生肌化瘀方联合痔瘘洗液对老年复杂性肛瘘患者术后创面愈合及创面肉芽组织Bcl-2、Bax表达的影响

Effects of shengji huayu recipe combined with hemorrhoid fistula lotion on postoperative wound healing and expression of Bcl-2 and Bax in wound granulation tissue in elderly patients with complex anal fistula

目的 探究生肌化瘀方联合痔瘘洗液对老年复杂性肛瘘患者术后创面愈合及创面肉芽组织B淋巴细胞瘤(B-cell lymphoma,Bcl)-2蛋白、Bcl-2相关X(Bcl-2 associated X protein,Bax)蛋白表达的影响。方法 选取我院收治的80例复杂性肛瘘患者,按随机数字表法分为常规组及试验组,每组40例。常规组给予痔瘘洗液治疗,试验组在常规组基础上加用生肌化瘀方治疗,比较2组治疗效果。结果 试验组总有效率、创面愈合率高于常规组,创面疤痕面积小于常规组(P <0.05);治疗后2组瘙痒、水肿、渗出及疼痛等症状评分以1分为主,且常规组评分分布更低(P <0.05);治疗后试验组放线菌门、变形菌门、Bax水平低于常规组,拟杆菌门、厚壁菌门以及Bcl-2水平高于常规组(P <0.05);2组治疗期间均未发生不良反应;出院后随访6个月,试验组复发率低于常规组(χ^(2)=4.507,P=0.034)。结论 生肌化瘀方联合痔瘘洗液在老年复杂性肛瘘术后患者中应用效果显著,可有效促使创面愈合及症状改善,减轻创面疤痕及机体炎症,调节菌群分布,抑制创面细胞凋亡,且安全性较高。

Objective To explore the effect of Shengji Huayu recipe combined with hemorrhoid fistula lotion on postoperative wound healing and the expression of B-cell lymphoma(Bcl)-2 protein and Bcl-2 associated X protein(Bax)in wound granulation tissue after complicated anal fistula surgery.Methods A total of 80 patients with complex anal fistulas treated at our hospital were selected and randomly divided into the control group and the experimental group according to the random number table method,with 40 cases in each group.The control group received routine treatment with anal fistula cleansing solution,while the experimental group received Shengji Huayu recipe on the basis of the control group.The therapeutic effects were compared between the two groups.Results The total effective rate and wound healing rate of the experimental group were higher than those of the control group,and the scar area of the wound was smaller than that of the control group(P<0.05).After treatment,the symptom scores of pruritus,edema,exudation and pain in the two groups were mainly 1 point,and the score distribution in the experimental group was lower than that of the control group(P<0.05).After treatment,the levels of Actinobacteria,Proteobacteria and Bax in the experimental group were lower than those of the control group,and the levels of Bacteroides,Firmicutes and Bcl-2 were higher than those of the control group(P<0.05).No adverse reactions occurred in the two groups during treatment.During the follow-up of 6 months after discharge,the recurrence rate of the experimental group was lower than that of the control group(χ^(2)=4.507,P=0.034).Conclusion Shengji Huayu recipe combined with Hemorrhoid Fistula Lotion has a significant effect in the application of elderly patients with complicated anal fistula surgery,which can effectively promote wound healing and symptom improvement,reduce wound scars and body inflammation,regulate the distribution of flora,and inhibit wound cell apoptosis.And it has high safety.