| 引用本文: |
谢有强, 叶杰阳, 王章, 陈贤家.透脓散加减方联合温和灸对肛痈术后创面愈合影响的临床观察[J].湖南中医药大学学报,2024,44(9):1627-1632[点击复制] |
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| 透脓散加减方联合温和灸对肛痈术后创面愈合影响的临床观察 |
| 谢有强,叶杰阳,王章,陈贤家 |
| (儋州市中医医院肛肠科, 海南 儋州 571700;儋州市中医医院脾胃科, 海南 儋州 571700) |
| 摘要: |
| 目的 探讨透脓散加减方联合温和灸对肛痈术后创面愈合的临床疗效。方法 选取2021年1月至2023年12月儋州市中医医院肛肠科肛痈患者120例，以简单随机化法分为观察组（n=60）、对照组（n=60）。两组均行切开引流术，对照组术后按照肛肠科常规处理，观察组在对照组的基础上给予透脓散加减方（1剂/d，治疗14 d）及温和灸（1次/d，治疗14 d）。比较两组患者临床疗效、创面疼痛评分（术后1、3、7、14 d）、创面渗出评分（术后3、7、14 d）、肛缘皮肤水肿评分（术后3、7、14 d）、创面肉芽组织评分（术后3、7、14 d）、创面愈合时间、血清学指标[肿瘤坏死因子-α（tumor necrosis factor-α, TNF-α）、白细胞介素-6（interleukin-6, IL-6）、血管内皮生长因子（vascular endothelial growth factor, VEGF）、表皮生长因子（epidermal growth factor, EGF）]（术后1、7、14 d）及安全性。结果 观察组治愈率（78.33%）较对照组（53.33%）高（P＜0.05）。与术后1 d比较，术后7、14 d两组创面疼痛评分均降低（P＜0.05），且观察组低于对照组（P＜0.05）。与术后3 d比较，术后7、14 d两组创面渗出、肛缘皮肤水肿、创面肉芽组织评分均降低（P＜0.05），且观察组低于对照组（P＜0.05）。观察组创面愈合时间短于对照组（P＜0.05）。与术后1 d比较，术后7、14 d两组血清TNF-α、IL-6水平均降低（P＜0.05），且观察组低于对照组（P＜0.05）；两组血清VEGF、EGF水平均升高（P＜0.05），且观察组高于对照组（P＜0.05）。治疗过程中，两组患者创面局部及全身均无明显不良反应。结论 肛痈患者术后采用透脓散加减方联合温和灸治疗，可减轻创面疼痛，减少创面渗出，促进创面愈合，降低炎症反应，提高血清VEGF、EGF水平，效果显著，且安全性高。 |
| 关键词: 肛痈 透脓散加减方 温和灸 创面愈合 创面疼痛评分 创面渗出评分 |
| DOI：10.3969/j.issn.1674-070X.2024.09.011 |
| 投稿时间：2024-02-29 |
| 基金项目:海南省卫生健康行业科研项目（琼卫﹝2019﹞ZD-176）。 |
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| Clinical observation on the effects of modified Tounong Powder combined with mild moxibustion on wound healing after anorectal abscess surgery |
| XIE Youqiang, YE Jieyang, WANG Zhang, CHEN Xianjia |
| (Anorectal Department, Danzhou Hospital of Chinese Medicine, Danzhou, Hainan 571700, China;Department of the Spleen and Stomach, Danzhou Hospital of Chinese Medicine, Danzhou, Hainan 571700, China) |
| Abstract: |
| Objective To explore the clinical efficacy of modified Tounong Powder combined with mild moxibustion on wound healing after anorectal abscess surgery. Methods A total of 120 patients with anorectal abscess in the Anorectal Department of Danzhou Hospital of Chinese Medicine from January 2021 to December 2023 were selected and divided into observation group (n=60) and control group (n=60) by simple randomization method. Incision and drainage were performed in both groups, and the control group received routine treatment according to anorectal department protocols after surgery, while the observation group was given modified Tounong Powder (one dose per day, for 14 days) and mild moxibustion (one session per day, for 14 days) on the basis of the control group. The clinical effect, wound pain scores (on the 1st, 3rd, 7th, and 14th days after surgery), wound exudation scores (on the 3rd, 7th, and 14th days after surgery), perianal skin edema scores (on the 3rd, 7th, and 14th days after surgery), wound granulation tissue scores (on the 3rd, 7th, and 14th days after surgery), wound healing time, serological indicators [tumor necrosis factor-α (TNF-α), interleukin-6 (interleukin-6), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF)] (on the 1st, 7th, and 14th days after surgery), and safety were compared between the two groups. Results The cure rate of in observation group (78.33%) was higher than that in the control group (53.33%) (P＜0.05). Compared with the first day after surgery, the wound pain scores in both groups was lower on the 7th and 14th day after surgery (P＜0.05), and those of the observation group was lower than those in the control group (P＜0.05). Compared with the 3rd day after surgery, the wound exudation, perianal skin edema, and wound granulation tissue scores of the two groups were lower on the 7th and 14th days after surgery (P＜0.05), and those of the observation group were lower than those in the control group (P＜0.05). The wound healing time of observation group was shorter than that in the control group (P＜0.05). Compared with the 1st day after surgery, the serum levels of TNF-α and IL-6 in both groups were decreased on the 7th and 14th days after surgery (P＜0.05), and the levels in the observation group were lower than the control group (P＜0.05). Conversely, the serum levels of VEGF and EGF in both groups were higher on the 7th and 14th days after surgery (P＜0.05), and the levels in the observation group were higher than the control group (P＜0.05). In the course of treatment, there were no obvious adverse reactions on the local and systemic wounds in the two groups. Conclusion Modified Tounong Powder combined with mild moxibustion can relieve wound pain, reduce wound exudation, promote wound healing, reduce inflammatory response, and increase serum VEGF and EGF levels in patients with anorectal abscess after surgery, with significant effects and high safety. |
| Key words: anorectal abscess modified Tounong Powder mild moxibustion wound healing wound pain score wound exudation score |
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