“祛腐生新”法在预防陈旧性肛裂术后创面迟缓愈合作用的临床研究

Clinical Study of‘Qu Fu Sheng Xin’Method in Preventing Delayed Wound Healing of Old Anal Fissure after Surgery

目的:基于“祛腐生新”理论,探讨中药制剂复方黄柏液预防陈旧性肛裂术后创面迟缓愈合的疗效。方法:将80例陈旧性肛裂患者按照随机数表法分为两组,均行常规肛裂切除术,术后第2天开始换药。治疗组(40例)选用中药制剂复方黄柏液纱条换药,对照组(40例)选用凡士林纱条换药。两组均治疗14 d后比较综合疗效、肛门狭窄发生情况,比较术后第1、3、7、14天切口疼痛、创缘水肿、创面出血、创面肉芽生长变化情况,以及术后第30天、90天生活质量普适量表(QOL-35)评分差异。结果:治疗组综合疗效情况、肛门狭窄发生情况优于对照组(P<0.05);治疗组切口疼痛、创缘水肿、创面出血、创面肉芽生长方面评分均低于对照组(P<0.05);两组患者术后第30天、90天QOL-35评分与术前相比均有提高,且治疗组在术后30 d评分高于对照组,差异有统计学意义(P<0.05)。结论:基于“祛腐生新”理论,术后采用中药制剂复方黄柏液进行换药对预防陈旧性肛裂术后创面迟缓愈合效果显著。

Objective:To discuss the effect of Compound Huangbai Liquid on delayed wound healing of post-operative old anal fissure,based on the theory of‘Qu Fu Sheng Xin’,which means removing necrotic tissues and generating new ones.Methods:80 patients diagnosed with old anal fissure were divided into the treatment group and the control group,with 40 cases in each group.All patients underwent anal fissure resection,and the dressing change was performed the day after surgery.The treatment group was given the dressing change with the gauze processed with Compound Huangbai Liquid,whereas the control group was given the dressing change with Vaseline gauze in the control group.After dressing change had performed for 14 days,the comprehensive efficacy and incidence of anal stenosis were evaluated in the two groups.Changes of incision pain,wound bleeding,edema and wound recovery were assessed at 1 d,3 d,7 d and 14 d after surgery.The scores of QOL-35 were assessed at 30 d and 90 d after surgery.Results:The efficacy in the treatment group was better than that in the control group in terms of clinical comprehensive curative effect and anal stenosis incidence(P<0.05);the scores of incision pain,wound bleeding,edema and wound recovery were lower in the treatment group than those in the control group(P<0.05).The scores of QOL-35 were increased at 30 d and 90 d after surgery in both groups,and the scores were higher in the treatment group than those in the control group at 30 d and 90 d after surgery(P<0.05).Conclusion:The dressing processed with Compound Huangbai Liquid is significantly effective in preventing delayed wound healing of old anal fissure after surgery based on the theory of‘Qu Fu Sheng Xin’.