五倍子汤加减熏洗促进肛瘘术后创面愈合效果评价

Evaluation of the Effect of Wubeizi Decoction Addition and Subtraction Fumigationon the Healing of Wound Healing After Anal Fistula

目的探讨五倍子汤加减熏洗促进肛瘘术后创面愈合效果。方法收集辽宁中医药大学附属第三医院2017年2月-2018年6月100例肛瘘术后创面未愈患者。按照治疗方法分组,对照组采取常规方案治疗,肛瘘术后创面未愈患者手术结束后的第2天用甲硝唑葡萄糖注射液50 mL灌肠保留15 min,用1∶5000高锰酸钾融合热水熏蒸,熏蒸半小时。每天均1次,治疗1周。五倍子汤组则采取五倍子汤加减熏洗治疗,手术后第2天进行熏洗坐浴,将五倍子汤加减煎煮为2500 mL,热气进行患处熏蒸,在药液温度降低在40℃左右开始进行坐浴,每次坐浴时间25 min,每天1次,持续治疗1周。比较两组疗效,临床创面愈合时间、疼痛持续时间、肿胀消失时间、排便恢复正常时间,治疗前后肛瘘术后创面未愈患者视觉模拟疼痛评分、生活质量平均分值,继发感染发生率。结果五倍子汤组疗效高于对照组,P<0.05;五倍子汤组临床创面愈合时间、疼痛持续时间、肿胀消失时间、排便恢复正常时间低于对照组,P<0.05;治疗前两组视觉模拟疼痛评分、生活质量平均分值比较无统计学差异,P>0.05;治疗后五倍子汤组视觉模拟疼痛评分、生活质量平均分值优于对照组,P<0.05;五倍子汤组与对照组继发感染发生率比较无统计学意义,P>0.05。结论五倍子汤加减方中各种药物可顺调气机、理气解郁、疏肝破气、清热燥湿解毒,将其联合中药熏蒸治疗,能够提高效果。五倍子汤加减熏洗治疗肛瘘术后创面未愈的疗效好,可更好减轻肛瘘术后创面未愈患者的疼痛,改善其生活质量,是一种值得推广的治疗方式。

Objective To explore the effect of Wubeizi Decoction on the healing of wounds after anal fistula.Methods 100 patients with unhealed wounds after anal fistula in third affiliated hospital of Liaoning university of traditional Chinese medicine from February 2017 to February 2018 were collected.According to the treatment group,the control group was treated with conventional regimen.The wound was not healed after anal fistula.On the second day after the operation,the metronidazole glucose injection 50 mL enema was kept for 15 minutes,and the hot water was mixed with 1∶5000 potassium permanganate.Fumigation for half an hour.Once a day,treatment for 1 week.The Wubeizi Decoction group was treated with Wubeizi Decoction addition and subtraction fumigation.On the second day after the operation,the bath was smoked and washed,and the above medicine was boiled to 2500 mL.The hot air was used for evidence-based examination.The bath temperature was lowered at 40℃,and the bathing time was 25 minutes per day,continued treatment for 1 week.The efficacy of the two groups was compared;the time of clinical wound healing,the duration of pain,the time of swelling disappeared,the time when the bowel movements returned to normal;the visual analog pain score and the average quality of life scores of patients with unhealed anal fistula before and after treatment;secondary infection incidence.Results The efficacy of Wubeizi Decoction group was higher than that of the control group,P<0.05.The time of wound healing,the duration of pain,the time of swelling disappeared,and the time when the bowel movement returned to normal were better in the Wubeizi Decoction group than in the control group,P<0.05.The visual analogue pain score and the average quality of life scores of the two groups were close,P>0.05.After treatment,the visual analog pain score and the average quality of life score of Wubeizi Decoction group were better than the control group,P<0.05.The incidence of secondary infection in the Wubeizi Decoction group was close to that of the control group,P>0.05.Conclusion Wubeizi Decoction addition and subtraction fumigation could regulate Qi,relieve depression,dredge liver and break Qi,clear heat,dry dampness and detoxify,and combine it with traditional Chinese medicine fumigation treatment to improve the effect.It can be seen that the effect of the treatment of anal fistula with the addition and subtraction of Fructus sinensis is better,can better alleviate the pain of patients with unhealed wounds after anal fistula,and improve the quality of life of patients with unhealed wounds after anal fistula.It is a treatment method worthy of promotion.