[1]闫骁春,陈显韬,宋小平.仙方活命饮加减联合中药及复方多黏菌素B软膏外敷对儿童肛周脓肿术后创面愈合的影响[J].陕西中医,2022,(11):1571-1575,1579.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.019]
　YAN Xiaochun,CHEN Xiantao,SONG Xiaoping.Effects of oral administration of modified Xianfang Huoming drink combined with external application of traditional Chinese medicine and external application of compound polymyxin B ointment on wound healing in children after perianal abscess surgery[J].,2022,(11):1571-1575,1579.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.019]
点击复制

仙方活命饮加减联合中药及复方多黏菌素B软膏外敷对儿童肛周脓肿术后创面愈合的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年11期
页码:
1571-1575,1579
栏目:
临床研究
出版日期:
2022-11-05

文章信息/Info

Title:
Effects of oral administration of modified Xianfang Huoming drink combined with external application of traditional Chinese medicine and external application of compound polymyxin B ointment on wound healing in children after perianal abscess surgery
作者:
闫骁春; 陈显韬; 宋小平
(四川大学华西广安医院肛肠科,四川 广安 638099)
Author(s):
YAN Xiaochun; CHEN Xiantao; SONG Xiaoping
(Department of Anorectal Surgery,West China Guang'an Hospital,Sichuan University,Guang'an 638099,China)
关键词:
肛周脓肿;  儿童;  仙方活命饮;  中药外敷;  复方多黏菌素B软膏;  创面愈合;  炎症反应
Keywords:
Perianorectal abscess;  Children;  Xianfang Huoming drink;  External application of traditional Chinese medicine;  Compound polymyxin B ointment;  Wound healing;  Inflammatory response
分类号:
R 657.15
DOI:
DOI:10.3969/j.issn.1000-7369.2022.11.019
文献标志码:
A
摘要:
目的:观察分析仙方活命饮加减口服联合中药及复方多黏菌素B软膏外敷对儿童肛周脓肿(PA)术后创面愈合的影响。方法:选取120例行手术治疗的儿童低位PA为观察对象,采用随机数字表法分为仙方活命饮组和软膏外敷组各60例,两组均常规行切开引流术,软膏外敷组术后给予自制中药及复方多黏菌素B软膏外敷,仙方活命饮组在软膏外敷组基础上联合仙方活命饮加减口服,比较两组术后2 周临床症状评分、炎症相关指标[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平、血清疼痛因子[去甲肾上腺素(NE)、5-羟色胺(5-HT)、P物质(SP)]水平、创面愈合情况、临床疗效及术后随访复发情况。结果:术后2 周,两组创面疼痛、创面分泌物、创面水肿、肉芽组织评分均显著降低(P<0.05),且仙方活命饮组症状评分明显低于软膏外敷组(P<0.05); 两组血清IL-6、IL-10、TNF-α及CRP水平均显著降低(P<0.05),且仙方活命饮组各指标水平明显低于软膏外敷组(P<0.05); 术后2周,两组血清NE、5-HT、SP水平均显著降低(P<0.05),且仙方活命饮组各因子水平明显低于软膏外敷组(P<0.05); 仙方活命饮组腐肉脱落时间、新生上皮出现时间和创面愈合时间均明显短于软膏外敷组(P<0.05); 仙方活命饮组临床总有效率显著高于软膏外敷组(P<0.05); 术后随访6个月,仙方活命饮组复发1例,复发率为2.44%; 软膏外敷组复发3例,复发率为9.38%,两组比较差异无统计学意义(P>0.05)。结论:仙方活命饮加减口服联合自制中药及复方多黏菌素B软膏外敷可有效减轻儿童PA术后临床症状、炎症反应和疼痛,促进创面愈合,临床疗效显著。
Abstract:
Objective:To observe and analyze the effects of oral administration of modified Xianfang Huoming drink combined with external application of self-made traditional Chinese medicine and external application of compound polymyxin B ointment on wound healing in children after perianal abscess(PA)surgery.Methods:120 cases of children with low PA who underwent surgical treatment were selected as the observation subjects,and they were divided into Xianfang Huoming drink group and ointment external application group by the random number table method,with 60 cases in each group.Both groups routinely underwent incision and drainage and received postoperative nursing,and ointment external application group was given external application of self-made traditional Chinese medicine and compound polymyxin B ointment after surgery while Xianfang Huoming drink group was combined with oral administration of modified Xianfang Huoming drink on the basis of ointment external application group.The clinical symptoms scores,levels of inflammation-related indicators [interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],levels of serum pain factors [norepinephrine(NE),5-hydroxytryptamine(5-HT),substance P(SP)] wound healing and clinical efficacy at 2 weeks after surgery and postoperative follow-up recurrence were compared between Xianfang Huoming drink group and ointment external application group.Results:At 2 weeks after surgery,the scores of wound pain,wound secretion,wound edema and granulation tissue in the two groups were significantly decreased(P<0.05),and the scores of symptoms in Xianfang Huoming drink group were significantly lower than those in ointment external application group(P<0.05).The levels of serum IL-6,IL-10,TNF-α and CRP were significantly reduced in both groups(P<0.05),and the levels were significantly lower in Xianfang Huoming drink group than those in ointment external application group(P<0.05).The levels of serum NE,5-HT and SP in Xianfang Huoming drink group and ointment external application group were significantly declined at 2 weeks after surgery(P<0.05),and the levels of factors in Xianfang Huoming drink group were significantly lower than those in ointment external application group(P<0.05).The carrion shedding time,emergence time of new epithelium and wound healing time in Xianfang Huoming drink group were significantly shorter compared with those in ointment external application group(P<0.05).The total clinical effective rate of 98.33% in Xianfang Huoming drink group was significantly higher than 88.33% in ointment external application group(P<0.05).At 6 months of follow-up after surgery,there was 1 case of recurrence in Xianfang Huoming drink group with the recurrence rate of 2.44%,and there were 3 cases of recurrence in ointment external application group with the recurrence rate of 9.38%(P>0.05).Conclusion:Oral administration of modified Xianfang Huoming drink combined with external application of self-made traditional Chinese medicine and external application of compound polymyxin B ointment can effectively relieve the clinical symptoms,inflammatory response and pain and promote the wound healing of children after PA surgery,and it has significant clinical efficacy.

