解毒活血汤促进肛周脓肿术后创面愈合的效果分析

Effect of Jiedu Huoxue Decoction on the Wound Healing after Operation of Perianal Abscess

目的:研究解毒活血汤治疗肛周脓肿术后患者创面愈合的临床效果及可能机制。方法:选择2017年1月~2019年1月我院肛肠科三病区收治的300例肛周脓肿患者,根据其就诊的顺序,随机数字表法均分为两组,各150例,两组均采取一期肛周脓肿根治术治疗,对照组于术后采用高锰酸钾溶液坐浴疗法,观察组于术后联合服用解毒活血汤治疗。均治疗4 w后,比较两组创面愈合的有效率,肛周脓肿患者创面的愈合时间和视觉模拟评分(visual analogue scale,VAS)评分,治疗前后肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数。结果:治疗后,观察组创面愈合的总有效率明显高于对照组(90.67 vs. 71.33%,P<0.05);观察组肛周脓肿患者创面愈合的时间明显短于对照组(P<0.05)。对照组治疗前后的肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数无明显的差异(P>0.05),观察组治疗后的肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数明显高于治疗前和对照组(P<0.05)。观察组术后3 d、1 w和2 w的VAS评分均明显低于对照组(P<0.05)。结论:解毒活血汤可能通过提升肉芽组织中的血红蛋白含量、羟脯氨酸含量、血管内皮生长因子水平以及组织微血管计数有效促进肛周脓肿术后的创面愈合,减轻术后疼痛。

Objective: To investigate the clinical promotion effect and possible mechanism of Jiedu Huoxue Decoction on wound healing in patients with perianal abscess. Methods: Selected 300 cases of patients with perianal abscess who were treated in our hospital from January 2017 to January 2019, according to the order of their visits, the random number table method is divided into two groups,150 cases each. Both groups were treated with one-stage radical operation for perianal abscess. The control group was treated with potassium permanganate solution hip bath after operation, while the observation group was treated with Jiedu Huoxue Decoction after operation. After 4 weeks of treatment, the total effective rate of wound healing was compared between the two groups. Whee healing time and visual analogue scale(VAS) score in patients with perianal abscess. The content of hemoglobin, hydroxyproline, vascular endothelial growth factor and microvessel count in granulation tissue were measured before and after treatment. Results: After treatment, the total effective rate of the observation group was significantly higher than control group(90.67 vs. 71.33%, P<0.05). The healing time of perianal abscess patients in the observation group was significantly shorter than that in the control group(P<0.05). There were no significant differences in hemoglobin content, hydroxyproline content, vascular endothelial growth factor level and tissue microvessel count before and after treatment in the control group(P>0.05). The hemoglobin content, hydroxyproline content, vascular endothelial growth factor level and tissue microvessel count in the observation group after treatment were significantly higher than those before treatment and in the control group(P<0.05). The VAS score of the observation group on the 3 rd, 1 st and 2 nd day after operation was significantly lower than that of the control group(P<0.05). Conclusion: Jiedu Huoxue Decoction can effectively promote wound healing after perianal abscess and improve postoperative pain by increasing hemoglobin content, hydroxyproline content, vascular endothelial growth factor level and tissue microvessel count in granulation tissue.