止痛促愈膏促进外痔术后创面愈合的临床研究
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摘要
目的：探讨止痛促愈膏促进外痔术后创面愈合的临床疗效
方法：通过参考大量的古籍文献,结合导师多年的临床经验组成止痛促愈膏的基本方。将符合纳入观察标准的患者60例随机分为两组,治疗组30例,对照组30例。治疗组术后患者给予止痛促愈膏换药,3g/次,一日2次；对照组术后患者给予生肌玉红膏换药,方法同前。两组均以14d为1疗程,术后第3、6、9、12、14天开始进行观察比较。对肛门疼痛、水肿、渗液程度进行观察,并选定创面面积、创面愈合时间、创口愈合率作为创口修复指标,将其按无、轻、中、重分别计为0、1、2、3分,对治疗前与治疗后进行观察统计分析
结果：应用止痛促愈膏术后换药,总有效率为96.7%,对照组总有效率为90%。经统计学处理,两组疗效有显著性差异(P<0.05),治疗组疗效明显优于对照组(P<0.05)。治疗组在缩短创面愈合时间、促进创面愈合、改善肛门疼痛、水肿等方面与对照组存在显著性差异(P<0.05)。
结论：止痛促愈膏治疗组与生肌玉红膏对照组比较,止痛促愈膏促进外痔术后创面愈合及防治疼痛、减轻水肿、感染等方面临床疗效确切,优于对照组。本方可促进痔术后创面愈合,减轻患者术后肿痛的发生。同时该药药源广,制剂简单、无毒副作用,值得在肛肠疾病术后换药中推广应用。
Objective:To observe the clinical curative effect of Zhitongcuyu Ointment for wounds healing after operation of anal fistula.
Methods:We assigned radomly 60 paitients of Anal Fistula to the treatment group (30caseds)or the control group (30 cases). The former was gived Zhitongcuyu Ointment smear the ointment directly on wounds after operation of Anal Fistula;the later given Shengjiyuhonggao Ointment. Both group were compared after a course of treatment (18days). The symptoms as anal ache, anal swelling, bearing-down, prolapsus were chosen as the observing criterious,which were calculated as 0,1,2,3points respectively based on no symptom, mild symptom, moderate symptom, serious symptom. Observation and statistics were maken both before and after the treatment.
Result:The totle effective rate of the treatment group was 96.7%, the totle effective rate of the control group was 90%.Though statistics,the totle effective of the two group was distinct difference(P<0.05).The treatment group were much better than the control group (P<0.05).
Conclusion:Zhitongcuyu Oinment has the function including clearing away pathogenic heat and removing pathogenic heat from blood, activating flow and drying the pathogenic dampness. The curative effect is marked in the treatment of anorectal diseases. It can improve such symptoms significantly as anal pain, anal swelling, bearing-down, prolapsus, bleeding and itch. ointment for external use is a kind of effective method for anorectal diseases.
方法：通过参考大量的古籍文献,结合导师多年的临床经验组成止痛促愈膏的基本方。将符合纳入观察标准的患者60例随机分为两组,治疗组30例,对照组30例。治疗组术后患者给予止痛促愈膏换药,3g/次,一日2次；对照组术后患者给予生肌玉红膏换药,方法同前。两组均以14d为1疗程,术后第3、6、9、12、14天开始进行观察比较。对肛门疼痛、水肿、渗液程度进行观察,并选定创面面积、创面愈合时间、创口愈合率作为创口修复指标,将其按无、轻、中、重分别计为0、1、2、3分,对治疗前与治疗后进行观察统计分析
结果：应用止痛促愈膏术后换药,总有效率为96.7%,对照组总有效率为90%。经统计学处理,两组疗效有显著性差异(P<0.05),治疗组疗效明显优于对照组(P<0.05)。治疗组在缩短创面愈合时间、促进创面愈合、改善肛门疼痛、水肿等方面与对照组存在显著性差异(P<0.05)。
结论：止痛促愈膏治疗组与生肌玉红膏对照组比较,止痛促愈膏促进外痔术后创面愈合及防治疼痛、减轻水肿、感染等方面临床疗效确切,优于对照组。本方可促进痔术后创面愈合,减轻患者术后肿痛的发生。同时该药药源广,制剂简单、无毒副作用,值得在肛肠疾病术后换药中推广应用。
Objective:To observe the clinical curative effect of Zhitongcuyu Ointment for wounds healing after operation of anal fistula.
Methods:We assigned radomly 60 paitients of Anal Fistula to the treatment group (30caseds)or the control group (30 cases). The former was gived Zhitongcuyu Ointment smear the ointment directly on wounds after operation of Anal Fistula;the later given Shengjiyuhonggao Ointment. Both group were compared after a course of treatment (18days). The symptoms as anal ache, anal swelling, bearing-down, prolapsus were chosen as the observing criterious,which were calculated as 0,1,2,3points respectively based on no symptom, mild symptom, moderate symptom, serious symptom. Observation and statistics were maken both before and after the treatment.
