目的:观察阳和汤化菜修复肛瘘术后阴证愈合缓慢创面的临床疗效及安全性。
方法:将符合纳入标准的120例低级别肛瘘术后缓慢愈合阴性创面患者按随机数字表法分为治疗组和对照组。治疗组60例,对照组60例。治疗组给予阳和汤配合常规治疗;对照组给予常规治疗,其中伤口表面用碘消毒,然后用无菌纱布覆盖。两组疗程均为10d。伤口分泌物评分,伤口肉芽组织评分,碱性成纤维细胞生长因子(bFGF)的表达水平,转化生长因子β1(TGF-β1),伤口中的表皮生长因子(EGF),比较创面愈合时间和临床疗效。
结果:两组患者年龄、性别比较差异无统计学意义(P>0.05)。手术后的第10天和第15天,治疗组创面分泌物评分高于对照组(P<0.01)。比较两组术后第10天和第15天,治疗组肉芽组织生长评分优于对照组(P<0.01)。手术后的第10天和第15天,bFGF的表达水平,治疗组TGF-β1和EGF因子强于对照组。治疗组创面愈合时间明显短于对照组(P<0.01)。比较两组患者治疗后的临床疗效,治疗组总体疗效明显高于对照组(P<0.01)。
结论:阳和汤化菜治疗肛瘘术后阴证愈合缓慢的创面疗效显著。它改善伤口分泌物,促进伤口肉芽组织的生长,缩短伤口愈合时间。其作用机制可能与控制伤口炎症有关。它与增加bFGF的表达有关,伤口组织中的TGF-β1和EGF,促进伤口血管生成和成纤维细胞增殖。
OBJECTIVE: To observe the clinical efficacy and safety of Yanghe decoction Huacai for the repair of Yin syndrome wounds with slow-healing after anal fistula surgery.
METHODS: A total of 120 patients with slow-healing negative wounds with after low-grade anal fistula surgery who met the inclusion criteria were divided into a treatment group and a control group based on a random number table method, with 60 patients in the treatment group and 60 patients in the control group. The treatment group was given Yanghe decoction Huacai in combination with routine treatment; the control group was only given routine treatment, in which the wound surface was disinfected with iodine, and then covered with sterile gauze. The course of treatment in both groups was 10 d. After treatment, the wound secretion score, wound granulation tissue score, the expression levels of basic fibroblast growth factor (bFGF), transforming growth factor β1 (TGF-β1), and epidermal growth factor (EGF) in the wound, wound healing time and clinical efficacy were compared.
RESULTS: There was no significant difference in age or gender between the two groups (P > 0.05). On the 10th and 15th days after the surgery, the wound secretion scores were higher in the treatment group than in the control group (P < 0.01). Comparing the two groups at the 10th and 15th day after surgery, the granulation tissue growth scores in the treatment group were better than the in control group (P < 0.01). On the 10th and 15th day after operation, the expression levels of bFGF, TGF-β1 and EGF factors in the treatment group were stronger than those in the control group. The healing time of the wounds in the treatment group was significantly shorter than in the control group (P < 0.01). The clinical efficacy of the two groups after treatment was compared, and the overall efficacy of the treatment group was significantly higher than that of the control group (P < 0.01).
CONCLUSIONS: Yanghe decoction Huacai have significant efficacy in the treatment of slow-healing wounds with Yin syndrome after anal fistula surgery. It improves wound secretions, promotes the growth of wound granulation tissue, and shortens wound healing time. Its mechanism of action may be related to the control of wound inflammation. It is related to increasing the expression of bFGF, TGF-β1 and EGF in wound tissue, and promoting wound angiogenesis and fibroblast proliferation.