清热祛湿汤联合低位切开高位挂线法治疗高位复杂性肛瘘

Qingre Qushi decoction combined with low-cutting and high-threading in the treatment of high complex anal fistula

目的观察清热祛湿汤联合低位切开高位挂线法治疗高位复杂性肛瘘的临床疗效。方法将62例高位复杂性肛瘘患者随机分为对照组与治疗组,各31例,对照组采用低位切开高位挂线法治疗,治疗组在对照组的基础上联合清热祛湿汤治疗,治疗周期14天。治疗后比较创面情况、炎性因子水平、肛门动力学及临床疗效。结果 2组术后第14天创面疼痛、水肿、渗出及肉芽组织较术后第1天均有改善(P<0.05),治疗组改善程度优于对照组(P<0.05);2组治疗后WBC、hs-CRP、IL-6、IL-8及ARP、RRP较治疗前降低,AMCP、ALCT较治疗前升高(P<0.05),治疗组降低和升高幅度较对照组明显(P<0.05);治疗组总有效率显著高于对照组(P<0.05)。结论清热祛湿汤联合低位切开高位挂线法治疗高位复杂性肛瘘,能够降低WBC、hs-CRP、IL-6及IL-8炎症因子水平,抑制炎症反应,减轻术后创面疼痛,减少创面水肿、渗出,促进创面愈合,降低ARP、RRP,升高AMCP,延长ALCT,改善肛门动力学指标,提高临床疗效。

Objective To observe the clinical efficacy ofQingre Qushi decoction combined with low-cutting and high-threading in the treatment of high complex anal fistula.Methods 62 patients with high complex anal fistula were randomly divided into a control group and the treatment group, 31 cases in the control group accepted low cut and high thread method, and the treatment group combined withQingre Qushi decoction on the basis of the control group treatment. Both two groups were given 14 days treatment. Wounds, the levels of inflammatory factors, anus dynamics and clinical efficacy were compared with before treatment.Results After 14 days treatment, wound pain, edema, exudation and granulation tissue were improved compared with before treatment （P〈0.05）, the improvement of the treatment group was better than that of the control group （P〈0.05）; After treatment, WBC, hs-CRP, IL-6, IL-8 and ARP, RRP reduced comparing with before treatment, the former AMCP, ALCT increased than before treatment （P〈0.05）, treatment group reduced and increased rate were superior to the control group significantly （P〈0.05）; The treatment group has a significantly higher total effective rate （P〈0.05）.Conclusion High complex anal fistula treated byQingre Qushi decoction combined with low-cutting and high-threading can reduce the WBC, hs-CRP, IL-6 and IL-8 levels of inflammatory cytokines and inhibit inflammation, and reduce postoperative wound pain, wound swelling, bleeding, promote wound healing and reduce ARP, RRP, increased AMCP, extend ALCT, anal improve dynamic parameters, improve clinical outcomes.