[1]邓台燕,王万里,杜忠群.龙胆泻肝汤坐浴联合低位全部切开高位挂线术对肛瘘患者创面愈合、肛肠动力学的影响[J].陕西中医,2021,(10):1429-1432.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.027]
 DENG Taiyan,WANG Wanli,DU Zhongqun.Effects of Longdan Xiegan decoction for sitz bath combined with low incision and high thread-drawing on wound healing and anorectal dynamics in patients with anal fistula[J].,2021,(10):1429-1432.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.027]
点击复制

龙胆泻肝汤坐浴联合低位全部切开高位挂线术对肛瘘患者创面愈合、肛肠动力学的影响
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年10期
页码:
1429-1432
栏目:
临床研究
出版日期:
2021-10-05

文章信息/Info

Title:
Effects of Longdan Xiegan decoction for sitz bath combined with low incision and high thread-drawing on wound healing and anorectal dynamics in patients with anal fistula
作者:
邓台燕王万里 杜忠群
(成都市第五人民医院肛肠科,四川 成都 611130)
Author(s):
DENG TaiyanWANG WanliDU Zhongqun
(Department of Anorectal,Chengdu Fifth People's Hospital,Chengdu 611130,China)
关键词:
肛瘘 低位全部切开高位挂线术 龙胆泻肝汤 肠道动力学 血清表皮生长因子 血管内皮生长因子
Keywords:
Fistula Low incision and high thread-drawing Longdan Xiegan decoction Intestinal dynamics Serum epidermal growth factor Vascular endothelial growth factor
分类号:
R 657.16
DOI:
DOI:10.3969/j.issn.1000-7369.2020.10.027
文献标志码:
A
摘要:
目的:探讨龙胆泻肝汤坐浴联合低位全部切开高位挂线术对肛瘘患者临床疗效、创面愈合、表皮生长因子及肛肠动力学指标的影响。方法:选取湿热下注型肛瘘患者102例,随机分成对照组和观察组,每组51例。对照组行高位全部切开高位挂线术治疗,观察组在对照组上述治疗的同时给予龙胆泻肝汤治疗。观察两组患者治疗1、7、15 d后创面面积、创面疼痛、创口愈合时间; 评估临床疗效; 酶联免疫吸附法测定患者血清中表皮生长因子(EGF)和血管内皮生长因子(VEGF)水平; 检查直肠静息压(RRP)、肛管静息压(ARP)、肛管最长收缩时间(ALCT)和肛管最大收缩压(AMCP)肛肠学指标。结果:治疗后观察组创面疼痛、创面面积及创口愈合时间均明显低于对照组(P<0.05)。两组之间总有效率比较差异无统计学意义(P>0.05)。观察组血清EGF和VEGF水平明显高于对照组(P<0.05); 两组治疗1 d后,血清EGF和VEGF水平比较无统计学差异(P>0.05)。两组组间及治疗前后AMCP和ALCT指标水平无明显变化(P>0.05)。两组间RRP和ARP水平较治疗前无统计学差异(P>0.05); 观察组RRP和ARP水平明显高于对照组(P<0.05)。与治疗前相比,两组治疗后RRP和ARP水平均显著降低(P<0.05)。 结论:龙胆泻肝汤坐浴联合低位全部切开高位挂线术可促进肛瘘患者创面愈合,保护肛门功能。
Abstract:
Objective:To explore the effects of Longdan Xiegan decoction for sitz bath combined with low incision and high thread-drawing on clinical efficacy,wound healing,epidermal growth factor and anorectal dynamics indexes in patients with anal fistula.Methods:A total of 102 patients with anal fistula of dampness-heat pouring downward type were enrolled.They were randomly divided into control group and observation group,51 cases in each group.The control group was treated with low incision and high thread-drawing,while observation group was treated with Longdan Xiegan decoction on basis of control group.The wound area,wound pain and wound healing time in both groups were observed after 1 d and 15 d of treatment.The clinical curative effect was evaluated.The levels of serum epidermal growth factor(EGF)and vascular endothelial growth factor(VEGF)were detected.The anorectal indexes [rectal rest pressure(RRP),anal rest pressure(ARP),rectal longest contraction time(ALCT),anal maximal contraction pressure(AMCP)] were examined.Results:After treatment,wound pain,wound area and wound healing time in observation group were significantly lower than those in control group(P<0.05).There was no significant difference in the total response rate between the two groups(P>0.05).After treatment,levels of serum EGF and VEGF in observation group were significantly higher than those in control group(P<0.05).After 1 d of treatment,there was no significant difference in levels of serum EGF and VEGF between the two groups(P>0.05).There was no significant change in AMCP or ALCT between the two groups before and after treatment(P>0.05).There was no significant difference in levels of RRP and ARP between the two groups before treatment(P>0.05).The levels of RRP and ARP in observation group were significantly higher than those in control group(P<0.05).After treatment,RRP and ARP levels in both groups were significantly decreased(P<0.05).Conclusion:Longdan Xiegan decoction for sitz bath combined with low incision and high thread-drawing can promote wound healing and protect anal function in patients with anal fistula.

