止痛如神汤箍围疗法在肛瘘术后患者中的应用及对疼痛程度的影响观察

Application of Zhitong Rushen Decoction Hooping Therapy in Patients after Anal Fistula Surgery and Its Influence on Pain Degree

目的:观察止痛如神汤箍围疗法在肛瘘术后患者中的应用效果以及对其疼痛程度的影响。方法:采用随机数字表法将2019年6月~2020年6月在本院接受诊治的124例肛瘘手术患者分为A、B组,各62例。A组患者在常规药物治疗的基础上给予凡士林纱布条换药,B组在A组的基础上加以止痛如神汤箍围疗法治疗,两组均治疗2周。对比分析两组的治疗有效率、创面愈合率、不同时段疼痛评分以及治疗前后中医症状积分、血清表皮生长因子(EGF)、纤维连接蛋白(FN)水平变化情况。结果:B组治疗后的临床有效率为93.54%,明显高于A组的80.65%(P<0.05)。两组治疗期间的创面愈合率均呈增高趋势(P<0.05),且B组治疗第3、7、14天的创面愈合率显著高于A组(P<0.05)。与治疗前相比,两组患者治疗第3、7、14天的VAS评分均明显降低(P<0.05),且B组患者治疗第3、7、14天的VAS评分均显著低于A组(P<0.05)。B组治疗后的肉芽形态、创面渗液等体征症状评分均明显低于A组(P<0.05)。两组患者治疗后的的EGF、FN水平较治疗前明显升高(P<0.05),且B组治疗后的EGF、FN水平均明显高于A组(P<0.05)。结论:止痛如神汤箍围疗法可明显减轻肛瘘患者术后创面疼痛,改善患者临床症状,升高其EGF、FN水平,促进创面愈合,效果显著。

Objective:To observe the application effect of Zhitong Rushen Decoction hooping therapy in patients after anal fistula surgery and its influences on pain degree.Methods:A total of 124 anal fistula patients who were treated in the hospital from June 2019 to June 2020 were divided into a group A and B by the random number table method,62 cases in each group.On basis of routine medication,the group A was given petrolatum gauze strips for dressing changes,while the group B was treated with Zhitong Rushen Decoction hooping therapy on the basis of the group A.Both groups were treated for 2 weeks.The response rate of treatment,wound healing rate,changes in scores of visual analogue scale(VAS)and TCM symptoms,levels of serum epidermal growth factor(EGF)and fibronectin(FN)before and after treatment were compared and analyzed between the two groups.Results:After treatment,clinical response rate of the group B was significantly higher than that of the group A(93.54%vs 80.65%)(P<0.05).The wound healing rate was increased during treatment in both groups(P<0.05).After 3 d,7 d and 14 d of treatment,wound healing rate in the group B was significantly higher than that in the group A(P<0.05).Compared with those before treatment,VAS scores were significantly decreased after 3 d,7 d and 14 d of treatment in both groups(P<0.05),which were significantly lower in the group B than the group A(P<0.05).After treatment,scores of granulation morphology and wound exudate in the group B were significantly lower than those in the group A(P<0.05).After treatment,levels of EGF and FN were significantly increased in both groups(P<0.05),which were significantly higher in the group B than the group A(P<0.05).Conclusion:Zhitong Rushen Decoction hooping therapy can significantly alleviate postoperative wound pain in patients with anal fistula,improve clinical symptoms,increase levels of EGF and FN,and promote wound healing,with significant effects.