摘要
目的 观察肛肠坐浴方对肛肠疾病湿热下注证患者术后创面愈合的影响。方法 将92例肛肠疾病湿热下注证术后患者随机分为治疗组46例、对照组46例。治疗组予肛肠坐浴方泡洗治疗,对照组予3%硼酸溶液洗剂泡洗治疗。观察2组临床疗效、创面愈合率、创面愈合时间、临床症状评分(肛周创面伤口疼痛、创面渗液和创面水肿评分)、血清C反应蛋白(CRP)水平、创面成纤维细胞含量、创面胶原纤维面积。结果 治疗组46例中,痊愈28例,显效12例,有效4例,无效2例,总有效率为95.65%;对照组46例中,痊愈24例,显效8例,有效5例,无效9例,总有效率为80.43%。经秩和检验,Z=-2.237,P=0.025,说明治疗组临床疗效明显优于对照组。治疗组在术后第7、14天创面愈合率均优于对照组,差异有统计学意义(P<0.05)。治疗组创面愈合时间为(13.41±4.86) d,对照组创面愈合时间为(15.76±5.31) d,治疗组较对照组缩短明显,差异有统计学意义(P<0.05)。2组术后不同时间肛周创面疼痛评分比较结果显示:术后第3天开始,2组肛周创面疼痛评分逐渐降低,不同时间点间差异有统计学意义(P<0.05);2组间肛周创面疼痛评分差异有统计学意义(P<0.05),治疗组的肛周创面疼痛评分明显低于对照组;随着治疗时间的延长,治疗组与对照组的肛周创面疼痛评分降低幅度不同,治疗组明显优于对照组(P<0.05)。2组术后不同时间肛周创面渗液评分比较结果显示:术后第3天开始,2组肛周创面渗液评分逐渐降低,不同时间点间差异有统计学意义(P<0.05);2组间肛周创面渗液评分差异有统计学意义(P<0.05),治疗组的肛周创面渗液评分明显低于对照组;随着治疗时间的延长,治疗组与对照组的肛周创面渗液评分降低幅度不同,治疗组明显优于对照组(P<0.05)。2组术后不同时间肛周创面水肿评分比较结果显示:术后第3天开始,2组肛周创面水肿评分逐渐降低,不同时间点间差异有统计学意义(P<0.05);2组间肛周创面水肿评分差异有统计学意义(P<0.05),治疗组的肛周创面水肿评分明显低于对照组;随着治疗时间的延长,治疗组与对照组的肛周创面水肿评分降低幅度不同,治疗组明显优于对照组(P<0.05)。2组术后不同时间血清CRP水平比较:术后第3天开始,2组患者血清CRP水平逐渐降低,不同时间点间差异有统计学意义(P<0.05);2组间血清CRP水平差异有统计学意义(P<0.05),治疗组血清CRP水平明显低于对照组;随着治疗时间的延长,治疗组与对照组的血清CRP水平降低幅度不同,治疗组明显优于对照组(P<0.05)。治疗组镜下成纤维细胞数为(75.24±18.86)个,对照组镜下成纤维细胞数为(42.67±16.75)个,说明治疗组明显优于对照组,2组比较差异有统计学意义(P<0.05)。治疗组镜下胶原纤维面积(31.37±8.00)%,对照组镜下胶原纤维面积(23.47±8.29)%,说明观察组明显优于对照组,2组比较差异有统计学意义(P<0.05)。结论 肛肠坐浴方可促进肛肠疾病湿热下注证患者术后创面愈合,减轻术后相关症状,缩短创面愈合时间。
Objective To observe the effect of a TCM hip bath formula on postoperative wound healing of patients with anorectal diseases characterized by damp-heat pouring downward.Methods 92 patients with anorectal diseases characterized by damp-heat pouring downward who have undergone operations were randomly divided into the treatment group(46 cases) and the control group(46 cases). The treatment group was given hip baths and the control group was treated with 3% boric acid solution. The clinical efficacy, wound healing rate, wound healing time, clinical symptom scores(perianal wound pain, wound exudation and wound edema scores), serum C-reactive protein(CRP) level, wound fibroblast content and wound collagenous fiber area were observed.Results In the treatment group of 46 cases, 28 cases were cured, 12 cases were significantly effective, 4 cases were effective, 2 cases were ineffective, and the total effective rate was 95.65%;In the control group of 46 cases, 24 cases were cured, 8 cases were significantly effective, 5 cases were effective, and 9 cases were ineffective. The total effective rate was 80.43%. The rank sum test showed Z=-2.237, P=0.025, indicating that the clinical efficacy of the treatment group is significantly better than that of the control group. The wound healing rate of the treatment group was better than that of the control group on the 7 th and 14 th day after operation, and the difference was statistically significant(P<0.05). The wound healing time in the treatment group was(13.41±4.86) d, and that in the control group was(15.76±5.31) d, suggesting that it took a significantly shorter amount of time for the treatment group to heal than for the control group, and the difference was statistically significant(P<0.05). The comparison of perianal wound pain scores between the two groups at different times after operation showed that from the third day after operation, the perianal wound pain scores of the two groups gradually decreased, and the differences between the various time points was statistically significant(P<0.05);There was significant difference in the pain scores of perianal wounds between the two groups(P<0.05). The pain scores of perianal wounds in the treatment group was significantly lower than that in the control group;With the extension of treatment time, the pain scores of perianal