参考文献/References:

[1] Yamamoto T,Kotze PG,Spinelli A,et al.Fistula-associated anal carcinoma in Crohn's disease[J].Expert Rev Gastroenterol Hepatol,2018,12(9):917-925.
[2] Emile SH,Khan SM,Adejumo A,et al.Ligation of intersphincteric fistula tract(LIFT)in treatment of anal fistula:An updated systematic review Meta-analysis and Meta-regression of the predictors of failure[J].Surgery,2020,167(2):484-492.
[3] 张爱明.益气活血托毒法在肛瘘术后的临床应用研究[J].陕西中医,2019,40(3):351-353.
[4] 杨 明,付 赞,冯 艳.经直肠腔内超声诊断肛瘘的临床意义[J].中国现代普通外科进展,2020,23(4):304-305.
[5] 王 健.复方黄柏液联合中药坐浴方治疗肛瘘术后患者临床研究[J].陕西中医,2017,38(8):1022-1023.
[6] Amato A,Bottini C,De Nardi P,et al.Evaluation and management of perianal abscess and anal fistula:SICCR position statement[J].Tech Coloproctol,2020,24(2):127-143.
[7] Lauretta A,Falco N,Stocco E,et al.Anal Fistula Laser Closure:The length of fistula is the Achilles' heel[J].Tech Coloproctol,2018,22(12):933-939.
[8] 高春波.清肠愈溃疡联合切开挂线术治疗复杂性肛瘘临床研究[J].陕西中医,2018,39(6):774-776.
[9] 杨冠群,郭 春.龙胆泻肝汤激活Bax/Caspase-3通路并诱导人角质形成细胞凋亡[J].中国麻风皮肤病杂志,2020,36(11):28-31.
[10] 吴 鸥,刘益明,田艳会,等.温针灸联合龙胆泻肝汤治疗带状疱疹后遗神经痛的效果[J].中华中医药学刊,2020,38(11):109-112.
[11] 于永祥.中国肛肠病诊治彩色图谱大全[M].沈阳:辽宁科学技术出版社,2015:213-215.
[12] 陈敏辉,吴康瑞,吴志辉.LIFT与切开挂线术治疗复杂性肛瘘的疗效评价[J].中国实用医药,2019,14(2):27-29.
[13] 高 昆.中药药线对口引流法与高位挂线低位全部切开 术治疗高位复杂性肛瘘临床比较[J].辽宁中医药大学学报,2018,20(6):216-219.
[14] Wanitsuwan W,Junmitsakul K,Jearanai S,et al.Video-assisted ligation of intersphincteric fistula tract for complex anal fistula:Technique and preliminary outcomes[J].Dis Colon Rectum,2020,63(11):1534-1540.
[15] Stazi A,Izzo P,D'Angelo F,et al.Video-assisted anal fistula treatment in the management of complex anal fistula:A single-center experience[J].Minerva Chir,2018,73(2):142-150.
[16] Brunner M,Schneider Ⅰ,Günther K,et al.Permacol collagen paste for cryptoglandular and Crohn's anal fistula[J].Tech Coloproctol,2019,23(2):135-141.
[17] Yamamoto T,Kotze PG,Spinelli A,et al.Fistula-associated anal carcinoma in Crohn's disease[J].Expert Rev Gastroenterol Hepatol,2018,12(9):917-925.
[18] 秦 琴,石历闻.龙胆泻肝汤临床应用及药理研究进展[J].国际中医中药杂志,2012,34(6):554-557.
[19] Alvarez-Mercado AI,Negrete-Sánchez E,Gulfo J,et al.EGF-GH axis in rat steatotic and non-steatotic liver transplantation from brain-dead donors[J].Transplantation,2019,103(7):1349-1359.
[20] 任红杰,赵安社,安谊沛,等.芪苈强心胶囊联合西药治疗慢性心力衰竭疗效及对患者NT-proBNP、hs-CRP、VEGF的影响[J].陕西中医,2019,40(6):711-713.
[21] 程一乘,李 雪,刘 薇,等.穴位埋线联合生物反馈治疗功能性排便障碍28例临床观察[J].中医杂志,2019,60(24):48-52.

