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祛瘀生肌散外敷对复杂性肛瘘创面修复的影响
彭彪,鲍虎豹,王燕燕,高晓楠,吴剑箫,张亚滨
石家庄市中医院石家庄 050051
摘要:
目的:观察祛瘀生肌散外敷对复杂性肛瘘创面修复的影响。方法:选取本院2022年10月—2023年6月收治的复杂性肛瘘术后患者120例,采用随机数字表法分为对照组和研究组各60例。对照组术后给予常规规范治疗,研究组术后给予祛瘀生肌散外敷治疗,术后1 d、3 d,检测两组患者的血清皮质醇、晚期氧化蛋白产物、去甲肾上腺素水平;术后1 d、7 d,检测两组患者血清6-酮前列腺素E1α、激活素A、神经肽Y、淀粉样蛋白A、5羟色胺、肿瘤坏死因子-α水平;术后1 d、14 d,检测两组患者肉芽组织血管内皮生长因子受体-2(VEGFR-2)、趋化因子配体5(CCL5)表达水平;计算并比较两组患者新生毛细血管数、创面渗液评分、慢性疼痛自我效能感量表(CPSS)评分及创面愈合时间,比较两组的临床疗效。结果:术后3 d,研究组血清皮质醇、晚期氧化蛋白产物、去甲肾上腺素含量较对照组低(P <0.05);术后7 d,研究组血清激活素A、淀粉样蛋白A、肿瘤坏死因子-α含量较对照组低,6-酮前列腺素E1α、神经肽Y、5羟色胺表达量较对照组低(P <0.05);术后14 d,研究组创面肉芽组织VEGFR-2表达水平、新生毛细血管数、CPSS评分高于对照组,CCL5表达水平、创面渗液评分低于对照组(P <0.05);研究组创面愈合时间较对照组短,总有效率较对照组高(P <0.05)。结论:祛瘀生肌散外敷治疗复杂性肛瘘术后患者,可减少创伤应激,抑制炎症及疼痛介质,促进毛细血管新生,减少创面渗液,缓解疼痛,促进创面愈合,提升疗效。
关键词:  祛瘀生肌散  复杂性肛瘘  毛细血管新生  血管内皮生长因子受体-2  趋化因子配体5
DOI:10.3969/j.issn.1007-6948.2025.03.001
投稿时间:2024-08-06
基金项目:河北省中医药管理局科研计划(2023375)
Influence of Quyu Shengji powder on wound repair of complicated anal fistula
PENG Biao,BAO Hu-bao,WANG Yan-yan
Department of Proctology, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, China
Abstract:
Objective To observe the effect of Quyu Shengji powder on wound repair of complicated anal fistula. Methods A total of 120 patients with complex anal fistula surgery treated in the hospital from October 2022 to June 2023 were divided into the control group and the study group by random number table method, with 60 cases in each group. The control group was given routine and standardized postoperative treatment, while the study group was given external treatment with Quyu Shengji powder. Serum cortisol, advanced oxidized protein products and norepinephrine levels were detected in 3 d. Serum levels of 6-keto prostaglandin E1α, activin A, neuropeptide Y, amyloid A, 5-hydroxytryptamine and tumor necrosis factor-α were detected 1 d and 7 d after surgery. The expression levels of CCL5 and VEGFR-2 in granulation tissue were detected 1 d and 14 d after surgery, the number of new capillaries was calculated, the wound fluid permeability was evaluated, the chronic pain self-efficacy scale (CPSS) was evaluated, the wound healing time of the two groups was recorded, and the clinical efficacy of the study group and the control group were compared. Results On 3 days after operation, the serum cortisol, late oxidized protein products and norepinephrine contents in the study group were lower than those in the control group (P <0.05). On the 7th day after operation, the contents of activin A, amyloid A and tumor necrosis factor-α in serum in the study group were lower than those in the control group, and the expressions of 6-keto prostaglandin E1α, neuropeptide Y and 5-hydroxytryptamine in the study group were lower than those in the control group (P <0.05). 14 days after surgery, the VEGFR-2 expression level, number of new capillaries and CPSS score in the study group were higher than those in the control group, while the CCL5 expression level and wound permeability score were lower than those in the control group (P <0.05). The wound healing time of the study group was shorter than that of the control group, and the total effective rate was higher (P <0.05). Conclusion Quyu Shengji powder can reduce traumatic stress, inhibit inflammation and pain mediators, promote capillary angiogenesis, reduce wound seepage, relieve pain, promote wound healing and improve curative effect in the treatment of patients with complicated anal fistula.
Key words:  Quyu Shengji powder  complex anal fistula  capillary neovascularization  vascular endothelial growth factor receptor-2  C-C motif chemokine ligand 5

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