| 引用本文:刘秦浪1，刘丹2，高壮1，韩焱1，郭新荣1，孙林梅2.“煨脓长肉”理论的中药热奄包对肛瘘术后创面的疗效及作用机制研究[J].世界中医药,2024,(07):. |
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| “煨脓长肉”理论的中药热奄包对肛瘘术后创面的疗效及作用机制研究 |
| Study on the Efficacy and Mechanism of Traditional Chinese Medicine Hot Package Based on the Theory of “Simmering Pus and Growing Flesh” on Postoperative Wound Healing of Anal Fistula |
| 投稿时间：2022-12-22 |
| DOI：10.3969/j.issn.1673-7202.2024.07.016 |
| 中文关键词: 肛瘘术后 煨脓长肉 中药热奄包 创面愈合 白细胞介素-1β 白细胞介素-6 肿瘤坏死因子-α 血管内皮生长因子 |
| English Keywords:Postoperative Anal Fistula Simmering Pus and Growing Flesh Traditional Chinese Medicine Hot Package Wound Healing Interleukin-1β Interleukin-6 Tumor necrosis factor-α Vascular Endothelial Growth Factor |
| 基金项目:国家自然科学基金面上项目（81473782）；陕西省重点研发计划项目（2021SF-415）；西安市卫生健康委员会面上项目（2023ms17） |
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| 中文摘要: |
| 目的：探讨“煨脓长肉”理论的中药热奄包紫竭散对肛瘘术后创面愈合的疗效及作用机制。方法：选取2021年4月至2022年4月西安市中医医院收治的湿热下注型低位单纯性肛瘘患者88例作为研究对象，按照简单随机数字表法分为观察组和对照组，每组44例，术后2组接受常规创面护理，对照组联合凡士林纱条填塞，观察组联合凡士林纱条与紫竭散热奄包填塞，对比分析2组的临床疗效及不同时间段白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF）的表达情况，并且评价观察组治疗方案的安全性。结果：2组患者的临床治愈率均为100%；在创面愈合时间方面，观察组更优(P<0.01)；在创面情况（肉芽组织的生长、分泌物、疼痛、创面愈合率）方面，2组比较，第3天差异不明显(P>0.05)，第7、14天观察组疗效更优(均P<0.05)；2组炎症介质的表达均呈明显下降趋势，生长因子VEGF明显升高，且观察组疗效更佳，其中术后第7、14天所有因子差异均有统计学意义(均P<0.01)。观察组用药前后未见明显皮肤过敏反应。结论：“煨脓长肉”的中药热奄包紫竭散对肛瘘术后创面愈合具有促进作用，可有效促进肉芽组织的生长，缩短愈合时间，可能与抑制炎症介质IL-1β、IL-6、TNF-α的释放并促进VEGF表达有关。 |
| English Summary: |
| To investigate the curative effect and possible mechanism of traditional Chinese medicine hot package Zijie powder on wound healing after anal fistula surgery based on the theory of “simmering pus and growing flesh”.Methods:A total of 88 patients with low-postion simple anal fistula of damp-heat type treated in Xi'an Hospital of Traditional Chinese Medicine from April 2021 to April 2022 were selected and were divided into the observation group and the control group with 44 cases in each group according to the simple random number table method.Both groups received conventional postoperative wound care，and the control group received additional treatment with vaseline gauze packing.The observation group was treated with vaseline gauze and Zijie powder hot package.The clinical efficacy of the two groups and the expression levels of related factors interleukin-1β(IL-1β)，interleukin-6(IL-6)，tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) in different time periods were compared and analyzed，and the safety of the treatment regimen in the observation group was evaluated.Results:The clinical cure rate was 100% in both groups.The observation group had a significantly shorter wound healing time(P<0.01).In terms of wound conditions(growth of granulation tissue，secretion，pain，wound healing rate)，there was no significant difference on day 3(P>0.05)，and the curative effect was better on day 7 and 14(P<0.05).The expression of inflammatory factors showed a significant decrease trend in both groups，and the growth factor VEGF showed a significant increase trend，with the observation group showing better effects.Significant differences were found in all factors on the 7th and 14th day after surgery(P<0.01).No obvious skin allergic reaction was observed in the observation group before and after treatment.Conclusion:The traditional Chinese medicine hot package Zijie powder with “simmering pus and growing flesh” can promote the wound healing after anal fistula operation，effectively promote the growth of granulation tissue and shorten the healing time.The mechanism may be related to the inhibition of IL-1β，IL-6，TNF-α and the promotion of VEGF expression. |
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