益气活血托毒法对减少肛瘘术后创面瘢痕形成的临床研究

“Correction qi and blood circulation care drug”treatment of anal fistula wound scarring reduction clinical research

目的观察益气活血托毒中药(愈创汤)对减少肛瘘术后创面瘢痕形成的影响,并从组织形态学探讨其作用机制。方法采用完全随机对照试验方法,将60例患者分治疗组和对照组各30例,两组术后均常规处理,治疗组加服中药愈创汤;比较患者创面愈合时间、成纤维细胞Ⅰ、Ⅲ型胶原的含量比例,综合疗效以及部分瘢痕上皮组织的显微形态结构。结果治疗组创面愈合时间明显快于对照组(P<0.05);两组综合疗效比较,差异无统计学意义(P>0.05);术后第7、14天:两组成纤维细胞Ⅰ、Ⅲ型胶原的含量比例有明显差异(P>0.05);治疗组瘢痕上皮修复较对照组完整、成熟,接近正常皮肤表皮形态结构。结论益气活血托毒中药具有减少肛瘘术后创面瘢痕形成,加速愈合,促进上皮生长的作用,可能与其在创面修复过程中的不同时期对创面肉芽组织中Collagen-Ⅰ、Collagen-Ⅲ含量的调控有关。

Objective To observe Correction qi and blood circulation care drug medicine （Yuchuang soup） to reduce the anal fistula postoperative wound scar formation,and to explore its mechanism from the tissue morphology. Methods Completely randomized controlled trial,60 patients were divided into a treatment group and a control group of 30 cases, postoperative conventional treatment,the treatment group took the medicine Yuchuang soup;compared with patients healing time,fibroblasts Ⅰ, Ⅲ proportion of collagen content, efficacy, and some scar epithelial tissue microscopic morphology. Results Treatment group wound healing time was significantly faster than the control group （ P 〈 0.05 ） ; two sets of comprehensive therapeutic effect, the difference was not statistically significant （ P 〉 0. 05） ;postoperative days 7 and 14 ：two fibroblast type Ⅰ , Ⅲ eollagenthe content ratio were significantly different （P 〉 0.05 ） ; the scar treatment group than the control group epithelial repair complete, mature, close to the normal epidermal morphology. Conclusion The the care drugs Yiqihuoxue Chinese medicine has reduce anal fistula wound scar formation, accelerate healing,promote the role of epithelial growth,may be related to different periods in the process of wound healing granu- lation tissue Collagen- Ⅰ , Collagen-Ⅲ content regulation related.