘘湿热下注证患者,以随机数字表法分为观察组和对照组,各48例。两组均术后予凡士林纱条换药等常规治疗。对照组进行中药坐浴治疗;观察组在对照组基础上联合萆薢渗湿汤加减治疗,连续治疗14 d。观察两组疗效。于治疗前后对患者创面症状体征进行评分,并检测创面渗出液中炎症介质[前列腺素E_(2)(PGE_(2))、白细胞介素(IL)-1β、细胞间黏附分子-1(ICAM-1)]及碱性成纤维细胞生长因子(b FGF)、转化生长因子-β1(TGF-β1)、表皮生长因子(EGF)水平。记录两组治疗过程中不良反应情况。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组创面水肿、疼痛、渗出及肉芽生长评分,渗液中ICAM-1、IL-1β、PGE_(2)水平较治疗前降低,且观察组低于对照组(P<0.05)。观察组术后14 d创面愈合率高于对照组,创面愈合时间短于对照组(P<0.05)。两组治疗后创面渗出液中b FGF、EGF及TGF-β1水平较治疗前升高,且观察组高于对照组(P<0.05)。两组治过程中无明显不良反应发生。结论 萆薢渗湿汤加减内服能有效下调肛瘘术后创面渗出液中相关炎症介质水平,上调创面渗出液中b FGF、TGF-β1、EGF水平,临床疗效显著,可明显促进患者术后创面的愈合,且安全性高。Objective To investigate the effect of Bexie Shenshi Decoction on wound healing after simple low anal fistula.Methods A total of 96 patients with damp-heat syndrome of simple low anal fistula who received surgical treatment in the Second Affiliated Hospital of Hebei University of Chinese Medicine from January 2023 to February 2024 were divided into control group and observation group by random number table method,with 48 cases in each group.Both groups were given conventional treatment such as Vaseline gauze dressing change after surgery.The control group received traditional Chinese medicine sit-bath treatment.The observation group was combined with the treatment of Bexie Shenshi Decoction on the basis of control group,continuous treatment for 14 d.The curative effect of the two groups was observed.The wound symptoms and signs of the subjects were scored before and after treatment.The levels of inflammatory mediators(prostaglandin E_(2)[PGE_(2)],interleukin[IL]-1β,intercellular adhesion molecule-1[ICAM-1]),basic fibroblast growth factor(bFGF),transforming growth factor-β1(TGF-β1),and epidermal growth factor(EGF)in wound exudate were detected.The adverse reactions in the two groups were recorded.Results The clinical efficacy of the observation group was better than that of the control group(P<0.05).The scores of wound edema,pain,exudate,and granulation growth ICAM-1,IL-1β,and PGE_(2) levels in exudation were lower in two groups after treatment than before treatment,and those in the observation group wer lower than the control group(P<0.05).The wound healing rate of the observation group was higher than that of the control group 14 days after operation, and the wound healing time was shorter than the control group (P<0.05). The levels of bFGF, EGF, and TGF-β1 in wound exudate of two groups after treatment were higher than those before treatment, and those in observation group were higher than those in the control group (P<0.05). No obvious adverse reactions occurred in all subjects. Conclusion The modified Bi

关 键 词：萆薢渗湿汤 中药坐浴 单纯性低位肛瘘 湿热下注证 炎症介质 创面渗出液 损伤修复因子 

分 类 号：R657.16[医药卫生—外科学]