自拟中药汤剂对早期低位肛周脓肿患者临床症状以及炎症反应的改善作用分析

Efficacy of self-made traditional Chinese medicine decoction on the clinical symptoms and inflammatory reaction in patients with low level perianal abscess in an early stage

目的应用自拟中药汤剂治疗早期低位肛周脓肿患者,观察治疗前后患者症状体征评分以及炎症因子水平,探讨自拟中药汤剂在早期低位肛周脓肿患者中的治疗效果,为临床治疗提供新的选择。方法选取2013年10月-2018年10月浙江省中医院收治的120例早期低位肛周脓肿患者为研究对象,根据治疗方法的不同将其分为观察组(63例)和对照组(57例)。对照组口服左氧氟沙星和甲硝唑各0.2 g,3次/d,观察组在对照组的基础上加用自拟中药汤剂治疗,每天1剂,所有患者均连续治疗14 d。比较2组临床疗效、治疗前后症状体征评分,并采用酶联免疫吸附法检测患者治疗前后超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)及前列腺素E2(PGE2)水平。结果观察组临床疗效明显优于对照组(P<0.05);治疗后,2组肛门疼痛、全身症状、肿块大小及肿块质地评分明显低于治疗前(均P<0.05),且观察组明显低于对照组(均P<0.05);2组TNF-α、PGE2及hs-CRP水平明显低于治疗前(均P<0.05),且观察组明显低于对照组(均P<0.05),2组IL-10水平明显高于治疗前(均P<0.05),且观察组明显高于对照组(P<0.05)。结论自拟中药汤剂治疗早期低位肛周脓肿患者临床疗效显著,能够有效改善患者症状体征,减轻炎症反应。

Objective To treat the early low perianal abscess patients with self-made traditional Chinese medicine decoction, observe the signs score and the levels of inflammatory cytokine before and after the treatment, and explore the clinical effect of self-made traditional Chinese medicine decoction in the treatment of early low perianal abscess, so as to provide a new choice for clinical treatment. Methods A total of 120 cases of early low perianal abscess in our hospital between October 2013 and October 2018 were selected and divided into observation group(n=63) and control group(n=57) according to the different treatment methods. The patients in the control group took orally 0.2 g of levofloxacin and metronidazole, three times a day, while the patients in the observation group took orally self-made traditional Chinese medicine decoction on the basis of the control group, and one dose of self-made traditional Chinese medicine decoction a day. All patients were treated for 14 days. The clinical effect, the symptoms and signs score of two groups were compared before and after the treatment. And the levels of high sensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-10(IL-10) and prostaglandin E2(PGE2) were detected by enzyme-linked immunosorbent assay before and after the treatment. Results The clinical effect in the observation group was significantly higher than that in the control group(P<0.05);After the treatment, the scores of anal pain, general symptom, tumor size and texture in both groups were significantly lower than those before the treatment(P<0.05), and the observation group were significantly lower than those of control group(P<0.05);The levels of TNF-α, PGE2 and hs-CRP in both groups were significantly lower than those before the treatment(P<0.05), and the observation group were significantly lower than those of control group(P<0.05), the level of IL-10 in both groups was significantly higher than that before treatment(P<0.05), and the observation group was significantly higher than that of control group(P<0.05). Conclusion The self-made traditional Chinese medicine decoction for early low perianal abscess has remarkable clinical effect, which can effectively improve the symptoms and signs of patients and reduce the inflammatory response.