内服汤药外治祛腐生肌法促进肛门术后创面愈合临床研究
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摘要
目的:观察肛门术后患者内服汤药外用祛腐生肌法对促进术后创面愈合的影响。方法:将筛选后的107例肛瘘手术患者进行单盲随机配对方法分为A组内服通便痔愈汤,凡士林纱换药;B组内服通便痔愈汤,第0～14天祛腐生肌膏Ⅰ号(2%硝本地平,15%生肌红粉膏)以祛瘀腐换药,第15天后祛腐生肌膏Ⅱ号(2%硝本地平生肌玉红膏)促进生肌换药。以一个月为一疗程,术后前14 d内观察排便、伤口疼痛、出血、水肿,分泌物多少、腐肉脱落时间,创面肉芽生长等情况;15 d后观察创面愈合、肛门坠胀不适感、肛门分泌物溢出、肛乳头肥大及肛门狭窄等情况。结果:研究发现,与A组相比,B组患者的排便情况、伤口疼痛等级、出血及水肿状况均有明显改善和缓解,分泌物量和腐肉脱落时间比较,差异均有统计学意义(P<0.05),B组患者肛门坠胀不适感、分泌物溢出情况等也优于A组患者好,无并发症出现。结论:内附汤药加外用祛腐生肌法联用的方法可以加速肛门术后创面愈合,效果优于单纯内服中药汤剂。
Objective:To observe the effect of oral administration of Decoction and external application of Qufu Shengji method on promoting wound healing after anal surgery.Method:107 selected patients undergoing anal fistula operation were randomly divided into group A with oral Tongbian Zhiyu Decoction,Vaseline gauze dressing change.Group B with oral Tongbian Zhiyu Decoction,0-14 days they were given Qufu Shengji Ointment No.1(2% Nifediping 15% Shengji Hongpin Ointment)to remove blood stasis and rot,15 days later,they were given Qufu Shengji Ointment No.2(2% Nifen Pingji Yuhong Ointment)to promote muscle regeneration.One month as a course of treatment,defecation,wound pain,hemorrhage,edema,secretion number,decayed meat time,wound growth and other conditions were observed within 14 days after operation;15 days later,wound healing,anal swelling discomfort,anal secretion overflow,anal papilla hypertrophy and anal stenosis were observed.Result:The study on day 0-14 found that compared with group A,defecation,wound pain,bleeding and edema in group B were significantly improved and alleviated,the amount of secretion and the time of putrefaction were significantly different between the two groups(P<0.05).After 15 days,the average healing time of wounds in group B was(22.8±6.02)d,while that in group A was(27.3±8.24)d,the difference was statistically significant(P<0.05).Anal swelling discomfort and secretion overflow in group B were also significantly better than those in group A,without complications.Conclusion:The method of combination of Neifu Decoction and external application of Qufu Shengji method can accelerate the wound healing after anal surgery,the effect is better than that of traditional Chinese medicine decoction.
Objective:To observe the effect of oral administration of Decoction and external application of Qufu Shengji method on promoting wound healing after anal surgery.Method:107 selected patients undergoing anal fistula operation were randomly divided into group A with oral Tongbian Zhiyu Decoction,Vaseline gauze dressing change.Group B with oral Tongbian Zhiyu Decoction,0-14 days they were given Qufu Shengji Ointment No.1(2% Nifediping 15% Shengji Hongpin Ointment)to remove blood stasis and rot,15 days later,they were given Qufu Shengji Ointment No.2(2% Nifen Pingji Yuhong Ointment)to promote muscle regeneration.One month as a course of treatment,defecation,wound pain,hemorrhage,edema,secretion number,decayed meat time,wound growth and other conditions were observed within 14 days after operation;15 days later,wound healing,anal swelling discomfort,anal secretion overflow,anal papilla hypertrophy and anal stenosis were observed.Result:The study on day 0-14 found that compared with group A,defecation,wound pain,bleeding and edema in group B were significantly improved and alleviated,the amount of secretion and the time of putrefaction were significantly different between the two groups(P<0.05).After 15 days,the average healing time of wounds in group B was(22.8±6.02)d,while that in group A was(27.3±8.24)d,the difference was statistically significant(P<0.05).Anal swelling discomfort and secretion overflow in group B were also significantly better than those in group A,without complications.Conclusion:The method of combination of Neifu Decoction and external application of Qufu Shengji method can accelerate the wound healing after anal surgery,the effect is better than that of traditional Chinese medicine decoction.
引文
[1]严银波.肛瘘术后中药熏洗效果观察[J].实用中医药杂志2015,31(12):1168.
[2]罗宏标.中药汤剂序贯换药促进低位单纯性肛瘘术后创面愈合30例疗效观察[J].湖南中医杂志,2017,33(1):55-57.
[3]陈祖清.紫芨洗剂促进低位单纯性肛瘘术后创面愈合40例[J].福建中医药,2017,48(2):14-15.
[4]孙凤伟.加味苦参汤坐浴熏洗对缓解肛瘘术后创面疼痛及促进愈合的效果观察[J].现代中西医结合杂志,2015,24(36):4076-4078.
[5]郑春菊.肛瘘术后创面愈合的中医学研究进展[J].世界中西医结合杂志,2014,9(2):207-209.
[6]Sugrur J,Nordenstam J,Abcarian H,et al.Pathogenesis and persistence of cryptoglandular anal fistula:a systematic review[J].Techniques in Coloproctology,2017,21(6):425-432.
[7]Ding J H,Bi L X,Zhao K,et al.Impact of three‐dimensional endoanal ultrasound on the outcome of anal fistula surgery:a prospective cohort study[J].Colorectal Disease,2015,17(12):1104-1112.
