青枝方对肛周脓肿术后创面愈合及炎性因子的影响

Effect of Qingzhi Decoction on Wound Healing and Inflammatory Factors after Perianal Abscess Surgery

目的观察青枝方水煎剂对肛周脓肿术后创面愈合的影响,探寻炎性因子的表达水平与预后的关系。方法依照治疗方案的不同将肛周脓肿患者100例分为观察组与对照组各50例。两组患者均采用肛周脓肿根治术治疗。对照组采用高锰酸钾坐浴,观察组采用青枝方水煎剂坐浴,直至创面愈合。统计两组临床疗效,比较两组患者术后不同时间点创面疼痛、创面渗出物、肉芽生长、创面愈合情况;采用流式荧光法检测血清炎性因子水平,比较两组患者术前及治疗7 d后血清炎性因子的变化情况。结果观察组治疗总有效率为98.00%,高于对照组的84.00%(P<0.05);观察组术后7 d创面疼痛、创面渗出物和肉芽生长情况评分低于对照组(P<0.05);观察组创面愈合时间均短于对照组(P<0.05)。两组组内前后对比,术后7 d血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平均低于术前(P<0.05);两组组间术后7 d对比,观察组血清TNF-α、IL-6水平均低于对照组,血清IL-4、IL-10值均高于对照组(P<0.05)。结论青枝方水煎剂坐浴能明显促进肛周脓肿患者术后肉芽生长和创面愈合,延缓或改善血清IL-4、IL-10分泌的减少,降低IL-6、TNF-α血清水平,减轻或抑制炎症反应,提高临床总有效率。

Objective:To observe the effect of Qingzhi Decoction on the healing of postoperative wounds in patients with perianal abscess and to explore the relationship between the expression levels of inflammatory factors and prognosis.Methods:A total of 100 cases of patients with perianal abscess were divided into an observation group and a control group of 50 patients each according to different treatment regimens.Both groups underwent radical surgery for perianal abscess.The control group received potassium permanganate sitz baths,while the observation group received Qingzhi Decoction sitz baths until the wound healed.The clinical efficacy was statistically analyzed,and the pain,exudate,granulation tissue growth,and healing of the wound at different postoperative time points were compared between the two groups.Serum inflammatory factor levels were detected using flow cytometric fluorescence,and the changes in serum inflammatory factors before and 7 days after treatment were compared between the two groups.Results:The overall effective rate in the observation group was 98.00%,which was higher than the 84.00%in the control group(P<0.05).The scores for postoperative pain,exudate,and granulation tissue growth in the observation group were lower than those in the control group 7 days after surgery(P<0.05).The healing time of the wounds in the observation group was shorter than that in the control group(P<0.05).Withingroup comparisons showed that the levels of serum tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interleukin-6(IL-6),and interleukin-10(IL-10)were lower 7 days after surgery than before surgery(P<0.05).Between-group comparisons 7 days after surgery showed that the serum levels of TNF-αand IL-6 were lower in the observation group than in the control group,and levels of IL-4 and IL-10 values were greater in the observation group(P<0.05).Conclusion:Qingzhi Decoction sitz baths can significantly promote the growth of granulation tissue and the healing of wounds in patients with perianal abscess after surgery,delay or improve the reduction in the secretion of serum IL-4 and IL-10,reduce the serum levels of IL-6 and TNF-α,alleviate or inhibit the inflammatory response,and increase the overall clinical efficacy.