五黄生肌方冲洗联合切开挂线术治疗肛周脓肿的临床疗效

Clinical effectiveness of Wuhuang Shengji Decoction irrigation combined with incision and hanging suture in treatment of patients with perianal abscess

    摘要
  • 摘要:
    目的 探究肛周脓肿患者应用五黄生肌方冲洗联合切开挂线术的临床疗效。
    方法 选择2022年1月-2024年1月在宁波市中医院肛肠科收治的121例肛周脓肿患者作为研究对象，根据治疗方法分为对照组(n=37)、阳性对照组(n=41)及研究组(n=43)。其中，对照组给予切开挂线术治疗，阳性对照组予以重组人表皮生长因子联合切开挂线术治疗，研究组则予以五黄生肌方冲洗联合切开挂线术治疗。观察三组临床疗效、腐肉脱落时间、新生皮出现时间、创面瘙痒消失时间、创面愈合时间及复发率。比较三组治疗前、治疗后14 d肛周疼痛视觉模拟评分(VAS)、创面分泌物评分及创面分泌物血管内皮生长因子(VEGF)和血小板衍生内皮细胞生长因子(PD-ECGF)表达水平。
    结果 研究组临床疗效(90.70%)高于阳性对照组(87.80%)及对照组(70.27%)，且研究组复发率(2.33%)低于阳性对照组(9.76%)及对照组(18.92%)，差异有统计学意义(P < 0.05)。腐肉脱落、新生皮出现、创面瘙痒消失及创面愈合所需时间呈现出研究组 < 阳性对照组 < 对照组的趋势，差异有统计学意义(P < 0.05)。治疗14 d后，VAS评分与分泌物评分呈现出研究组 < 阳性对照组 < 对照组的趋势；VEGF及PD-ECGF呈现出对照组 < 阳性对照组 < 研究组的趋势，差异均有统计学意义(P < 0.05)。
    结论 肛周脓肿患者应用五黄生肌方冲洗联合切开挂线术的疗效确切，可上调创面分泌物VEGF和PD-ECGF的表达，促进创面愈合，且复发率较低。

     

    Abstract:
    OBJECTIVE To explore the clinical efficacy of Wuhuang Shengji decoction irrigation combined with incision and hanging suture in patients with perianal abscess.
    METHODS A total of 121 patients with perianal abscess admitted to the Anorectal Department of Ningbo Traditional Chinese Medicine Hospital from Jan. 2022 to Jan. 2024 were selected as the study subjects. According to the treatment methods, they were divided into a control group (n=37), a positive control group (n=41) anda research group (n=43). The control group was treated with incision and hanging suture, the positive control group was treated with recombinant human epidermal growth factor combined with incision and hanging suture, and the research group was treated with Wuhuang Shengji Decoction irrigation combined with incision and hanging suture. The clinical efficacy, the time of necrotic tissue shedding, new skin appearing, wound itch disappearing and wound healing and the recurrence rate were observed. The visual analogue scale (VAS), wound secretion score and expression levels of vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor (PD-ECGF) in wound secretions were compared before and 14 days after treatment in the three groups.
    RESULTS The clinical efficacy of the study group (90.70%) was higher than that of the positive control group (87.80%) and control group (70.27%); the recurrence rate of the study group (2.33%) was lower than that of the positive control group (9.76%) and the control group (18.92%), and the differences were statistically significant (P < 0.05). The time required for necrotic tissue shedding, new skin appearing, wound itch disappearing and wound healing followed the trend of study group < positive control group < control group, the differences were statistically significant (P < 0.05). After 14 days of treatment, the VAS score and secretion score followed the trend of the study group < positive control group < control group; VEGF and PD-ECGF followed the trend of control group < positive control group < study group, and the differences were statistically significant (P < 0.05).
    CONCLUSION The application of Wuhuang Shengji decoction combined with incision and hanging suture for patients with perianal abscess is effective, which can upregulate the expression of VEGF and PD-ECGF in wound secretions, promote wound healing, and has a low recurrence rate.

     

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