[8]Liu J Z,Li M.Effect of Shengji Yuhong plaster on the wound healing after anal fistula surgery[J].Journal of Hainan Medical University,2016,1(1):76-78.
[9]Ortega A E,Gesek A,Linnebur M.Selected Techniques of Anal Fistula Surgery from Antiquity Through the Early 20th Century Illustrated[J].Diseases of the Colon&Rectum,2017,60(6):636-646.
[10]Limura E.Modern management of anal fistula[J].World Journal of Gastroenterol,2015,21(1):12-20.
[11]王燕.五味消毒饮加味保留灌肠促进肛瘘术后创面愈合的临床观察[J].世界科学技术:中医药现代化,2015,10(1):2034-2038.
[12]黄莉.生肌玉红膏纱条促进肛瘘术后创面愈合的护理体会[J].贵阳中医学院学报,2013,35(6):219-220.
[13]王建民.生肌散1号促进肛瘘术后创面愈合的临床研究[J].安徽中医药大学学报,2014,3(1):46-48.
[14]沈锋.康复新外用联合中药熏洗在低位肛瘘术后的应用[J].浙江创伤外科,2016,2(1):329-330.
[15]乐明玲.中医药促进肛瘘术后创面愈合研究进展[J].亚太传统医药,2016,12(18):67-68.
[16]黄子慧.祛腐生肌法治疗结核性溃疡临床观察[J].北京中医药,2016,35(3):247-249.
[17]殷玉梅.中医祛腐生肌法换药对肛周脓肿、肛瘘术后患者创面愈合的影响[J].中国实用医药,2017,12(20):83-84.
[18]及立志.肛门直肠病“祛腐生肌”疗法的运用[J].中国社区医师,2018,14:5.
[19]万坤华.祛腐生肌法治疗疮疡病的临床研究[J].当代医学,2017,23(28):50-51.
[20]武瑞仙.古代医籍对慢性伤口及祛腐生肌方剂的记载[J].吉林中医药,2016,36(10):30-33.
[21]石庆生.祛腐生肌膏治疗慢性皮肤溃疡疗效观察[J].实用中医药杂志,2016,32(6):600-601.
[22]熊书华.黄芪桂枝五物汤联合祛腐生肌膏对肛肠病术后创面的影响[J].河南中医,2016,36(1):24-25.
[2]罗宏标.中药汤剂序贯换药促进低位单纯性肛瘘术后创面愈合30例疗效观察[J].湖南中医杂志,2017,33(1):55-57.
[3]陈祖清.紫芨洗剂促进低位单纯性肛瘘术后创面愈合40例[J].福建中医药,2017,48(2):14-15.
[4]孙凤伟.加味苦参汤坐浴熏洗对缓解肛瘘术后创面疼痛及促进愈合的效果观察[J].现代中西医结合杂志,2015,24(36):4076-4078.
[5]郑春菊.肛瘘术后创面愈合的中医学研究进展[J].世界中西医结合杂志,2014,9(2):207-209.
[6]Sugrur J,Nordenstam J,Abcarian H,et al.Pathogenesis and persistence of cryptoglandular anal fistula:a systematic review[J].Techniques in Coloproctology,2017,21(6):425-432.
[7]Ding J H,Bi L X,Zhao K,et al.Impact of three‐dimensional endoanal ultrasound on the outcome of anal fistula surgery:a prospective cohort study[J].Colorectal Disease,2015,17(12):1104-1112.
[8]Liu J Z,Li M.Effect of Shengji Yuhong plaster on the wound healing after anal fistula surgery[J].Journal of Hainan Medical University,2016,1(1):76-78.
[9]Ortega A E,Gesek A,Linnebur M.Selected Techniques of Anal Fistula Surgery from Antiquity Through the Early 20th Century Illustrated[J].Diseases of the Colon&Rectum,2017,60(6):636-646.
[10]Limura E.Modern management of anal fistula[J].World Journal of Gastroenterol,2015,21(1):12-20.
[11]王燕.五味消毒饮加味保留灌肠促进肛瘘术后创面愈合的临床观察[J].世界科学技术:中医药现代化,2015,10(1):2034-2038.
[12]黄莉.生肌玉红膏纱条促进肛瘘术后创面愈合的护理体会[J].贵阳中医学院学报,2013,35(6):219-220.
[13]王建民.生肌散1号促进肛瘘术后创面愈合的临床研究[J].安徽中医药大学学报,2014,3(1):46-48.
[14]沈锋.康复新外用联合中药熏洗在低位肛瘘术后的应用[J].浙江创伤外科,2016,2(1):329-330.
[15]乐明玲.中医药促进肛瘘术后创面愈合研究进展[J].亚太传统医药,2016,12(18):67-68.
[16]黄子慧.祛腐生肌法治疗结核性溃疡临床观察[J].北京中医药,2016,35(3):247-249.
[17]殷玉梅.中医祛腐生肌法换药对肛周脓肿、肛瘘术后患者创面愈合的影响[J].中国实用医药,2017,12(20):83-84.
[18]及立志.肛门直肠病“祛腐生肌”疗法的运用[J].中国社区医师,2018,14:5.
[19]万坤华.祛腐生肌法治疗疮疡病的临床研究[J].当代医学,2017,23(28):50-51.
[20]武瑞仙.古代医籍对慢性伤口及祛腐生肌方剂的记载[J].吉林中医药,2016,36(10):30-33.
[21]石庆生.祛腐生肌膏治疗慢性皮肤溃疡疗效观察[J].实用中医药杂志,2016,32(6):600-601.
[22]熊书华.黄芪桂枝五物汤联合祛腐生肌膏对肛肠病术后创面的影响[J].河南中医,2016,36(1):24-25.
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