柏氏透脓方联合手术治疗肛周脓肿形成炎性包块的临床评价
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摘要
目的:评价柏氏透脓方联合手术治疗肛周脓肿形成炎性包块的临床疗效。方法:择符合观察标准的肛周脓肿伴炎性包块的住院患者120例,用随机数字表法随机分为2组,每组各60例。所有患者均行切开引流术,观察组患者术后口服柏氏透脓方,对照组患者术后口服甲硝唑片,疗程7 d。检测两组患者治疗前后血清学指标(血常规、肝肾功能)。采用浅表及经直肠腔内超声测量炎性包块长径,评价临床治疗有效率,并记录肛周水肿、坠胀疼痛、创口渗液等临床症状消失时间。治疗后6个月,随访疾病复发情况。结果:治疗后,两组患者白细胞数、中性细胞比率均较治疗前明显改善(P<0.05),血肌酐、丙氨酸氨基转移酶均无明显改变,且组间比较差异无统计学意义(P>0.05)。治疗后,两组患者炎性包块长径均明显缩小,其中观察组总有效率95.0%、对照组为75.0%,观察组的有效率明显优于对照组(P<0.05);观察组患者的水肿、坠胀疼痛、创口渗液等临床症状消失时间均明显短于对照组(P<0.05)。治疗后6个月随访,观察组有2例复发(占3.3%),对照组15例复发(占25%),观察组复发率显著低于对照组(P<0.01)。结论:柏氏透脓方联合手术治疗肛周脓肿形成炎性包块,能有效缩小炎性包块长径,提高治疗总有效率,降低复发率。
Objective: To evaluate the clinical efficacy of Bai's Tounong(promoting pus drainage) Prescription combined with operation in the treatment of perianal abscess with inflammatory mass. Methods: 120 patients with perianal abscess accompanied by inflammatory mass who met the observation criteria were randomly divided into two groups according to random number table,60 cases in each group. All patients were treated with operation of incision and drainage. The observation group was orally treated with Bai's Tounong Prescription after operation,and the control group was orally treated with metronidazole tablets after operation,with a course of 7 days. The serological parameters including indexes of blood routine,liver and kidney function were measured before and after treatment. The long diameter of inflammatory mass was measured by superficial and transrectal ultrasonography to evaluate the clinical effective rate,and the disappearance time of clinical symptoms such as perianal edema,swelling pain and wound exudation was recorded. Six months after treatment,the recurrence of the disease was followed-up. Results: After treatment,the ratio of leukocyte and the ratio of neutrophil in the two groups were significantly improved(P<0.05),while the serum levels of creatinine and alanine aminotransferase showed no obvious changes,and there were no statistically significant differences between the two groups(P>0.05). After treatment,the long diameter of inflammatory mass in both groups was significantly reduced,and the total effective rates were 95.0% in the observation group and 75.0% in the control group. The total effective rate of the observation group was significantly better than that of the control group(P<0.05). The disappearance time of edema,swelling pain,wound exudation and other clinical symptoms in the observation group were significantly shorter than those in the control group( P<0.05). During the 6-month follow-up after treatment,there were 2 cases of recurrence in the observation group( accounted for 3.3%) and 15 cases of recurrence in the control group( accounted for 25%). The recurrence rate in the observation group was significantly lower than that in the control group( P<0.01). Conclusion: Bai's Tounong Prescription combined with operation in the treatment of perianal abscess with inflammatory mass can effectively reduce the long diameter of inflammatory mass,improve the total effective rate and decrease the recurrence rate.