相似文献/References:

[1]张爱明.益气活血托毒法在肛瘘术后的临床应用研究[J].陕西中医,2019,(3):351.
[2]瞿 胤,张志君,芦亚峰,等.促愈熏洗方促进肛瘘术后大鼠肛门部创面修复效果及机制探究[J].陕西中医,2021,(7):823.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.002]
 QU Yin,ZHANG Zhijun,LU Yafeng,et al.Effect and mechanism of Cuyu Xunxi formula on promoting wound repair in anal fistula rats[J].,2021,(10):823.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.002]
[3]瞿 胤,张志君,郑 德,等.促愈熏洗方对肛瘘术后患者创面愈合及创面肉芽组织的影响[J].陕西中医,2022,(10):1414.[doi:DOI:10.3969/j.issn.1000-7369.2022.10.022]
 QU Yin,ZHANG Zhijun,ZHENG De,et al.Curative effect of Cuyu Xunxi formula on wound after anal fistula operation and the influence in wound granulation tissue[J].,2022,(10):1414.[doi:DOI:10.3969/j.issn.1000-7369.2022.10.022]
[4]郭 伟,闫丽霞,常少青,等.基于转化生长因子-β1信号通路探讨紫草生肌膏对肛瘘大鼠的干预作用[J].陕西中医,2023,(2):144.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.002]
 GUO Wei,YAN Lixia,CHANG Shaoqing,et al.Intervention of Zicao Shengji unguent on rats with anal fistula based on TGF-β1 signaling pathway[J].,2023,(10):144.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.002]
[5]梅苹苹,郭修田,冯文哲,等.加味生肌玉红膏对肛瘘模型大鼠术后创面的作用及血清炎症因子水平的影响[J].陕西中医,2024,(2):153.[doi:DOI:10.3969/j.issn.1000-7369.2024.02.002]
 MEI Pingping,GUO Xiutian,FENG Wenzhe,et al.Modified Shengji Yuhong ointment on wound model rats after anal fistula surgery and serum inflammatory factors[J].,2024,(10):153.[doi:DOI:10.3969/j.issn.1000-7369.2024.02.002]
[6]彭 彪,鲍虎豹,高晓楠,等.祛瘀生肌散对湿热下注型肛瘘患者术后创面愈合的影响[J].陕西中医,2024,(12):1644.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.012]
 PENG Biao,BAO Hubao,GAO Xiaonan,et al.Influence of Quyu Shengji powder on postoperative wound healing in patients with anal fistula of damp-heat downward flow[J].,2024,(10):1644.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.012]

更新日期/Last Update: 2021-10-09