肛周难愈性创面的中西医研究进展

A review on treating perianal refractory wounds in traditional Chinese medicine and Western medicine

难愈性创面的治疗时间长,难度大,疗效差,患者依从性低,发生在肛周的难愈性创面有过之而无不及,患者的生活质量受到的影响也比较严重,病程日久可对患者造成严重的心理负担,是临床医疗中亟待解决的难题。近年来随着基础研究的不断深入及新的治疗技术的应用,中医和西医对本病的认识和治疗水平逐步提高和加深。文章总结了近年来中医对本病病因病机的认识及中医内治和外治不同治疗方法对本病的治疗效果,西医对本病的形成机制和微观物质对创面愈合的影响及药物或现代治疗手段对本病的治疗效果。中医主要从阴阳、整体观念、脏腑、气血等理论知识对难愈性创面发病机制进行阐述,通过内治和外治药物达到治疗本病的效果,西医主要分析各类细胞因子、酶类及细菌生物膜等对创面愈合的影响,通过运用各种医疗技术、生长因子、新型生物材料和创面修复敷料来促进创面的愈合。通过中医和西医各自对本病的认知,期望对了解本病的发生机制和治疗有一定的指导作用,也为临床实际治疗过程中能综合运用多种治疗手段及中西医结合的思想带来启发,达到全面而又有针对性地快速治愈疾病的目的。

The treatment time of refractory wounds is long,the treatment is difficult,the efficacy is poor,and the compliance of patients is low.The perianal refractory wounds are even worse,and the quality of life of patients is also seriously affected.The long course of disease can cause serious psychological burden to patients,which is a medical problem to be solved urgently in clinical treatment.In recent years,with the deepening of basic research and the application of new treatment techniques,the understanding and treatment level of TCM and Western medicine on the disease have gradually improved and deepened.The paper summarizes the knowledge of TCM on the etiology and pathogenesis of this disease in recent years,the therapeutic effect of different internal and external treatment methods of TCM,the formation mechanism of this disease and the influence of microscopic substances on wound healing of Western medicine,and the therapeutic effect of drugs or modern treatment methods on this disease.TCM mainly expounds the pathogenesis of perianal refractory wounds from Yin(阴) and Yang(阳),holistic concept,zang-fu organs(脏腑),Qi(气)-blood and other theoretical knowledge,and achieves the effect of treating the disease through internal and external drugs.Western medicine mainly analyzes the influence of various cytokines,enzymes and bacterial biofilms on wound healing.The healing of wounds is promoted through the use of various medical technologies,growth factors,novel biomaterials and wound repair dressings.Through the cognition of TCM and Western medicine on the disease,it is expected to have a certain guiding role in understanding the pathogenesis and treatment of the disease,and also bring inspiration for the actual clinical treatment process to use a variety of treatment means and the idea of combining TCM and Western medicine,so as to achieve a comprehensive and targeted rapid cure of the disease.