wounds in the treatment group and the control group decreased differently, and the treatment group was significantly better than the control group(P<0.05). The comparison of perianal wound exudation scores between the two groups at different times after operation showed that from the third day after operation, the perianal wound exudation scores of the two groups gradually decreased, and the difference between different time points was statistically significant(P<0.05);There was significant difference in perianal wound exudation scores between the two groups(P<0.05). The perianal wound exudation scores of the treatment group was significantly lower than that of the control group;With the extension of treatment time, the reduction of perianal wound exudation scores in the treatment group and the control group was different, and the treatment group was significantly better than the control group(P<0.05). The comparison of perianal wound edema scores between the two groups at different times after operation showed that the perianal wound edema scores of the two groups gradually decreased from the third day after operation, and the difference between different time points was statistically significant(P<0.05);There was significant difference in perianal wound edema scores between the two groups(P<0.05). The perianal wound edema scores of the treatment group was significantly lower than that of the control group;With the extension of treatment time, the reduction of perianal wound edema scores in the treatment group and the control group was different, and the treatment group was significantly better than the control group(P<0.05). Comparison of serum CRP levels in the two groups at different times after operation: from the third day after operation, the serum CRP levels in the two groups gradually decreased, and the difference between different time points was statistically significant(P<0.05);There was significant difference in the level of serum CRP between the two groups(P<0.05). The perianal serum CRP in the treatment group was significantly lower than that in the control group;With the extension of treatment time, the reduction of serum CRP in the treatment group was different from that in the control group, and the treatment group was significantly better than that in the control group(P<0.05). The number of fibroblasts under microscope in the treatment group was(75.24±18.86) and that in the control group was(42.67±16.75), indicating that the treatment group was significantly better than the control group, and the difference was statistically significant(P<0.05). The area of collagen fibers under microscope in the treatment group was(31.37±8.00)% and that in the control group was(23.47±8.29)%, indicating that the treatment group was significantly better than the control group, and the difference was statistically significant(P<0.05).Conclusions The hip bath can promote wound healing of patients with anorectal diseases characterized by damp-heat pouring downward, relieve postoperative related symptoms, and shorten wound healing time.
作者
刘建乔
吴承东
刘仍海
张羽
李宇栋
LIU Jianqiao;WU Chengdong;LIU Renghai;ZHANG Yu;LI Yudong(Department of Proctology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010;Department of Proctology,Dongfang Hospital,Beijing University of Chinese Medicine)
出处
《现代中医临床》
2022年第5期7-12,18,共7页
Modern Chinese Clinical Medicine
基金
北京市优秀人才培养资助青年骨干个人项目(No.2018000021469G253)
北京中医医院院级课题暨两院合作课题(No.YJ-201723)。
关键词
肛肠术后
肛肠坐浴方
创面愈合
湿热下注证
postoperative care of anorectal diseases
TCM hip bath formula
wound healing
damp-heat pouring downward
作者简介
刘建乔,男,硕士,主治医师;通信作者:吴承东,男,副主任医师,E-mail:wuchengdong2@126.com。
