清热化湿熏洗方治疗湿热下注型肛瘘切除术后临床研究
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R657.1+6;R266

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Clinical Study on Heat-Clearing and Damp-Resolving Fumigation Prescription for Post-Anal Fistulectomy of Damp-Heat Pouring Downward Type
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    摘要:

    目的:观察清热化湿熏洗方治疗湿热下注型肛瘘切除术后患者的临床疗效。方法:选取2022年 1月—2023年12月湖州市吴兴区中西医结合医院肛肠科收治的90例湿热下注型肛瘘切除术后患者,按随机数 字表法分为研究组、对照组各45例,最终研究组、对照组各42例完成研究。2组术后均给予常规对症治疗, 在此基础上,研究组给予清热化湿熏洗方熏蒸、坐浴治疗,对照组给予高锰酸钾熏蒸、坐浴治疗。2组均在术 后治疗3天,术后21天随访。术后21天,比较2组临床疗效。术后1天、术后21天,比较2组中医证候积分、 创面症状(创面疼痛、组织水肿、创面渗液及肉芽形态) 评分、血清炎症因子[干扰素-γ(IFN-γ)、白细胞 介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)] 水平、细胞生长因子[表皮生长因子(EGF)、血管内皮细 胞生长因子(VEGF)、转化生长因子-β (TGF-β)] 水平。比较2组创面愈合率、创面渗液持续时间、创面 愈合时间及安全性。结果:术后21天,研究组总有效率95.24% (40/42),高于对照组80.95% (34/42)(P< 0.05)。2组中医证候积分均较术后1天降低(P<0.05),研究组中医证候积分低于对照组(P<0.05)。2组创面 疼痛、组织水肿、创面渗液及肉芽形态评分均较术后1天降低(P<0.05),研究组上述4项评分均低于对照 组(P<0.05)。2组血清IFN-γ、IL-1β及TNF-α水平均较术后1天降低(P<0.05),研究组上述3项指标水平 均低于对照组(P<0.05)。2组EGF、VEGF及TGF-β水平均较术后1天升高(P<0.05),研究组上述3项指标 水平均高于对照组(P<0.05)。研究组创面愈合率高于对照组(P<0.05),创面渗液持续时间、创面愈合时间 均短于对照组(P<0.05)。治疗期间,2组均未发现明显异常及过敏反应。结论:清热化湿熏洗方治疗湿热下 注型肛瘘切除术后患者可提高临床疗效,缓解临床症状及创面症状,促进创面渗液吸收及创面愈合,安全性高。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Heat-Clearing and Damp-Resolving Fumigation Prescription in treating post-anal fistulectomy of damp-heat pouring downward type. Methods:A total of 90 cases of patients after anal fistulectomy of damp-heat pouring downward type treated in the Anorectal Department at Huzhou Wuxing Hospital of Traditional Chinese and Western Medicine from January 2022 to December 2023 were selected and divided into the study group and the control group according to the random number table method,with 45 cases in each group. Finally, 42 cases in each group completed the study. Both groups received routine postoperative symptomatic treatment. Additionally,the study group received fumigation and sitting bath treatment with Heat-Clearing and Damp- Resolving Fumigation Prescription,and the control group received potassium permanganate fumigation and sitting bath treatment. Both groups were treated for 3 days postoperatively and followed up at 21 days postoperatively. At 21 days postoperatively,the clinical efficacy was compared between the two groups. At 1 day and 21 days postoperatively,the traditional Chinese medicine syndrome scores,wound symptom scores (wound pain,tissue edema,wound exudate, and granulation morphology), serum inflammatory factor levels [interferon-γ (IFN-γ), interleukin-1β (IL-1β), tumor necrosis factor-α( TNF-α)],and cell growth factor levels [epidermal growth factor( EGF),vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β)] were compared between the two groups. The wound healing rate, wound exudate duration, wound healing time, and safety were compared between the two groups. Results: At 21 days postoperatively, the total effective rate was 95.24% (40/42) in the study group, which was higher than 80.95% (34/42) in the control group (P<0.05). The traditional Chinese medicine syndrome scores in the two groups were decreased when compared with those at 1 day postoperatively (P<0.05), and the study group had lower traditional Chinese medicine syndrome scores than the control group (P<0.05). The wound pain,tissue edema, wound exudate,and granulation morphology scores in the two groups were decreased when compared with those at 1 day postoperatively (P<0.05),and the study group had lower scores in these four items than the control group (P<0.05). The levels of IFN-γ,IL-1β,and TNF-α in serum in the two groups were reduced when compared with those at 1 day postoperatively (P<0.05),and the study group had lower levels of these three indicators than the control group (P< 0.05). The levels of EGF,VEGF,and TGF-β in the two groups were increased when compared with those at 1 day postoperatively (P<0.05),and the study group had higher levels of these three indicators than the control group (P< 0.05). The wound healing rate was higher in the study group than that in the control group (P<0.05),and the wound exudate duration and wound healing time were shorter in the study group than those in the control group (P<0.05). During treatment,no significant abnormalities or allergic reactions were observed in either group. Conclusion:Heat- Clearing and Damp-Resolving Fumigation Prescription for patients after anal fistulectomy for anal fistula of damp-heat pouring downward type can improve clinical efficacy, alleviate clinical and wound symptoms and promote wound exudate absorption and wound healing,with high safety.

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吴庆平,孟惠芳.清热化湿熏洗方治疗湿热下注型肛瘘切除术后临床研究[J].新中医,2025,57(23):42-48

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  • 在线发布日期: 2025-12-12
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