紫黄生肌膏联合中药熏洗促进混合痔术后创面愈合的临床观察
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摘要
目的:观察紫黄生肌膏联合外科坐浴方对混合痔术后创面的临床疗效及其安全性。方法:采用开放、随机对照的研究方法,将60例混合痔外剥内扎术后患者随机分为对照组(外科坐浴方)和治疗组(紫黄生肌膏联合外科坐浴方)。通过观察术后患者第1、7、14天的创面疼痛、水肿、创面渗液、肉芽生长、创面愈合率、临床疗效情况及治疗前后有无出现不良反应等,总结其临床疗效及其安全性。此外,从对照组和治疗组随机抽出15例于第7、14天取创面肉芽组织作病理分析,观察镜下创面成纤维细胞数目及新生毛细血管数情况。结果:与对照组同期比较,治疗组在术后第7天,疼痛评分有显著改善,术后第7、14天的创面水肿评分、渗液评分、肉芽生长评分、创面愈合率均有明显改善(P<0.05),术后1个月的临床疗效与对照组比较有显著改善(P<0.05),术后第7、14天创面新生毛细血管数及成纤维细胞数目较对照组有显著差异(P<0.05)。结论:混合痔外剥内扎术后创面应用紫黄生肌膏联合外科坐浴方熏洗治疗能明显减少术后水肿及疼痛,促进创面愈合,值得临床推广。
Objective: To observe the clinical efficacy and safety of Surgery Sitz Bath Decoction combined with Zihuang Shengji Plaster on the wound healing of mixed hemorrhoids operation. Methods: Using an open, randomized, controlled approach, sixty patients with mixed hemorrhoids were divided into the control group(Surgery Sitz Bath Decoction) and the treatment group(Zihuang Shengji Plaster combined with Surgery Sitz Bath Decoction). The wound healing rate, clinical curative condition and adverse reactions before and after treatment were analyzed by observing the postoperative pain, edema, wound exudation, granulation growth at 1 d, 7 d and 14 d after operation to summarize its clinical efficacy and safety. In addition, 15 cases were randomly selected from the control group and the treatment group at the 7 th day and the 14 th day, and the number of fibroblasts and the number of newborn capillaries were observed. Results: Compared with the control group, the wound pain score, edema score, exudate score, granulation growth score and wound healing rate were significantly different between the 7 th day and the 14 th day after operation(P<0.05). There were significant differences in the number of new capillaries and the number of fibroblasts on the 7 th day and the 14 th day after operation(P<0.05). Conclusion: Surgery Sitz Bath Decoction combined with Zihuang Shengji Plaster in the treatment of mixed hemorrhoids after surgery can significantly reduce postoperative edema and pain, promote wound healing, which is worthy of clinical promotion.
Objective: To observe the clinical efficacy and safety of Surgery Sitz Bath Decoction combined with Zihuang Shengji Plaster on the wound healing of mixed hemorrhoids operation. Methods: Using an open, randomized, controlled approach, sixty patients with mixed hemorrhoids were divided into the control group(Surgery Sitz Bath Decoction) and the treatment group(Zihuang Shengji Plaster combined with Surgery Sitz Bath Decoction). The wound healing rate, clinical curative condition and adverse reactions before and after treatment were analyzed by observing the postoperative pain, edema, wound exudation, granulation growth at 1 d, 7 d and 14 d after operation to summarize its clinical efficacy and safety. In addition, 15 cases were randomly selected from the control group and the treatment group at the 7 th day and the 14 th day, and the number of fibroblasts and the number of newborn capillaries were observed. Results: Compared with the control group, the wound pain score, edema score, exudate score, granulation growth score and wound healing rate were significantly different between the 7 th day and the 14 th day after operation(P<0.05). There were significant differences in the number of new capillaries and the number of fibroblasts on the 7 th day and the 14 th day after operation(P<0.05). Conclusion: Surgery Sitz Bath Decoction combined with Zihuang Shengji Plaster in the treatment of mixed hemorrhoids after surgery can significantly reduce postoperative edema and pain, promote wound healing, which is worthy of clinical promotion.
引文
[1]中华中医药学会.中医肛肠科常见病诊疗指南.北京:中国中医药出版社,2012:1
[2]宗行万之助.疼痛的估价-用特殊的视觉模拟评分法作参考(VAS).疼痛学杂志,1994,2(4):153
[3]黄河,陆金根,曹永清.促愈汤改善混合痔术后疼痛和水肿的临床观察.上海中医药杂志,2008,42(8):124-126
[4]颜帅,甄曙光,文科,等.外科坐浴方结合窄谱红光照射促进低位单纯性肛瘘术后创面愈合临床研究.辽宁中医药大学学报,2017,19(8):143-146
[5]国家中医药管理局.中医病证诊断疗效标准.北京:中国医药科技出版社,2012:53-54
[6]杨建华,王晓鹏,孙明明,等.中药熏洗疗法治疗湿热下注型混合痔术后并发症20例临床观察.中国民族民间医药,2016,25(22):75-77
[7]蔡而玮,吴燕燕.紫白膏治疗混合痔术后水肿的临床研究.中华中医药杂志,2013,28(9):2785-2787
[8]郭冬婕,陈瑜,李斌.“煨脓长肉”理论的临床运用与理性思考.中华中医药杂志,2017,32(11):4812-4814
[2]宗行万之助.疼痛的估价-用特殊的视觉模拟评分法作参考(VAS).疼痛学杂志,1994,2(4):153
[3]黄河,陆金根,曹永清.促愈汤改善混合痔术后疼痛和水肿的临床观察.上海中医药杂志,2008,42(8):124-126
[4]颜帅,甄曙光,文科,等.外科坐浴方结合窄谱红光照射促进低位单纯性肛瘘术后创面愈合临床研究.辽宁中医药大学学报,2017,19(8):143-146
[5]国家中医药管理局.中医病证诊断疗效标准.北京:中国医药科技出版社,2012:53-54
[6]杨建华,王晓鹏,孙明明,等.中药熏洗疗法治疗湿热下注型混合痔术后并发症20例临床观察.中国民族民间医药,2016,25(22):75-77
[7]蔡而玮,吴燕燕.紫白膏治疗混合痔术后水肿的临床研究.中华中医药杂志,2013,28(9):2785-2787
[8]郭冬婕,陈瑜,李斌.“煨脓长肉”理论的临床运用与理性思考.中华中医药杂志,2017,32(11):4812-4814