萆薢渗湿汤对肛瘘栓填塞修补术后湿热下注证的疗效

Effect of Bixie Shenshi Decoction on the dampness-heat syndrome in patients after caulking and repairment of anal fistula plugs

目的 探讨萆薢渗湿汤治疗肛瘘栓填塞修补术后湿热下注证患者的疗效及对创面愈合、创面组织胶原蛋白Ⅰ型(collagen typeⅠ,COLⅠ)、胶原蛋白Ⅲ型(collagen typeⅢ,COLⅢ)表达的影响。方法 选取80例肛瘘患者作为研究对象,按照随机数字表法分为观察组(40例,采用肛瘘栓填塞修补术联合萆薢渗湿汤治疗)和对照组(40例,采用肛瘘栓填塞修补术治疗)。观察2组患者治疗后的临床疗效、创面愈合情况、创面组织COLⅠ和COLⅢ的表达情况、症状积分以及并发症。结果 治疗后,观察组的临床总有效率(67.50%)高于对照组(45.00%),P<0.05。2组创面愈合情况评分组间、时间点及交互比较差异均有统计学意义(P<0.001),观察组术后3、7、14 d创面愈合情况均显著优于对照组(P<0.05)。治疗前,2组患者创面组织COLⅠ、COLⅢ表达情况比较差异无统计学意义(P>0.05);治疗2个月后,观察组患者创面组织COLⅠ、COLⅢ表达情况高于对照组(P<0.05)。治疗前,2组患者肛周流脓、局部刺痛感、形体困重和大便黏腻不爽等症状积分比较差异无统计学意义(P>0.05);治疗后,观察组患者肛周流脓、局部刺痛感、形体困重和大便黏腻不爽等症状积分均低于对照组患者(P<0.05)。治疗2个月后,观察组肛门红肿、创面感染和出血等并发症总发生率低于对照组(P<0.05)。结论 萆薢渗湿汤治疗肛瘘栓填塞修补术后湿热下注证疗效确切,能够提高创面愈合率,提升创面组织COLⅠ、COLⅢ的表达情况,改善中医症状,降低并发症发生的风险。

Objective To investigate the curative effect of Bixie Shenshi Decoction on the damp-heat syndrome in patients after caulking and repairment of anal fistula plug,and the effect on wound healing and the expression of collagen typeⅠ(COLⅠ)and collagen typeⅢ(COLⅢ)in wound tissue.Methods A total of 80 patients with anal fistula were selected as research objects,and were divided into observation group(40 cases treated with anal plugging and repairment combined with Bixie Shenshi Decoction)and control group(40 cases treated with anal plugging and repairing only)according to random number table method.The clinical efficacy,wound healing,expressions of COLⅠand COLⅢin wound tissue,symptom scores and complications were observed.Results After treatment,the total clinical effective rate of the observation group was 67.50%,higher than that of the control group 45.00%(P<0.05).There were statistically significant differences in the evaluation of wound healing between the 2 groups(P<0.001).The wound healing of the observation group was significantly higher than that of the control group on the 3rd,7th and 14th days after surgery(P<0.05).Before treatment,there was no difference in the expressions of COLⅠand COLⅢin wound tissues between the 2 groups(P>0.05).After 2 months of treatment,the expressions of COLⅠand COLⅢin wound tissue of observation group were higher(P<0.05).Before treatment,there was no difference in the scores of symptoms such as perianal pus flow,local tingling sensation,body congestion and sticky stool between the 2 groups(P>0.05).After treatment,the scores of perianal pus,local tingling,body weight,sticky stool and other symptoms in observation group were lower(P<0.05).After 2 months of treatment,the incidence of total complications such as anal swelling,wound infection and bleeding in the observation group was lower(P<0.05).Conclusion Bixie Shenshi Decoction is effective in treating the damp-heat syndrome after caulking and repairing anal fistula plug.It can improve the wound healing rate,enhance the expressions of COLⅠand COLⅢin wound tissue,improve the symptoms of traditional Chinese medicine and reduce the risk of complications.