祛腐化瘀生肌汤熏蒸坐浴在高位复杂性肛瘘术后的应用效果

Applicative Effect Analysis of Qufu Huayu Shengji Decoction Fumigation Sitting Bath after Operation of High Complex Anal Fistula

目的分析祛腐化瘀生肌汤熏蒸坐浴在高位复杂性肛瘘(HCAF)术后的应用效果。方法选取2019年1月至2020年10月蚌埠市第三人民医院院收治的104例HCAF手术患者为研究对象,按照不同治疗方法分为对照组和观察组,每组52例。其中,对照组给予常规坐浴治疗,观察组给予祛腐化瘀生肌汤蒸熏坐浴治疗,均治疗7 d。比较两组的临床疗效,创面恢复时间(新生上皮出现时间、创口愈合时间)、疼痛评分[视觉模拟评分法(VAS)评分]、炎症相关指标[白细胞计数(WBC)、中性粒细胞百分比(NEUT%)、红细胞沉降率(ESR)、C反应蛋白(CRP)]水平变化及不良反应发生情况。结果观察组的总效率高于对照组[94.23%(49/52)比80.77%(42/52)](P<0.05)。观察组的新生上皮出现时间、创口愈合时间均短于对照组[(4.2±1.3)d比(5.0±1.9)d、(9.7±2.4)d比(14.0±3.1)d](P<0.05)。不同时点间、组间VAS评分的主效应差异有统计学意义(P<0.01);时点间与组间不存在交互作用(P>0.05)。与术后1 d相比,术后3、7 d两组的VAS评分均降低,且观察组低于对照组(P<0.05)。不同时点间、组间WBC、NEUT%、ESR、CRP的主效应差异有统计学意义(P<0.05);时点间与组间存在交互作用(P<0.05)。与术后1 d相比,术后7 d两组的WBC、NEUT%、ESR、CRP水平均降低,且观察组低于对照组(P<0.05)。两组的不良反应发生率比较差异无统计学意义(P>0.05)。结论祛腐化瘀生肌汤熏蒸坐浴治疗能有效缓解肛瘘术后疼痛,降低炎症相关指标表达水平,缩短创面愈合时间。

Objective To analyze the applicative effect of Qufu Huayu Shengji decoction fumigation sitting bath after operation of high complex anal fistula(HCAF).Methods A total of 104 HCAF patients admitted to the Third People′s Hospital of Bengbu from Jan.2019 to Oct.2020 were included,and divided into a control group and an observation group according to different treatment methods,with 52 patients in each group.The control group was given routine sitting bath treatment,and the observation group was given Qufu Huayu Shengji decoction fumigation sitting bath treatment,for 7 days.The clinical efficacy of the two groups,recovery time of wound(emergence time of new epithelium and wound healing time),pain score[visual analogue scale(VAS)score],the levels of inflammation related indicators[white blood cell count(WBC),neutrophilic granulocyte percentage(NEUT%),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)]level change and the occurrence of adverse reactions were compared.Results The total effective rate of the observation group was higher than that of the control group[94.23%(49/52)vs 80.77%(42/52)](P<0.05).The emergence time of new epithelium and wound healing time in the observation group were shorter than those in the control group[(4.2±1.3)d vs(5.0±1.9)d,(9.7±2.4)d vs(14.0±3.1)d](P<0.05).The main effect difference of VAS score between different time points and groups was statistically significant(P<0.01),there was no interaction between time points and groups(P>0.05).Compared with 1 d after operation,the VAS score of the two groups decreased on 3 and 7 d after operation,and the VAS score of the observation group was lower than that of the control group(P<0.05).The main effect differences of WBC,NEUT%,ESR and CRP between different time points and groups were statistically significant(P<0.05),and there were interactions between time points and groups(P<0.05).Compared with 1 d after operation,the levels of WBC,NEUT%,ESR and CRP in the two groups decreased 7 d after operation,and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qufu Huayu Shengji decoction fumigation sitting bath can effectively relieve postoperative pain of anal fistula,reduce the expression level of inflammatory indicators,and shorten the wound healing time.