[1]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):1644-1648.[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,(12):1644-1648.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.012]
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祛瘀生肌散对湿热下注型肛瘘患者术后创面愈合的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年12期
页码:
1644-1648
栏目:
临床研究
出版日期:
2024-12-05

文章信息/Info

Title:
Influence of Quyu Shengji powder on postoperative wound healing in patients with anal fistula of damp-heat downward flow
作者:
彭 彪; 鲍虎豹; 高晓楠; 吴剑箫; 张亚滨
(石家庄市中医院肛肠一科,河北 石家庄 050051)
Author(s):
PENG Biao; BAO Hubao; GAO Xiaonan; WU Jianxiao; ZHANG Yabin
(Department of Anal and Intestinal Medicine,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050051,China)
关键词:
肛瘘;  祛瘀生肌散;  创面愈合;  胶原蛋白;  肛门功能;  炎性因子
Keywords:
Anal fistula;  Quyu Shengji powder;  Wound healing;  Collagen;  Anal function;  Inflammatory factor
分类号:
R 657.1
DOI:
DOI:10.3969/j.issn.1000-7369.2024.12.012
文献标志码:
A
摘要:
目的:探究祛瘀生肌散对湿热下注型肛瘘患者术后创面愈合、创面组织Ⅰ型胶原蛋白(COLⅠ)、Ⅲ型胶原蛋白(COLⅢ)表达的影响。方法:选取120例肛瘘手术患者为研究对象,随机数表法分为参照组和中药组,每组60例,参照组给予伤口常规换药,中药组给予祛瘀生肌散外敷换药。比较两组治疗21 d后的临床疗效、术后创面愈合情况[创面愈合率、COLⅠ、COLⅢ、转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)]、创口评分、炎性因子水平、肛门功能[大便失禁严重程度(Wexner)量表、肛管静息压、最大收缩压]。结果:治疗21 d后,中药组临床疗效高于参照组(P<0.05)。中药组创面愈合率显著高于参照组(P<0.05)。两组COLⅠ、COLⅢ、TGF-β1、VEGF水平、肛管静息压、最大收缩压显著升高,且中药组高于参照组(均P<0.05)。两组分泌物评分、水肿评分、肉芽评分、炎性因子水平、Wexner评分显著降低,且中药组低于参照组(均P<0.05)。结论:祛瘀生肌散能够加快湿热下注型肛瘘患者术后创面愈合,上调COLⅠ、COLⅢ因子水平。
Abstract:
Objective:To explore the influence of Quyu Shengji powder on postoperative wound healing and expression of wound tissue collagen type Ⅰ(COLⅠ)and collagen type Ⅲ(COLⅢ)in patients with anal fistula of damp-heat downward flow.Methods:120 patients with anal fistula surgery were selected as the research subjects,and were divided into reference group and traditional Chinese medicine group,with 60 cases in each group.The reference group was given routine wound dressing change,while the traditional Chinese medicine group was given Quyu Shengji powder for external application.The clinical efficacy and postoperative wound healing status [wound healing rate,COLⅠ,COLⅢ,transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)],wound score,inflammatory factors,and anal function [fecal incontinence severity scale(Wexner),anal resting pressure,maximum systolic pressure] were compared between groups after 21 days of treatment.Results:After 21 days of treatment,the clinical efficacy in traditional Chinese medicine group was significantly higher than that in reference group(P<0.05).The wound healing rate in traditional Chinese medicine group with(94.27±2.16)% was significantly higher than(85.37±1.24)% in reference group(P<0.05).The levels of COLⅠ,COLⅢ,TGF-β1 and VEGF,anal resting pressure and maximum systolic pressure in the two groups were significantly increased,and the indicators in traditional Chinese medicine group were higher than those in reference group(all P<0.05).The secretion score,edema score,granulation score,inflammatory factors levels and Wexner score were significantly decreased in both groups,and the scores and levels in traditional Chinese medicine group were lower(all P<0.05).Conclusion:Quyu Shengji powder can accelerate postoperative wound healing in patients with anal fistula of damp-heat downward flow,and up-regulate COLⅠ and COLⅢ levels.