参考文献/References:

[1] 胡银瑶,胡响当,彭天书,等.引流扩创术联合复方芩柏颗粒剂坐浴对艾滋病合并肛周脓肿患者的疗效观察[J].中国艾滋病性病,2021,27(7):748-750.
[2] 杭州市疾病预防控制中心,苏州市疾病预防控制中心,上海市疾病预防控制中心,等.特殊健康状态儿童预防接种专家共识之十三——肛周脓肿与预防接种[J].中国实用儿科杂志,2019,34(3):177-178.
[3] 杨建华,王晓鹏,文 科,等.中药熏洗联合窄谱红光照射促进肛周脓肿术后创面愈合的临床观察[J].吉林中医药,2021,41(2):213-216.
[4] 宿 佳,王梅青,杨 坤.银黄解毒促愈汤对肛周脓肿术后创面愈合的影响[J].河北中医药学报,2020,35(4):30-33.
[5] 高桂云,宋维民,米园园,等.一次性根治术与常规切开引流术治疗肛周脓肿的临床效果比较[J].山东医药,2021,61(35):79-82.
[6] 莫智峰,袁马保,谢俊锋,等.一次性根治术和分期手术对小儿肛周脓肿预后影响的比较研究[J].中华小儿外科杂志,2021,42(1):49-52.
[7] 张文星,王 荣,牟永旭.基于数据挖掘的中药熏洗促进肛周脓肿术后愈合的用药规律研究[J].上海中医药杂志,2021,55(3):22-26.
[8] 唐 平,毛 红,李 薇,等.中医药介入的快速康复外科在肛周脓肿和肛瘘术后的应用研究[J].四川中医,2020,38(5):176-178.
[9] 高宏平,翟新影,刘行稳.加减仙方活命饮治疗肛肠病术后118例[J].浙江中西医结合杂志,2010,20(3):168-169.
[10] 陈莹璐,傅 燕.仙方活命饮药线挂线治疗高位肛瘘的临床观察[J].中国中医急症,2020,29(7):1238-1240.
[11] 吴在德,吴肇汉.外科学[M].9版.北京:人民卫生出版社,2018:339.
[12] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,2017:94.
[13] 商洪才,王保和,张伯礼.中药新药症候及疗效评价[J].中药新药与临床药理,2004,35(5):365-368.
[14] 国家中医药管理局.中医肛肠科病证诊断疗效标准[M].南京:南京大学出版社,1994:1332.
[15] 张志君,郑 德,汪庆明,等.杨巍治疗肛痈病临证经验[J].辽宁中医杂志,2019,46(4):709-710.
[16] 熊志刚,郭虹君,马 凯,等.明代医家薛己论治肛肠疾病特色探析[J].现代中医临床,2020,27(2):51-53.
[17] 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,2021,42(10):1429-1432.
[18] 杨文静,刘 宾,崔 鑫,等.中性粒细胞与淋巴细胞比值和血小板计数对慢性难愈性创面术后感染的预测价值[J].陕西医学杂志,2021,50(5):546-549.
[19] 朱建富,刘 荣,黄媛莉.康复新液纱条联合挂线术对肛周脓肿切口愈合及感染创面愈合的影响[J].中医杂志,2019,60(5):405-409.
[20] 陈欣玥,陈宗翰,赵维佳.地奈德乳膏联合复方多黏菌素B软膏治疗儿童中重度特应性皮炎[J].昆明医科大学学报,2020,41(12):104-107.
[21] 徐跃军,郭志伟,陈 艳,等.复方多黏菌素B软膏联合中药坐浴对老年肛周脓肿术后患者伤口愈合效果及血清表皮生长因子表达的影响[J].实用老年医学,2021,35(1):41-44.
[22] 王云飞,阙华发,王 军,等.祛腐化瘀补虚生肌外治法治疗慢性下肢溃疡的临床研究[J].世界中西医结合杂志,2020,15(1):29-35.
[23] 胡 军,周 中.关节镜下清理结合仙方活命饮治疗急性化脓性膝关节炎的临床观察[J].南京中医药大学学报,2019,35(2):148-151.
[24] 胡科科,黄 挺,叶知锋,等.改良仙方活命饮治疗肝射频消融术后不良反应的临床研究[J].浙江中医药大学学报,2022,46(2):193-197.
[25] 康东坤,高外毛,张红珍,等.黄芪总皂苷对脂多糖诱导的BV2小胶质细胞的抗炎机制[J].中国病理生理杂志,2022,38(2):276-283.
[26] 郝秀丽,刘应科,王 坤,等.黄芪桂枝汤联合维生素D对反复呼吸道感染患儿免疫功能水平与血清炎症因子的影响探究[J].吉林中医药,2021,41(9):1197-1200.
[27] 陆平祝,常楚瑞,龙庆德.苦参生品及麸炒品水提液抗炎镇痛作用初步研究[J].时珍国医国药,2021,32(8):1908-1910.
[28] 措毛吉,王烈宏,王榀华,等.苦参碱注射液对宫颈癌化疗的增敏效果及对机体免疫功能、预后的影响[J].中国临床医生杂志,2021,49(4):500-503.
[29] 缪艳燕,徐帮会,徐 剑,等.金银花的HPLC指纹图谱建立及其抗炎作用谱-效关系研究[J].中国药房,2020,31(20):2497-2502.
[30] 高 超,刘 杰,胡峰霞.陈皮酚类化合物调控AHR和NF-κB通路抗苯并芘诱导的肺上皮细胞损伤[J].现代食品科技,2021,37(2):36-43,274.
[31] 王凤龙,刘 员,张来宾,等.当归抗炎镇痛作用研究进展[J].中国实验方剂学杂志,2021,27(15):197-209.
[32] 杨玉赫,徐雪娇,李陈雪,等.赤芍化学成分及药理作用研究新进展[J].化学工程师,2021,35(9):42-44,31.
[33] 樊江波,黄琳红.益母草活性成分芫花素对小鼠凝血及抗炎作用的研究[J].西安交通大学学报:医学版,2019,40(1):158-161.

