人参白茅根汤在促进肛瘘术后创面愈合中的应用价值研究

Effect of ginseng rhizoma imperatae decoction on wound healing in anal fistula after operation

目的研究人参白茅根汤对肛瘘术后创面生长因子及炎症指标的影响。方法纳入2013年4月至2017年4月武汉市第八医院收治的70例接受切开挂线术治疗的肛瘘患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组各35例。对照组术后接受高锰酸钾坐浴干预,观察组术后口服人参白茅根汤并进行人参白茅根汤坐浴干预。观察记录两组患者总体疗效、创面愈合时间,比较两组入院时及术后2 w创面生长因子和炎症指标水平变化情况及两者的关系。结果观察组患者总体疗效和显效率均优于对照组(均P <0.05);观察组创面平均愈合时间为(23.54±3.61) d,对照组为(28.29±4.57) d,两组比较差异有统计学意义(P <0.05)。两组术后2 w时EGF、VEGF、FGF-1水平均高于入院时(均P <0.05),且观察组均高于对照组及IFN-γ水平均与EGF、VEGF及FGF-1水平具有负相关性(均P <0.05)。结论人参白茅根汤用于肛瘘切开挂线术后能缩短术后创面愈合时间,这可能与人参白茅根汤促进创面生长因子分泌、减轻炎症反应有关。

Objectives To investigate the effect of ginseng rhizome imperatae decoction on growth factors and inflammatory factors of wound in patients with fistula after operation.Methods Seventy patients with fistula who received seton in Number 8 Hospital of Wuhan City between April 2013 and April 2017 were recruited as study subjects.They were randomly assigned to treatment group and control group using random number table,with 35 patients in each group.Patients in control group received routine post-operation treatment and those in treatment group received oral and hip bath of ginseng rhizome imperatae decoction.We compare between the two groups overall effectiveness,time to wound healing,and levels of growth factors and inflammatory factors at admission and two weeks after operation.We analyzed the relationship between levels of growth factors and inflammatory factors.Results Overall curative rate and effective rate were significantly better in treatment group than in control group(P<0.05).Average time to wound healing was 23.54±3.61 days in treatment group and 28.29±4.57 days in control group,with significant between-group difference(P<0.05).In both groups,levels of EGF,VEGF,an FGF-1 were significantly higher two weeks after operation than at admission(P<0.05)and levels were significantly higher in treatment group than in control group(P<0.05).In both groups,levels of IL-6,TNF-α,an IFN-γwere significantly lower two weeks after operation than at admission(P<0.05)and levels were significantly lower in treatment group than in control group(P<0.05).There were negative correlations between levels of IL-6,TNF-α,an IFN-γand levels of EGF,VEGF,and FGF-1 two weeks after operation(P<0.05).Conclusion Ginseng rhizome imperatae decoction can shorten time to wound healing in patients receiving seton for fistula.This is possibly related to its effect to promote expression of growth factors at the wound and alleviate inflammatory response.