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加味薏苡附子败酱散对复杂性肛瘘术后创面愈合及证候积分的影响
冯奇,葛丽娜,吴剑箫
0
石家庄市中医院肛肠一科石家庄 050051;河北省生殖医院生殖医学科石家庄 050000
摘要:
目的:探讨加味薏苡附子败酱散在复杂性肛瘘术后患者中的应用效果及对创面愈合及证候积分的影响。方法:选择2018年5月—2020年2月石家庄市中医院收治的复杂性肛瘘患者86例,随机分为两组,各43例。两组患者均拟行肛瘘切开挂线术治疗,对照组术后常规换药,并给予高锰酸钾混合温开水熏洗,早晚各换药1次,观察组在对照组基础上联合加味薏苡附子败酱散干预,两组均完成14 d干预并完成6个月随访,比较两组证候积分、术后创面愈合率、复发率、排便情况、肛门功能Williams评分及健康调查简表(SF-36)评分。结果:观察组手术后14 d 瘙痒(0.67±0.12)分、发热(0.75±0.19)分、肿痛(0.71±0.15)分、畏寒(0.70±0.16)分及流脓评分(0.78±0.21)分均低于对照组瘙痒(1.42±0.24)分、发热(1.40±0.23)分、肿痛(1.84±0.31)分、畏寒(1.76±0.29)分及流脓评分(1.56±0.23)分,差异有统计学意义(t=5.612、7.413、7.132、8.091、6.436,P=0.01);观察组手术后创面愈合率为93.02%,高于对照组74.42%,差异有统计学意义(χ2=7.493,P=0.032);观察组术后6个月复发率为2.33%,低于对照组16.28%,差异有统计学意义(χ2 =6.783,P=0.015);观察组手术后14 d 排便次数(0.74±0.11)分、排便困难(0.85±0.13)分、排便不尽(0.71±0.10)分及肛门功能Williams评分(0.78±0.14)分低于对照组排便次数(1.69±0.21)分、排便困难(1.52±0.21)分、排便不尽(1.69±0.21)分及肛门功能Williams评分(1.72±0.11)分,差异有统计学意义(t=7.125、6.404、 6.526、5.113,P=0.01);SF-36评分(89.34±6.15)分高于对照组(78.96±5.69)分(t=6.012,P=0.01)。结论:加味薏苡附子败酱散用于复杂性肛瘘患者术后能促进创面愈合,降低证候积分,改善患者肛门功能和生活质量,能缩短排便时间,降低术后复发率。
关键词:  加味薏苡附子败酱散  复杂性肛瘘  证候积分
DOI:10.3969/j.issn.1007-6948.2021.02.023
投稿时间:2020-09-27
基金项目:河北省中医药管理局科技计划(2019436)
Study on the Effect of Modified Yiyi Fuzi Baijiang Powder on Wound Healing and Syndrome Score after Complicated Anal Fistula Operation
FENG Qi,GE Li-na,WU Jian-xiao
First Department of Anorectal, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang (050051), China
Abstract:
Objective To explore the application effect of Jiawei Coix Fuzi Baijiang Powder in patients with complicated anal fistula surgery and its influence on wound healing and syndrome scores. Methods A total of 86 patients were selected as subjects, and the computerized random number method was divided into two groups, each with 43 cases. Both groups of patients were planned to undergo anal fistula incision and thread-drawing operation. The control group was routinely changed dressings after surgery. It was given potassium permanganate mixed with warm water for fumigation, once in the morning and once in the evening. The observation group was combined with the control group. Intervention with Yiyi Fuzi Baijiang San. Both groups completed 14-day intervention and completed a 6-month follow-up. The syndrome score, postoperative wound healing rate, recurrence rate, defecation, anal function Williams score and health survey summary (SF -36) score of the two groups were compared. Results 14 days after the operation, the observation group had pruritus (0.67±0.12) points, fever (0.75±0.19) points, swelling and pain (0.71±0.15) points, chills (0.70±0.16) points and pus score (0.78±0.21) points. The scores were lower than those of the control group for itching (1.42±0.24), fever (1.40±0.23), swelling and pain (1.84±0.31), chills (1.76±0.29) and pus score(1.56±0.23) (t =5.612, 7.413, 7.132, 8.091, 6.436, P=0.01). The wound healing rate of the observation group after surgery was 93.02% higher than that of the control group 74.42% (χ2=7.493, P=0.032). The observation group recurred 6 months after surgery. The rate of 2.33% was lower than that of the control group, 16.28% (χ2=6.783, P=0.015). The observation group had defecation times (0.74±0.11) points, dysfunction (0.85±0.13) points, and incomplete defecation (0.71±0.10) 14 days after surgery. Points and anal function Williams score (0.78±0.14) points were lower than control group' s defecation frequency (1.69±0.21) points, dysfunction (1.52±0.21) points, incomplete defecation (1.69±0.21) points and anal function Williams scores(1.72±0.11) points (t=7.125, 6.404, 6.526, 5.113, P=0.01); SF-36 score (89.34±6.15) points are higher than that of the control group (78.96±5.69) points (t=6.012, P=0.01). Conclusion Modi?ed Yiyi Fuzi Baijiang Powder can promote wound healing, reduce syndrome scores, improve patient’s anal function and quality of life, shorten defecation time and reduce postoperative recurrence rate in patients with postoperative complex anal ?stula.
Key words:  Modi?ed Yiyi Fuzi Baijiang Powder  complex anal ?stula  syndrome integral

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