清毒排脓汤加减冲洗治疗急性高位肛周脓肿的疗效及对创面愈合的影响

Curative Effect of Irrigation Therapy with Modified Qingdu Painong Decoction(清毒排脓汤加减)on Acute High Perianal Abscess and Its Influences on Wound Healing

目的分析清毒排脓汤加减冲洗治疗急性高位肛周脓肿(acute high perianal abscess,AHPA)的疗效及对创面愈合的影响。方法选取医院2020年1月—2021年12月102例AHPA患者,随机数字表法分为观察组(51例)及对照组(51例)。两组均接受高位虚挂线术治疗,对照组术后采用高锰酸钾坐浴治疗,观察组术后采用清毒排脓汤随症加减冲洗治疗。比较两组临床疗效、创面愈合情况、炎症因子水平[白细胞介素(interleukin,IL)-8、肿瘤坏死因子-α(tumor necorsis factor-α(TNF-α)、IL-6]、肛门功能[肛管最大收缩压(maximum systolic pressure of anal canal,MASP)、肛管静息压(anal tube resting pressure,ARP)]。结果观察组总有效率为92.16%(47/51),高于对照组的76.47%(39/51)(P<0.05);观察组治疗后7 d、14 d创面肉芽形态、创面渗液、肛门水肿及疼痛等评分均低于对照组(P<0.05);观察组创面腐肉脱落时间、创面渗液消失时间、住院时间、创面愈合时间均短于对照组(P<0.05);观察组治疗后血清IL-8、TNF-α、IL-6均低于对照组(P<0.05);观察组治疗后MASP、ARP均低于对照组(P<0.05)。结论清毒排脓汤随症加减冲洗治疗AHPA疗效显著,能有效促进创面愈合,缓解炎症反应,改善肛门功能。

Objective To analyze the curative effect of irrigation therapy with Modified Qingdu Painong Decoction(清毒排脓汤加减)on acute high perianal abscess(AHPA)and its influences on wound healing.Methods A total of 102 patients with AHPA in the hospital were enrolled between January 2020 and December 2021.According to random number table method,they were divided into observation group(51 cases)and control group(51 cases).Both groups underwent high loose thread-drawing.After that,the control group was treated with potassium permanganate for sitz bath,while the observation group was given irrigation therapy with Modified Qingdu Painong Decoction.The clinical curative effect,wound healing,levels of inflammatory factors[interleukin(IL)-8,tumor necrosis factor-α(TNF-α),IL-6]and anal function[maximum anal systolic pressure(MASP),anal canal rest pressure(ARP)]were compared between the two groups.Results The total response rate of the observation group was higher than that of control group[92.16%(47/51)vs 76.47%(39/51)](P<0.05).At 7 d and 14 d after treatment,the scores of wound granulation morphology,wound exudate,anal edema and pain in the observation group were all lower than those in the control group(P<0.05).The shedding time of wound carrion,disappearance time of wound exudate,hospitalization time and wound healing time in the observation group were shorter than those in the control group(P<0.05).After treatment,the levels of serum IL-8,TNF-αand IL-6 in the observation group were lower than those in the control group(P<0.05).The levels of MASP and ARP were lower than those in the control group(P<0.05).Conclusion The curative effect of irrigation therapy with Modified Qingdu Painong Decoction is significant on AHPA,which can effectively promote the wound healing,relieve the inflammation response and improve the anal function.