复方黄柏液对高位复杂性肛瘘术后创面愈合疗效评价研究

Evaluation of the curative effect of compound fluid of cortex phellodendri on wound healing after high complex anal fistula

关键词:  高位复杂性肛瘘  祛腐生新  创面愈合  复方黄柏液

Key words:  high complex anal fistula  Qufu Shengxin method  wound healing  compound fluid of cortex phellodendri

摘要:

[目的] 从祛腐生新角度，探讨复方黄柏液对高位复杂性肛瘘术后创面愈合疗效的影响。[方法] 将80例高位复杂性肛瘘病人按照随机数表法分为两组，均行常规肛瘘切开挂线术，术后第1天开始换药。治疗组（40例）采用复方黄柏液纱条换药，对照组（40例）采用凡士林纱条换药。观察两组患者术后创面愈合时间，比较术后第3、7、14天创面愈合率、创面分泌物情况、创面肉芽生长情况、创面疼痛情况，术后第1、10天血清中白细胞介素1β（IL-1β）、表皮生长因子（EGF）和8-羟基脱氧鸟苷（8-OHDG）指标变化以及术后第90天生活质量（SF-36）评分情况。[结果] 治疗组术后创面愈合时间短于对照组，术后第3、7、14天创面愈合率高于对照组，术后第7、14天创面分泌物情况、肉芽生长情况及创面疼痛情况评分均优于对照组，差异均有统计学意义（P＜0.05）；术后第10天，两组IL-1β、8-OHDG水平均明显减低，且治疗组低于对照组（P＜0.05），两组EGF水平均有所上升，且治疗组上升幅度大于对照组（P＜0.05）；SF-36量表评分方面，术后90d随访发现两组患者生活质量评分与术前相比均有提高，且治疗组评分均优于对照组（P＜0.05）。[结论] 基于中医祛腐生新法，术后采用中药制剂复方黄柏液进行换药对促进高位复杂性肛瘘术后创面愈合疗效显著。

Abstract:

[Objective] From the Qufu Shengxin,the effect of compound fluid of cortex phellodendri on wound healing after high complexity anal fistula was investigated. [Methods] According to the random digital table method,80 patients diagnosed with high complex anal fistula were divided into two groups. All patients underwent routine anal fistula incision and thread drawing,changed dressing on the first day after operation. The treatment group(40 case) was changed with compound cortex phellodendri liquid gauze,and the control group(40 case) was changed with vaseline gauze. The wound healing time of the two groups was observed,and the wound surface healing rate,wound secretion,wound granulation growth and wound pain on the 3rd,7th and 14th day after operation were compared. To compare the postoperative 1,10d serum I-1β(interleuki-1β),EGF(epidermal growth factor) and 8-OHDG(8-hydrox-2'-deoxyguanosine) index changes. Postoperative quality of life(SF-36) scores at 90 d after surgery were assessed to compare the changes as well. [Results] The wound healing time in the treatment group was shorter than that in the control group,and the wound healing rate on the 3rd,7th and 14th day after operation was higher than that in the control group. The scores of wound secretion,granulation growth and wound pain on the 7th and 14 th day after operation were better than those in the control group(P<0.05);On the 10th day after surgery,IL-1β and 8-OHDG levels in both groups were significantly decreased,and those in the treatment group were lower than those in the control group(P<0.05). EGF levels in both groups were increased,and those in the treatment group were higher than those in the control group(P<0.05). In terms of SF-36 scale score,90 days after operation,it was found that the quality of life scores of the two groups were improved compared with those before operation,and the scores of the treatment group were better than those of the control group(P<0.05). [Conclusion] Based on the method of traditional Chinese medicine for Qufu Shengxin,dressing change with compound fluid of cortex phellodendri after surgery has a significant effect on promoting wound healing after High complex anal fistula.