参考文献/References:

[1] SORENSEN K M,MOLLER S,QVIST N.Video-assisted anal fistula treatment versus fistulectomy and sphincter repair in the treatment of high cryptoglandular anal fistula:A randomized clinical study[J].BJS Open,2021,5(5):97.
[2] 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,2023,44(2):144-148.
[3] 江聪,杨保伟,田甜.肛瘘经括约肌间瘘管结扎后肛门功能恢复的相关影响因素分析[J].中国现代医学杂志,2023,33(13):34-39.
[4] KANG J,LIU Y,PENG S,et al.Efficacy and safety of traditional Chinese medicine external washing in the treatment of postoperative wound of diabetes complicated with anal fistula:Study protocol of a randomized,double-blind,placebo-controlled,multi-center clinical trial[J].Front Pharmacol,2022,13(1):938270.
[5] 童蕾,尹和宅.郭氏苦柏方坐浴治疗肛瘘术后患者疗效观察及对创面的影响[J].新中医,2023,55(4):86-90.
[6] 戚文月,高记华,田茂生,等.痛痒消洗剂对肛瘘术后创伤大鼠创面愈合的影响[J].中华中医药杂志,2023,38(3):1246-1249.
[7] 中华中医药学会.中医肛肠科常见病诊疗指南[M].北京:中国中医药出版社,2011:1-5.
[8] 中国医师协会肛肠医师分会临床指南工作委员会.肛瘘诊治中国专家共识(2020版)[J].中华胃肠外科杂志,2020,23(12):1123-1130.
[9] 安阿珥.肛肠病学[M].北京:人民卫生出版社,2015:244-246.
[10] CAM C,SELCUK S,ASOGLU M R,et al.Validation of the Wexner scale in women with fecal incontinence in a Turkish population[J].Int Urogynecol J,2011,22(11):1375-1379.
[11] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:132.
[12] 陶晓春,梁宏涛,银浩强,等.促愈汤联合常规治疗对低位单纯性肛瘘术后患者的临床疗效[J].中成药,2021,43(6):1673-1676.
[13] 王姗姗,梁海松,杨瑞勇,等.电针董氏“三其穴”配合耳穴贴压治疗复杂性肛瘘术后并发症:一项真实世界研究[J].中国针灸,2021,41(7):730-734.
[14] 唐丽利,冯文哲,石鹏,等.加味生肌玉红膏促进湿热证肛瘘术后创面愈合的实验研究[J].时珍国医国药,2023,34(8):1798-1802.
[15] 江志峰,李建平,王宝光.麻子仁汤加味联合川椒祛毒汤熏洗对高位复杂性肛瘘术后患者肛门功能的影响[J].陕西中医,2023,44(2):195-198,204.
[16] 侯毅,郑雪平,谭妍妍,等.改良TROPIS术对高位肛瘘患者术后肛门功能的长期影响与危险因素分析[J].天津医药,2023,51(1):86-91.
[17] RUZICKA J,GRAJCIAROVA M,VISTEJNOVA L,et al.Hyperbaric oxygen enhances collagen Ⅲ formation in wound of ZDF rat[J].Physiol Res,2021,70(5):787-798.
[18] 孙小媚,刘微,阚丽娜,等.自身免疫性肝炎、原发性胆汁性肝硬化及其重叠综合征患者白介素-17、核转录因子-κB、转化生长因子β1表达水平及意义[J].陕西医学杂志,2023,52(10):1367-1370.
[19] 杨曼,张红艳,张宇星,等.肛瘘术后感染病原菌及血清VEGF和VEGFR-2与创面愈合的关系[J].中华医院感染学杂志,2023,33(3):415-419.
[20] MENG Y C,FAN J C,BIAN W N.Effectiveness of calamine lotion as an adjunctive therapy to mometasone furoate ointment in the treatment of infant eczema:A retrospective study[J].Medicine,2022,101(35):e30237.
[21] DAGHIAN S G,FARAHPOUR M R,JAFARIRAD S.Biological fabrication and electrostatic attractions of new layered silver/talc nanocomposite using Lawsonia inermis L.and its chitosan-capped inorganic/organic hybrid:Investigation on acceleration of Staphylococcus aureus and pseudomonas aeruginosa infected wound healing[J].Mater Sci Eng C Mater Biol Appl,2021,128(1):112294.
[22] MA H,YAO W,PENG B,et al.Mercury-containing preparations attenuate neutrophil extracellular trap formation in mice and humans through inhibiting the ERK1/2 pathway[J].J Ethnopharmacol,2024,321(1):117421.
[23] 刘颖,余炼,尹园缘,等.基于Fas/Fas L通路探讨象皮生肌膏对肛瘘术后模型大鼠创面细胞凋亡的影响[J].世界科学技术-中医药现代化,2023,25(8):2800-2809.
[24] 莫颖,王凤梅,帕提古丽?阿斯讨拜,等.补体因子H相关蛋白1促进巨噬细胞分泌肿瘤坏死因子-α调控足细胞增殖和迁移实验研究[J].陕西医学杂志,2024,53(4):444-448.
[25] DENG H,ZHANG J,YUAN X.The effects of phellodendron decoction on wound healing of anal fistula after anal fistulotomy[J].Evid Based Complement Alternat Med,2022,2022(1):7363006.

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备注/Memo

备注/Memo:
基金项目:河北省中医药管理局科研项目(2023375)
更新日期/Last Update: 2024-12-05