肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮的疗效观察

Observation on the curative effect of Jiedu Xiaoyong Decoction in the period of hot toxin after operation of perianal necrotizing fasciitis

关键词:  肛周坏死性筋膜炎  解毒消痈饮  中药治疗  热毒炽盛期

Key words:  perianal necrotizing fasciitis  Jiedu Xiaoyong Decoction  traditional Chinese medicine treatment  the period of heat-toxin exuberance

摘要:

[目的] 探讨解毒消痈饮治疗肛周坏死性筋膜炎术后热毒炽盛期的临床效果。[方法] 将60例肛周坏死性筋膜炎患者随机分为对照组和观察组，各30例。对照组采用术后对症支持的常规治疗+痛痒消洗剂坐浴，观察组在对照组的基础上，术后口服解毒消痈饮治疗。[结果] 观察组治疗后第3、7、14天视觉模拟评分量表（VAS）评分均低于对照组，差异具有统计学意义（P<0.05）；两组治疗14 d后白细胞（WBC）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）较治疗前显著减低，且观察组明显低于对照组（P<0.05），而血红蛋白（Hb）较治疗前明显升高，且观察组优于对照组（P<0.05）；两组治疗14 d后坏死性筋膜炎实验室风险指数评分（LRINEC）、Fournier坏疽严重程度指数（FGSI）均较治疗前显著减低，且观察组明显低于对照组（P<0.05）；观察组治疗后第7、14天创面渗液和创面水肿情况评分均低于对照组，差异具有统计学意义（P<0.05）；观察组创面愈合时间较对照组短（P<0.05）；观察组的总有效率优于对照组（P<0.05）。[结论] 肛周坏死性筋膜炎术后热毒炽盛期应用解毒消痈饮疗效确切，能够有效缓解术后疼痛，降低炎症反应，提高血红蛋白含量，有利于评估患者术后病情及预后，减轻术后创面渗液和创面水肿，加速创面愈合。

Abstract:

[Objective] To explore the clinical effect of Jiedu Xiaoyong Decoction in treating perianal necrotizing fasciitis with the period of heat-toxin exuberance after operation. [Methods] The 60 patients with perianal necrotizing fasciitis were randomly divided into observation group and control group,with 30 cases in each group. The control group was treated with postoperative symptomatic support routine treatment+Tong Yangxiao Lotion sitz bath,and the observation group was on the basis of the control group,and took the Jiedu Xiaoyong Decoction after the operation. [Results] VAS scores in the observation group were lower than those in the control group at day 3,7 and 14 after treatment,and the difference was statistically significant(P<0.05);After 14 days of treatment,white blood cells(WBC),C-reactive protein(CRP) and interleukin-6(IL-6) in both groups were significantly lower than before treatment,and the observation group was significantly lower than the control group(P<0.05),while hemoglobin(Hb) was significantly higher than before treatment,and the observation group was better than the control group(P<0.05);After 14 days of treatment,laboratory risk index score(LRINEC) and fournier gangrene severity index(FGSI) of necrotizing fasciitis in both groups were significantly lower than before treatment,and observation group was significantly lower than control group(P<0.05). The wound drainage and wound edema scores of the observation group were lower than those of the control group on the 7th and 14th day after treatment,and the difference was statistically significant(P<0.05). The wound healing time of observation group was shorter than that of control group(P<0.05). The total effective rate of observation group was better than control group(P<0.05). [Conclusion] The application of Jiedu Xiaoyong Decoction in the heat toxic peak period after the operation of perianal necrotizing fasciitis has definite curative effect,which can effectively relieve postoperative pain,reduce inflammatory response,improve hemoglobin content,facilitate the evaluation of postoperative condition and prognosis of patients,reduce postoperative wound seepage and wound edema,and accelerate wound healing.