Result:The totle effective rate of the treatment group was 96.7%, the totle effective rate of the control group was 90%.Though statistics,the totle effective of the two group was distinct difference(P<0.05).The treatment group were much better than the control group (P<0.05).
Conclusion:Zhitongcuyu Oinment has the function including clearing away pathogenic heat and removing pathogenic heat from blood, activating flow and drying the pathogenic dampness. The curative effect is marked in the treatment of anorectal diseases. It can improve such symptoms significantly as anal pain, anal swelling, bearing-down, prolapsus, bleeding and itch. ointment for external use is a kind of effective method for anorectal diseases.
引文
[1]石焕芝,任宝印.肛门直肠疾病流行病学分析[J].中国肛肠病杂志2000,20(3)：1 0.12.
[2]付小兵.生长因子与创伤修复.北京人民军医出版社,1991；145.
[3]张锁成.陕西中医,1994;15(6)：260
[4]王平.福建中医药,1995：(3)：29
[5]周辉.消肿活血定痛汤为主辨证治疗炎性外痔158例.陕西中医,2006,27(5)：534’535
[6]冷伟.止痛如神汤治疗急症痔.安徽中医临床杂志,1997,9(1)：54
[7]邵继林,喻德洪.中国肛肠病杂志,1988;2(8)：114—115
[8]杨干亭.安徽医学,1993;14(3)：29
[9]汪韶蜂,刘小球,张子云.痔安舒熏洗剂治疗炎性痔78例临床观察.湖南中医药导报,2004,10(12)：33 34
[10]胡伯虎.大肠肛门病治疗学.科学技术文献出版社,2004：256.
[11]孙继东,刘慧文.现代中西医结合杂志,1999;8(10)：1706
[12]杨鸿培,黄国平.消肿止痛膏治疗痔疮75例.河北中医,2001,239(1)：845
[13]刘少琼,李朝员,李国生.复方芙蓉花叶栓治疗肛门病210例[J].湖南中医杂志,2001,17(4)：39
[14]陆德铭.中医外科学,1996;140
[15]李庆华等.中国肛肠病杂志,1998;3(18)：31—32
[16]王光荣.福建中医药,1993;14(4)：62
[17]胡伯虎.大肠肛门病治疗学.科学技术文献出版社,2004；258.
[18]吴敬伟,吴静河.三棱针刺血拔罐配合中药治疗痔疮[J].中国针灸1995(2)：113
[19]Parks AG Haemorrhoids Hosp[J]. Rep,1995,104:135—156.
[20]丁义江.丁氏肛肠病学[M].北京：人民卫生出版社,2006：239-247。
[21]Thomson W 耶. The nature ofhemo 玎 hoids[J]. Br J Surg,1975, 62(5):542.552.
[22]Londer PB, Kamm MA,Nichds RJ, ct al. hemmorrhoids:pathology pathophysiology and etiology[J]. Br J Surg:1994,81(7):946 — 954.
[23]安阿钥.肛肠病学,1998：102
[24]刘汉章.中国肛肠病杂志1990;10(1)：24
[25]董耀林.中国肛肠病杂志1987,4(7);26
[26]李爱莉,魏庄英.中国肛肠病杂志1999,3(19);25
[27]吴明.沈阳医学1991;(5、6)：61
[28]丁义山.中国肛肠病杂志1987;(1)：3
[29]张庆荣等.临床大肠肛门外科学1992
[30]赵海涛,陈玉林.创面用药与创面愈合.现代康复,2001：5(1)：10-11.
[31]陈孝平.外科学[M].北京：人民卫生出版社,2005.8：236--237。
[32]谭新华,陆德铭.中医外科学[M].北京：人民卫生出版社,1999：88。
[32]董礼.疼痛与针刺镇痛.辽宁中医杂志,2005,32(8)：768.
[34]张东铭.大肠肛门局部解剖与手术学[M].合肥：安徽科学技术出版社24—26.
[35]魏民.病理学.第1舨,北京：中国中医药出版社,1999：99.
[36]许方方,俞永湘.复方角菜酸酯栓促进痔疮术后康复的临床观察.安徽卫生职业技术学院学报,2004：3(4)：26—27.
[37]郭颂铭、葛步军.碱性成纤维细胞生长因子对肛周术后创面愈合的影响.复旦学报(医学版),2003：30(1)：74—76.
[38]赵建勤.用B一七叶皂甙钠治疗痔瘘术后水肿的体会
[39]牟家琬,杨胜华,孙玉梅等.龙脑与异龙脑的体外抗菌作用的研究[J].华西药学杂志,1989,4(1)：20.
