紫连膏对肛肠术后感染性创口愈合及创面肉芽组织的影响

Effect of Zilian ointment on healing of infectious wound and wound granulation tissue after anorectal operation

目的探讨紫连膏对肛肠术后感染性创口愈合及创面肉芽组织的影响。方法将104例行肛肠术患者随机分为治疗组(n=52)和对照组(n=52);对照组术后采用凡士林纱条敷于患处,治疗组采用紫连膏纱条敷于患处,2组均治疗至创口愈合。观察2组治疗前后创口指标评分和创口面积,检测2组治疗前后血清炎症因子、分泌物因子水平和治疗12 d后肉芽组织中相关细胞因子CD68、VEGF、SMA阳性表达情况。结果治疗后2组疼痛、红肿、渗液评分和创口面积均显著低于治疗前(P均<0.05),且治疗组疼痛、红肿、渗液评分和创口面积显著低于对照组(P均<0.05);治疗组上皮开始覆盖创口时间和创口愈合时间均明显短于对照组(P均<0.05);治疗后2组CRP、IL-1β、PGE2、LTB4、TNF-α、IFN-γ水平均显著低于治疗前(P均<0.05),且治疗组显著低于对照组(P均<0.05),IL-10水平显著高于治疗前(P均<0.05),且治疗组显著高于对照组(P均<0.05);治疗后12 d治疗组肉芽组织中CD68、VEGF、SMA阳性率显著高于对照组(P均<0.05),2组Lyn阳性率比较差异无统计学意义(P>0.05)。结论紫连膏能够有效促进肛肠患者术后创口恢复,并能减轻机体炎症反应,降低肉芽组织相关因子水平,效果显著,安全性高,值得临床推广应用。

Objective It is to explore the effect of Zilian ointment on healing of infectious wound and wound granulation tissue after anal operation after anorectal surgery. Methods 104 patients undergoing anorectal surgery were randomly divided into treatment group（ n = 52） and control group（ n = 52）. After surgery in the control group,vaseline sliver was applied to the affected area,and in the treatment group Zilian ointment sliver was applied to the affected area,and both treatments were not stopped until wound healed. The wound index scores and wound area before and after treatment were observed,the levels of serum inflammatory factors,secretion factors before and after treatment,and positive expression of related cytokines in granulation tissue such as CD68,VEGF,SMA after treatment for 12 days were detected in both groups. Results After treatment,the scores of pain,red swelling,cataclysm and wound area were significantly lower than those before treatment in both groups（ P〈0. 05）,and these indexes in the treatment group were lower than those in the control group（ P〈0. 05）; the time of epithelium covering and wound healing of the treatment group were significantly shorter than that in the control group（ P〈0. 05）; the levels of CRP,IL-1β,PGE2,LTB4,TNF-α,IFN-γ were significantly lower while that of IL-10 was significantly higher than those before treatment in both groups（ P〈0. 05）,and the decrease or increase of these indexes in the treatment group were more significant than those in the control group（ P〈0. 05）. After treatment for 12 days,the positive rate of expression of CD68,VEGF,SMA in the treatment group was significantly higher than that in the control group（ P〈0. 05）,but there was no statistically significant difference between the two groups（ P〈0. 05）. Conclusion Zilian ointment can effectively promote postoperative wound recovery,relieve the body＇s inflammatory response,down-regulate the levels of granulation tissue related factors in the patients after anorectal,the effect is remarkable with high safety,it is worthy of clinical popularization and application.