外用冲合膏联合复方黄柏液创面灌洗对肛周坏死性筋膜炎术后创面愈合效果影响

Effect of external Chonghe ointment combined with wound lavage using compound Huangbai liquid on wound healing after perianal necrotizing fasciitis surgery

目的探讨外用冲合膏联合复方黄柏液创面灌洗对肛周坏死性筋膜炎术后创面愈合效果的影响。方法选取自2018年8月至2020年8月沈阳市肛肠医院收治的70例肛周坏死性筋膜炎术后患者为研究对象。根据随机数字表法将患者分为A组和B组,每组各35例患者。两组患者均进行手术治疗,A组术后给予常规西医治疗,B组应用冲合膏联合复方黄柏液创面灌洗。比较两组患者术后疼痛评分,血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)水平,以及临床疗效。结果 B组患者术后7 d、术后15 d、术后30 d疼痛评分均显著低于A组,两组比较,差异有统计学意义(P<0.05)。两组患者术后2周、术后4周VEGF与bFGF水平均显著高于术后当日,且B组高于A组,差异有统计学意义(P<0.05)。B组有效率为85.71%(30/35),高于A组的68.57%(24/35),两组比较,差异有统计学意义(P<0.05)。结论冲合膏联合复方黄柏液创面灌洗具有活血消肿、清热解毒、散结祛腐之效,可以显著改善肛周坏死性筋膜炎患者临床症状和体征,缓解疼痛,对肛周坏死性筋膜炎术后患者有较好的的治疗效果。

Objective To investigate the effect of external Chonghe ointment combined with wound lavage using compound Huangbai liquid on wound healing after perianal necrotizing fasciitis surgery.Methods A retrospective study was performed on 70 cases of patients with postoperative perianal necrotizing fasciitis who were admitted from August 2018 to August 2020.Patients were randomly divided into the Group A and Group B,each with 35 cases.Patients in both groups received surgical treatment,Group A of patients received conventional western medicine treatment after surgery;Group B of patients were treated with conventional western medicine treatment combined with compound Huangbai liquid for wound lavage.Postoperative pain scores,vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)levels and clinical efficacy were compared between both groups.Results The pain scores of Group B at postoperative 7 days,15 days and 30 days were significantly lower than those of Group A,and the difference between the two groups was statistically significant(P<0.05).The levels of VEGF and bFGF at 2 weeks and 4 weeks after surgery in both groups were significantly higher than those on the day after surgery,and levels of Group B were higher than those of Group A(P<0.05).The effective rate of Group B was 85.71%(30/35),which was higher than that of Group A(68.57%,24/35),P<0.05.Conclusion External Chonghe ointment combined with wound lavage using compound Huangbai liquid has the effects of quickening the blood and dispersing swelling,clearing away heat and toxic material,dispeling knot and removing corruption.It can improve the clinical symptoms and signs of patients with perianal necrotizing fasciitis and relieve pain.It has a good therapeutic effect on patients with perianal necrotizing fasciitis after operation.