相似文献/References:

[1]张 新.益气养血汤联合痔炎冲洗灵治疗肛周脓肿合并糖尿病患者切开〖JZ〗对口引流挂线术后创面愈合的影响[J].陕西中医,2019,(3):368.
[2]孙林梅,张永丽.肛周脓肿发病与中医体质相关性研究*[J].陕西中医,2019,(1):106.
[3]陈 悦,尚莉丽.从“伏毒”学说论治儿童支气管哮喘[J].陕西中医,2021,(3):350.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.021]
[4]刘 芳,杨 雪,张肖瑾.加味五虎汤联合孟鲁司特钠治疗儿童咳嗽变异性哮喘临床观察[J].陕西中医,2021,(5):612.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.017]
　LIU Fang,YANG Xue,ZHANG Xiaojin.Clinical observation of modified Wuhu decoction combined with Montelukast sodium in the treatment of cough variant asthma in children[J].,2021,(11):612.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.017]
[5]赵珍珍,史艳平,邱 锐,等.清热活血方联合阿奇霉素治疗儿童肺炎支原体肺炎临床研究[J].陕西中医,2021,(5):616.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.018]
　ZHAO Zhenzhen,SHI Yanping,QIU Rui,et al.Effect of Qingre Huoxue decoction with Azithromycin on mycoplasma pneumoniae pneumonia in children[J].,2021,(11):616.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.018]
[6]许凤丽,纪 红,宫为大,等.鼠神经生长因子穴位注射联合Bobath法治疗运动发育迟缓患儿临床疗效[J].陕西中医,2021,(5):650.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.027]
　XU Fengli,JI Hong,GONG Weida,et al.Effect of acupoint injection of NGF combined with Bobath method in the treatment of children with motor development retardation[J].,2021,(11):650.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.027]
[7]李 宁,黄怡玲,姚翠婵.十味败毒汤治疗儿童特异性皮炎疗效及对患儿睡眠的影响[J].陕西中医,2021,(7):873.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.015]
[8]徐贵安,刘 诗,王珏岚,等.益气健脾汤加减联合拖线引流治疗泛发性肛周脓肿临床研究[J].陕西中医,2021,(7):926.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.030]
　XU Guian,LIU Shi,WANG Juelan,et al.Clinical study on modified Yiqi Jianpi decoction combined with thread-dragging drainage therapy in the treatment of generalized perianal abscess[J].,2021,(11):926.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.030]
[9]冯欣欣,朱学亮,张全锁,等.头针联合单唾液酸四己糖神经节苷酯钠治疗小儿痉挛性瘫痪疗效及对患儿血清神经生长因子、内皮素水平影响[J].陕西中医,2021,(7):948.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.037]
[10]赵 娜,高 爽,李桂华,等.中医药治疗腺体肥大临床研究进展[J].陕西中医,2021,(7):974.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.043]

备注/Memo

备注/Memo:
基金项目:四川省中医药管理局科研课题(2020LC0120)
更新日期/Last Update: 2022-11-09