苋归愈创方治疗热毒蕴结型低位肛周脓肿术后30例

Xiangui Yuchuang Fang in Treatment of Low Perianal Abscess with Heat-toxin Amassment Type after Operation in 30 Cases

目的探讨苋归愈创方治疗热毒蕴结型低位肛周脓肿术后的疗效。方法将60例热毒蕴结型低位肛周脓肿肛术后患者按随机数字表法分为治疗组和对照组各30例,治疗组予苋归愈创方坐浴,对照组予高锰酸钾溶液坐浴,1次/d,2组疗程均为14 d。比较2组术后第1、3、7天肛门疼痛VAS评分和创面分泌物量评分,手术前1天及术后第7、14天血清碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)水平及创面愈合时间及术后第7、14天创面愈合率,并于术后第21天比较2组疗效。结果术后第3、7天与术后第1天比较、术后第7天与术后第3天比较,2组肛门疼痛VAS评分和创面分泌物量评分均降低(P均<0.05),且术后第3、7天治疗组上述指标均低于对照组(P均<0.05);2组术后第7、14天与手术前1天比较及术后第14天与术后第7天比较,2组血清bFGF、VEGF、TGF-β1水平均升高(P均<0.05),术后第7、14天治疗组上述指标均高于对照组(P均<0.05);治疗组创面愈合时间短于对照组(P<0.05);术后第14天与术后第7天比较,2组创面愈合率均升高(P均<0.05),且术后第14天治疗组创面愈合率高于对照组(P<0.05);术后第21天,治疗组治愈率高于对照组(P<0.05)。结论苋归愈创方可减轻热毒蕴结型低位肛周脓肿术后患者肛门疼痛,减少创面分泌物,上调血清bFGF、VEGF与TGF-β1水平,促进创面愈合,具有临床推广价值。

Objective:To study the therapeutic effect of Xiangui Yuchuang Fang on low perianal abscess with heat-toxin amassment type after operation.Methods:Sixty patients with low perianal abscess of heat-toxin amassment type after operation were divided into treatment group and control group according to random number table method,with 30 patients in each group.The treatment group was treated with Xiangui Yuchuang Fang sitz bath,and the control group was treated with potassium permanganate solution sitz bath.All the administrations were performed once daily for 14 days.The visual analogue scale(VAS)score of anal pain and wound secretion score were evaluated on the 1st,3rd and 7th days after operation,and the serum levels of basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)were detected before operation and on the7th and 14th days after operation.The curative effect on the 21st day after operation and wound healing time were observed,and the wound healing rates on the 7th and 14th days after operation were calculated.Results:Compared with the 1st day after operation,the VAS scores of anal pain and wound secretion scores of both groups decreased significantly on the 3rd and 7th days after operation(P<0.05);compared with that before operation,the serum levels of bFGF,VEGF and TGF-β1 on the 7th and 14th days after operation increased significantly(P<0.05).The VAS scores of anal pain and wound secretion scores on the 7th day after operation were significantly lower than those on the 3rd day after operation in both groups(P<0.05),and the serum levels of bFGF,VEGF and TGF-β1 on the 14th day after operation were significantly higher than those on the 7th day after operation(P<0.05).Compared with the control group,the VAS scores of anal pain and wound secretion scores of the treatment group decreased significantly on the 3rd and 7th days after operation(P<0.05);the serum levels of bFGF,VEGF and TGF-β1 increased significantly on the 7th and 14th days after operation(P<0.05);the wound healing rate increased significantly on the 14th day after operation(P<0.05),the wound healing time shortened significantly(P<0.05).Conclusion:Xiangui Yuchuang Fang can relieve the anal pain,reduce the wound secretion,promote the wound healing and increase the serum levels of bFGF,VEGF and TGF-β1 in patients with low perianal abscess of heat-toxin amassment type after operation.