摘要
目的探讨中药熏蒸联合透脓散加减治疗肛周脓肿术后创面愈合的疗效及其对肛门功能、炎症因子、生长因子的影响。方法选取2022年3月至2024年3月该院收治的193例肛周脓肿术后患者作为研究对象,根据患者是否愿意使用中药熏蒸治疗分为观察组(102例)和对照组(91例),进一步采用Python进行倾向性匹配分析,按1∶1匹配原则均衡治疗前易混杂因素,最终2组各有60例配对成功。对照组以透脓散加减联合常规清洗治疗,观察组在对照组基础上增加中药熏蒸治疗。比较2组临床疗效、中医证候积分、创面相关指标评分、肛门功能指标水平、炎症因子水平、生长因子水平及不良反应。结果观察组总有效率为93.33%,高于对照组的78.33%,差异有统计学意义(P<0.05)。观察组治疗后肛周肿痛、肉腐成脓、恶寒发热、舌红苔黄积分均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后创面视觉模拟评分法评分、水肿评分、渗液评分均低于对照组,创面肉芽生长评分高于对照组,差异均有统计学意义(P<0.05)。观察组治疗后肛管最大收缩压、肛管静息压、直肠最大耐受阈值均高于对照组,差异均有统计学意义(P<0.05)。观察组治疗后白细胞介素-6、降钙素原、超敏C反应蛋白水平均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后血管内皮生长因子、成纤维生长因子、表皮生长因子水平均高于对照组,差异均有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论中药熏蒸联合透脓散加减对肛周脓肿术后有良好的疗效,可促进创面愈合,改善中医证候积分,改善患者创面状态,提升肛门肌群压力水平,抑制炎症因子水平,提高各种生长因子水平,且安全性较好。
Objective To investigate the curative effect of traditional Chinese medicine fumigation combined with Toupyosan on wound healing after perianal abscess surgery and its influence on anal function,inflammatory factors and growth factors.Methods A total of 193 postoperative patients with perianal abscess admitted to the hospital from March 2022 to March 2024 were selected as the research objects,and they were divided into observation group(102 cases)and control group(91 cases)according to whether they were willing to use traditional Chinese medicine fuming treatment.Python was further used for propensity score matching analysis,and the confounding factors before treatment were balanced by 1∶1.Finally,60 cases in each group were successfully matched.The control group was treated with addition and reduction of Toupyosan plus conventional cleaning,and the observation group was treated with traditional Chinese medicine fumigation on the basis of the control group.The clinical efficacy,TCM syndrome score,wound related index score,anal function index level,inflammatory factor level,growth factor level,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 93.33%,which was higher than 78.33%of the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of perianal swelling and pain,pus of flesh rot,cold and fever,red tongue and yellow fur in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the visual analogue scale score,edema score,and exudation score of the observation group were lower than those of the control group,and the wound granulation growth score was higher than that of the control group,and the differences were statistically significant(P<0.05).After treatment,the anal maximum systolic pressure,anal resting pressure and rectal maximum tolerance threshold in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of interleukin-6,procalcitonin and high-sensitivity C reactive protein in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of vascular endothelial growth factor,fibroblast growth factor and epidermal growth factor in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Traditional Chinese medicine fumigation combined with Toupyosan has a good effect on perianal abscess after operation,which can promote wound healing,improve the state of TCM score,improve the wound state of patients,increase the pressure level of anal muscle group,inhibit the level of inflammatory factors,and improve the level of growth factors,with good safety.
作者
张坤
赵雪芳
郭金玲
冯江敏
尤明辉
王立波
渠兴甫
赵娜
王光娜
王帅
ZHANG Kun;ZHAO Xuefang;GUO Jinling;FENG Jiangmin;YOU Minghui;WANG Libo;QU Xingfu;ZHAO Na;WANG Guangna;WANG Shuai(Department of Anorectal Surgery,the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine,Baoding,Hebei 073000,China)
出处
《检验医学与临床》
2025年第19期2644-2649,共6页
Laboratory Medicine and Clinic
基金
河北省中医药管理局中医药类科学研究课题计划项目(2023307)。
关键词
肛周脓肿
透脓散加减
中药熏蒸
创面愈合疗效
肛门功能
炎症因子
perianal abscess
addition and subtraction of Toupyosan
traditional Chinese medicine fumigation
wound healing efficacy
anal function
inflammatory factor
作者简介
张坤,男,主治医师,主要从事中西医结合肛肠外科诊疗方面的研究;通信作者:王帅,E-mail:1406942499qq.com。