Objective: To evaluate the clinical efficacy of Bai's Tounong(promoting pus drainage) Prescription combined with operation in the treatment of perianal abscess with inflammatory mass. Methods: 120 patients with perianal abscess accompanied by inflammatory mass who met the observation criteria were randomly divided into two groups according to random number table,60 cases in each group. All patients were treated with operation of incision and drainage. The observation group was orally treated with Bai's Tounong Prescription after operation,and the control group was orally treated with metronidazole tablets after operation,with a course of 7 days. The serological parameters including indexes of blood routine,liver and kidney function were measured before and after treatment. The long diameter of inflammatory mass was measured by superficial and transrectal ultrasonography to evaluate the clinical effective rate,and the disappearance time of clinical symptoms such as perianal edema,swelling pain and wound exudation was recorded. Six months after treatment,the recurrence of the disease was followed-up. Results: After treatment,the ratio of leukocyte and the ratio of neutrophil in the two groups were significantly improved(P<0.05),while the serum levels of creatinine and alanine aminotransferase showed no obvious changes,and there were no statistically significant differences between the two groups(P>0.05). After treatment,the long diameter of inflammatory mass in both groups was significantly reduced,and the total effective rates were 95.0% in the observation group and 75.0% in the control group. The total effective rate of the observation group was significantly better than that of the control group(P<0.05). The disappearance time of edema,swelling pain,wound exudation and other clinical symptoms in the observation group were significantly shorter than those in the control group( P<0.05). During the 6-month follow-up after treatment,there were 2 cases of recurrence in the observation group( accounted for 3.3%) and 15 cases of recurrence in the control group( accounted for 25%). The recurrence rate in the observation group was significantly lower than that in the control group( P<0.01). Conclusion: Bai's Tounong Prescription combined with operation in the treatment of perianal abscess with inflammatory mass can effectively reduce the long diameter of inflammatory mass,improve the total effective rate and decrease the recurrence rate.
引文
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[8] 谢杰斌,陈荣.肛周脓肿细菌谱及药敏变化特点[J].中华医院感染学杂志,2017,23(1):95- 97.
[9] 苏昆明,廖凤鸣.肛周脓肿根治术与切开引流术效果比较[J].中国肛肠病杂志,2016,34(9):77- 79
[10] 方征宇,潘志芸,李乾元,等. 清热活血法对肛周脓肿术后创面愈合的影响[J].中华全科医学,2017,15(6):1037- 1039.
[11] 刘晨,张洁颖. 柏连松教授治疗肛痈的经验体会[J].继续医学教育,2015,14(7):127- 128.
[2] 王昱,柏连松. 柏连松教授临床用药经验举隅[J].中医药导报,2017,24(16):41- 45.
[3] 王昱,柏连松. 中药湿热敷促进高位复杂性肛瘘术后创面愈合36例[J].福建中医药,2017,24(3):28- 30.
[4] 梁文杰,方朝义,沈莉,等. 实验诊断学在现行《中医病证诊断疗效标准》中的应用分析[J].河北中医药学报,2011,26(2):47- 48.
[5] 梁起寿,刘成伟. 手术治疗肛周脓肿的临床观察[J].中国实用医药,2016,23(12):46- 47.
[6] 阮璐璐. 肛周脓肿一期根治术疗效分析[J].吉林医学,2013,34(20):4015- 4016.
[7] HUANG- FU S H,JIANG B,DING Y J,et al. Intersphincteric incision with seton at the inner opening plus contra- aperture drainage through the abscess cavity for treatment of horseshoe perianal abscess[J].WCJD,2016,24(7):1128.
[8] 谢杰斌,陈荣.肛周脓肿细菌谱及药敏变化特点[J].中华医院感染学杂志,2017,23(1):95- 97.
[9] 苏昆明,廖凤鸣.肛周脓肿根治术与切开引流术效果比较[J].中国肛肠病杂志,2016,34(9):77- 79
[10] 方征宇,潘志芸,李乾元,等. 清热活血法对肛周脓肿术后创面愈合的影响[J].中华全科医学,2017,15(6):1037- 1039.
[11] 刘晨,张洁颖. 柏连松教授治疗肛痈的经验体会[J].继续医学教育,2015,14(7):127- 128.