自拟中药外洗方对肛周脓肿术后患者创面愈合进程的影响研究

Effects of Traditional Chinese Medicine External Washing Protocol on Process of Wound Healing in Patients After Perianal Abscess Surgery

目的:探讨自拟中药外洗方对肛周脓肿术后患者创面愈合进程的影响。方法:选取2019年3月至2023年3月该院肛周脓肿术后患者100例,依据简单随机数字表法分为观察组与对照组,各50例。对照组患者采用高锰酸钾坐浴治疗,观察组患者采取自拟中药外洗方,均治疗2周。统计两组患者干预前后中医证候积分、临床疗效、创面康复情况(肛门疼痛程度、创面出血情况和创面愈合情况)、创面愈合时间(腐肉脱落时间、创面上皮出现时间和创面愈合时间)、炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和白细胞介素8(IL-8)]水平、转化生长因子-β1(TGF-β1)及血管内皮生长因子(VEGF)水平。结果:干预后,两组患者肛周肿痛、口干便秘、恶寒发热、夜寐不安和小便困难评分较干预前降低,且观察组患者较对照组降低,差异均有统计学意义(P<0.05)。观察组患者治疗总有效率(47/50,94.00%)高于对照组(40/50,80.00%),差异有统计学意义(P<0.05)。干预后,两组患者肛门疼痛程度、创面出血情况和创面愈合情况评分较干预前降低,且观察组患者较对照组降低,差异均有统计学意义(P<0.05)。观察组患者腐肉脱落时间、创面上皮出现时间和创面愈合时间短于对照组,差异均有统计学意义(P<0.05)。干预后,两组患者血清IL-6、TNF-α和IL-8水平较干预前降低,且观察组患者较对照组降低;干预后,两组患者血清TGF-β1、VEGF水平较干预前升高,且观察组患者较对照组升高,上述差异均有统计学意义(P<0.05)。结论:采取自拟中药外洗方干预肛周脓肿术后患者,可有效缓解临床症状,改善创面愈合情况,下调炎症因子水平,上调TGF-β1、VEGF水平,利于提高疾病整体干预效果。

OBJECTIVE:To probe into the effects of traditional Chinese medicine external washing protocol on process of wound healing in patients after perianal abscess surgery.METHODS:Totally 100 patients with perianal abscess surgery in the hospital from Mar.2019 to Mar.2023 were extracted to be divided into the observation group and control group via the random number table method,with 50 cases in each group.The control group was treated with potassium permanganate sitz bath,while the observation group received traditional Chinese medicine external washing protocol,both groups were treated for 2 weeks.Traditional Chinese medicine syndrome scores,clinical efficacy,wound rehabilitation(degree of anal pain,wound bleeding and wound healing),wound healing time(time for rotting flesh shedding,time for wound epithelium emergence,time for wound healing),inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-8],transforming growth factor-β1(TGF-β1)and vascular endothelial growth factor(VEGF)levels before and after intervention were analyzed.RESULTS:After intervention,the scores of perianal swelling,dry mouth and constipation,chilliness and fever,restlessness and difficulty in urination in two groups were lower than those before intervention,and the observation group was lower than the control group,with statistically significant differences(P<0.05).The total effective rate of observation group(47/50,94.00%)was higher than that of control group(40/50,80.00%),the difference was statistically significant(P<0.05).After intervention,the scores of anal pain,wound bleeding and wound healing in two groups were lower than those before intervention,and the observation group was lower than the control group,with statistically significant differences(P<0.05).The time of rotting flesh shedding,wound epithelium emergence and wound healing in the observation group were shorter than those in the control group,with statistically significant differences;after intervention,serum levels of IL-6,TNF-αand IL-8 in two groups were lower than those before intervention,and the observation group was lower than the control group;after intervention,the serum levels of TGF-β1 and VEGF in two groups were higher than those before intervention,and the observation group was higher than the control group,with statistically significant differences(P<0.05).CONCLUSIONS:Application of traditional Chinese medicine external washing protocol in patients after perianal abscess surgery can effectively alleviate the clinical symptoms of patients,improve wound healing,reduce the levels of inflammatory factors,and up-regulate the levels of TGF-β1 and VEGF,which is conducive to improving the overall intervention effect.