[40]朱秀媛,王文杰,徐桂芳等.麝香的药理研究Ⅲ—麝香抗炎作用原理[J].中国医学科学院学报,1989;11(1)：52-56.
[41]刘国声,康建忠,王永林等.儿种常用中药对革兰氏阴性肠内致病菌的体外抗菌作用[J]. Chin.Mcd,1950;68(9、10):52.
[42]王梦月,贾敏如,马逾英等.白芷镇痛有效部位的化学成分研究[J].中国药学杂志,2005,40(8)：584.
[2]付小兵.生长因子与创伤修复.北京人民军医出版社,1991；145.
[3]张锁成.陕西中医,1994;15(6)：260
[4]王平.福建中医药,1995：(3)：29
[5]周辉.消肿活血定痛汤为主辨证治疗炎性外痔158例.陕西中医,2006,27(5)：534’535
[6]冷伟.止痛如神汤治疗急症痔.安徽中医临床杂志,1997,9(1)：54
[7]邵继林,喻德洪.中国肛肠病杂志,1988;2(8)：114—115
[8]杨干亭.安徽医学,1993;14(3)：29
[9]汪韶蜂,刘小球,张子云.痔安舒熏洗剂治疗炎性痔78例临床观察.湖南中医药导报,2004,10(12)：33 34
[10]胡伯虎.大肠肛门病治疗学.科学技术文献出版社,2004：256.
[11]孙继东,刘慧文.现代中西医结合杂志,1999;8(10)：1706
[12]杨鸿培,黄国平.消肿止痛膏治疗痔疮75例.河北中医,2001,239(1)：845
[13]刘少琼,李朝员,李国生.复方芙蓉花叶栓治疗肛门病210例[J].湖南中医杂志,2001,17(4)：39
[14]陆德铭.中医外科学,1996;140
[15]李庆华等.中国肛肠病杂志,1998;3(18)：31—32
[16]王光荣.福建中医药,1993;14(4)：62
[17]胡伯虎.大肠肛门病治疗学.科学技术文献出版社,2004；258.
[18]吴敬伟,吴静河.三棱针刺血拔罐配合中药治疗痔疮[J].中国针灸1995(2)：113
[19]Parks AG Haemorrhoids Hosp[J]. Rep,1995,104:135—156.
[20]丁义江.丁氏肛肠病学[M].北京：人民卫生出版社,2006：239-247。
[21]Thomson W 耶. The nature ofhemo 玎 hoids[J]. Br J Surg,1975, 62(5):542.552.
[22]Londer PB, Kamm MA,Nichds RJ, ct al. hemmorrhoids:pathology pathophysiology and etiology[J]. Br J Surg:1994,81(7):946 — 954.
[23]安阿钥.肛肠病学,1998：102
[24]刘汉章.中国肛肠病杂志1990;10(1)：24
[25]董耀林.中国肛肠病杂志1987,4(7);26
[26]李爱莉,魏庄英.中国肛肠病杂志1999,3(19);25
[27]吴明.沈阳医学1991;(5、6)：61
[28]丁义山.中国肛肠病杂志1987;(1)：3
[29]张庆荣等.临床大肠肛门外科学1992
[30]赵海涛,陈玉林.创面用药与创面愈合.现代康复,2001：5(1)：10-11.
[31]陈孝平.外科学[M].北京：人民卫生出版社,2005.8：236--237。
[32]谭新华,陆德铭.中医外科学[M].北京：人民卫生出版社,1999：88。
[32]董礼.疼痛与针刺镇痛.辽宁中医杂志,2005,32(8)：768.
[34]张东铭.大肠肛门局部解剖与手术学[M].合肥：安徽科学技术出版社24—26.
[35]魏民.病理学.第1舨,北京：中国中医药出版社,1999：99.
[36]许方方,俞永湘.复方角菜酸酯栓促进痔疮术后康复的临床观察.安徽卫生职业技术学院学报,2004：3(4)：26—27.
[37]郭颂铭、葛步军.碱性成纤维细胞生长因子对肛周术后创面愈合的影响.复旦学报(医学版),2003：30(1)：74—76.
[38]赵建勤.用B一七叶皂甙钠治疗痔瘘术后水肿的体会
[39]牟家琬,杨胜华,孙玉梅等.龙脑与异龙脑的体外抗菌作用的研究[J].华西药学杂志,1989,4(1)：20.
[40]朱秀媛,王文杰,徐桂芳等.麝香的药理研究Ⅲ—麝香抗炎作用原理[J].中国医学科学院学报,1989;11(1)：52-56.
[41]刘国声,康建忠,王永林等.儿种常用中药对革兰氏阴性肠内致病菌的体外抗菌作用[J]. Chin.Mcd,1950;68(9、10):52.
[42]王梦月,贾敏如,马逾英等.白芷镇痛有效部位的化学成分研究[J].中国药学杂志,2005,40(8)：584.