| 摘要: |
| 目的:观察解毒生肌汤溻渍配合紫草油纱换药促进肛瘘多切口浮线引流术后创面愈合的疗效。方法:将112 例接受肛瘘多切口浮线引流手术患者随机分为对照组与观察组各56 例，两组均予常规治疗。对照组于便后采用温水溻渍并紫草油纱条塞入，观察组采用解毒生肌汤溻渍联合紫草油纱辅助引流，观察两组第1、4、9、14 天和1、2 个月的肛瘘创面分泌物渗出及伤口水肿、疼痛程度、创面愈合率及愈合时间等。结果:术后第4、9、14 天，观察组创面分泌物评分分别为(3.74±0.42)分、(3.55±0.51)分、(3.11±0.37)分，高于对照组的(3.41±0.62)分、(3.23±0.54)分、(2.74±0.47)分，差异有统计学意义(P ＜ 0.05)。观察组创面水肿评分(1.26±0.26)分，明显低于对照组的(2.74±0.48)分。观察组术后第9、14 天和1、2 个月创面愈合率分别(15.17±3.48)%、(31.28±2.74)%、(65.18±7.15)%、(85.21±6.18)%，高于对照组的(9.31±2.15)%、(19.37±2.71)%、(45.27±6.18)%、(79.38±5.48)%，差异有统计学意义(P ＜ 0.05)。对照组创面愈合时间为(46.37±5.27)d，明显高于观察组的(57.24±8.12)d，观察组术后第4、9、14 天和1 个月疼痛VAS 评分分别为(7.24±1.02)分、(5.94±0.84)分、(3.75±0.49)分、(2.57±0.31)分，低于对照组的(8.01±1.28)分、(6.27±0.87)分、(4.31±0.47)分、(3.15±0.25)分，差异均有统计学意义(P ＜ 0.05)。结论:解毒生肌汤溻渍联合紫草油纱条换药可显著增加肛瘘多切口浮线引流术后前期良性渗出，减轻创面水肿，降低患者术后疼痛程度，加快创面愈合。 |
| 关键词: 解毒生肌汤 溻渍疗法 紫草油纱 肛瘘手术 |
| DOI：10.3969/j.issn.1007-6948.2020.02.012 |
| 投稿时间：2019-10-11 |
| 基金项目:四川省中医药管理局科学技术研究专项项目(2018QN021) |
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| Application of Jiedu Shengji Decoction and Lithocarpic Oil Yarn in Postoperative Anal Fistula |
| HOU Yanmei,HE Tao-hong,ZHOU Ce |
| Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu610000, China |
| Abstract: |
| Objective To observe the clinical effect of self-made Jiedu Shengji Decoction and comfrey oil yarn assisted drainage in promoting wound healing after anal fistula multi-incision floating drainage. Methods A total of 112 patients who underwent anal fistula and incision drainage during the period were randomly divided into control group and observation group. The two groups of patients were treated with conventional anti-infective treatment. The control group was treated with warm water fumigation after washing,and the comfrey oil gauze was inserted into the anus. The patients in the observation group were treated with detoxifying and stimulating the skin soup and comfrey oil yarn to assist drainage. Group patients changed their dressing twice a day. The indexes of exudation and wound edema, degree of pain, wound healing rate and healing time of anal fistula wounds in the first, the fourth, the ninth and the 14th day, the first and the second month were observed respectively. Results On the 4th, 9th and 14th day after operation, the wound secretion scores of the observation group were(3.74±0.42), (3.55±0.51) and (3.11±0.37).The control group scores were(3.41±0.62), (3.23±0.54) and (2.74±0.47),which are higher than the observation group (P <0.05). There was no significant difference in wound secretion between the two groups at 1st and 2nd months after operation(P >0.05). The wound edema score of the observation group was (1.26±0.26), which was significantly lower than that of the control group (2.74±0.48). The wound healing rates of the observation group at the 9th, 14th day and the 1st and 2nd month were(15.17±3.48), (31.28±2.74), (65.18±7.15) and(85.21±6.18) respectively. The control groups were(9.31±2.15), (19.37±2.71), (45.27±6.18) and (79.38±5.48). The wound healing rate of the observation group was signi?cantly higher than that of the control group at the 9th, 14th day and the 1st and 2nd month after operation (P<0.05). The wound healing time of the control group was (46.37±5.27), which was signi?cantly higher than that of the observation group (57.24±8.12) (P<0.05). The pain VAS scores of the observation group at the 4th, 9th, 14th day and the 1st month were (7.24±1.02), (5.94±0.84), (3.75±0.49) and (2.57±0.31), the control groups were (8.01±1.28), (6.27±0.87), (4.31±0.47) and (3.15±0.25). The pain VAS scores of the observation group were signi?cantly lower on the 4th, 9th, 14th day and the 1st postoperative day in the control group (P<0.05). Conclusion The prescription detoxifying Shengji Decoction combined with comfrey oil gauze can signi?cantly increase the benign exudation in the early postoperative period, relieve the edema of the wound, reduce the postoperative pain and accelerate the wound healing, which is suitable for clinical promotion. |
| Key words: Jiedu Shengji Decoction fumigation lithocarpic oil yarn anal ?stula operation |
