Abstract:

Objective　To observe the effect of fumigation and washing with Shengji Zhitong Fang combined with antibacterial drugs for patients with perianal abscess. Methods　One hundred and twenty-three patients with perianal abscess treated at Shangqiu First People's Hospital from October 2020 to February 2023 were selected for the randomized controlled trial. They were divided into a control group (60 cases) and a combined group (63 cases) by the computer randomization method. There were 35 males and 25 females in the control group; they were (50.25±5.31) years old. There were 37 males and 26 females in the combined group; they were (50.33±5.25) years old. The control group received regular antimicrobial treatment. The combined group took fumigation and washing with Shengji Zhitong Fang combined with antibacterial drugs. The wound healing, improvement of inflammatory factors and pain indicators, and recovery of anal function were compared between the two groups. t test was applied. Results　Before the treatment, there were no statistical differences in epidermal growth factor (EGF), inflammatory factors, pain mediators, and anal function indicators between the two groups (all P>0.05). After the treatment, the wound healing time and scab shedding time in the combined group were shorter than those in the control group [(20.45±5.17) d vs. (23.75 ± 5.31) d and (4.33±1.25) d vs. (5.26±1.49) d], and the EGF level in the combined group was higher than that in the control group [(0.75±0.12) μg/L vs. (0.58±0.11) μg/L], with statistical differences (t=3.492, 3.757, and 8.178; all P<0.05). After the treatment, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin 1β (IL-1β) in the combined group were lower than those in the control group [(7.44±2.31) mg/L vs. (10.33±3.82) mg/L, (20.33±5.41) ng/L vs. (23.72±5.18) ng/L, and (60.45±10.27) ng/L vs. (67.44±10.25) ng/L], with statistical differences (t=5.105, 3.546, and 3.777; all P<0.05). After the treatment, the levels of 5-hydroxytryptamine (5-HT) and serum P substance (SP) and the score of Visual Analogue Scale (VAS) in the combined group were lower than those in the control group [(0.31±0.12) μmol/L vs. (0.55±0.23) μmol/L, (8.45±2.33) ng/L vs. (10.76±3.25) ng/L, and (3.13±0.26) vs. (4.77±1.27)], with statistical differences (t=7.305, 4.547, and 10.033; all P<0.05). The Wexner scores 3, 7, 14 d after the treatment in the combined group were lower than those in the control group [(10.35±2.27) vs. (12.25±3.49), (7.66±2.13) vs. (10.28±3.16), and (5.04±1.32) vs. (7.79±2.45)], with statistical differences (t=3.596, 5.415, and 7.800; all P<0.05). Conclusion　Fumigation and washing with Shengji Zhitong Fang combined with antibacterial drugs for patients with perianal abscess can promote their wound healing and anal function, and alleviate their inflammation and pain.

Key words:

Perianal abscess, Shengji Zhitong Fang, Fumigation and washing with traditional Chinese medicine, Antibacterial therapy, Wound healing

摘要：

目的　观察生肌止痛方熏洗结合抗菌药物治疗肛周脓肿患者的效果。方法　选取2020年10月至2023年2月商丘市第一人民医院收治的123例肛周脓肿患者进行随机对照试验。采用电脑随机分组法将其分为对照组60例和联合组63例。对照组男35例，女25例，年龄（50.25±5.31）岁。联合组男37例，女26例，年龄（50.33±5.25）岁。对照组采用常规抗菌药物治疗，联合组采用生肌止痛方熏洗结合抗菌药物治疗。比较两组患者创面愈合情况，炎症因子、疼痛指标改善情况和肛门功能恢复情况。采用t检验。结果　治疗前，两组患者表皮生长因子（epidermal growth factor，EGF）、炎症因子、疼痛介质、肛门功能指标比较，差异均无统计学意义（均P>0.05）。治疗后，联合组创面愈合时间为（20.45±5.17）d，结痂脱落时间为（4.33±1.25）d，均低于对照组［（23.75±5.31）d、（5.26±1.49）d］，EGF为（0.75±0.12）μg/L，高于对照组（0.58±0.11）μg/L，差异均有统计学意义（t=3.492、3.757、8.178，均P<0.05）。治疗后，联合组C-反应蛋白（C-reactive protein，CRP）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素-1β（interleukin 1β，IL-1β）水平均低于对照组［（7.44±2.31）mg/L比（10.33±3.82）mg/L、（20.33±5.41）ng/L比（23.72±5.18）ng/L、（60.45±10.27）ng/L比（67.44±10.25）ng/L］，差异均有统计学意义（t=5.105、3.546、3.777，均P<0.05）。治疗后，联合组5-羟色胺（5-hydroxytryptamine，5-HT）、P物质（serum P substance，SP）水平和视觉模拟疼痛量表（Visual Analogue Scale，VAS）评分均低于对照组［（0.31±0.12）μmol/L比（0.55±0.23）μmol/L、（8.45±2.33）ng/L比（10.76±3.25）ng/L、（3.13±0.26）分比（4.77±1.27）分］，差异均有统计学意义（t=7.305、4.547、10.033，均P<0.05）。联合组治疗3、7、14 d后肛门失禁评分（Wexner）均低于对照组［（10.35±2.27）分比（12.25±3.49）分、（7.66±2.13）分比（10.28±3.16）分、（5.04±1.32）分比（7.79±2.45）分］，差异均有统计学意义（t=3.596、5.415、7.800，均P<0.05）。结论　生肌止痛方熏洗结合抗菌治疗肛周脓肿患者能促进创面愈合，对缓解炎性反应及疼痛和改善肛门功能均有积极作用。

关键词:

肛周脓肿, 生肌止痛方, 中药熏洗, 抗菌治疗, 创面愈合