| 摘要: |
| 目的:评价火针烙法排脓联合地榆油敷料填塞在糖尿病会阴部脓肿治疗中的效果。方法:选取天津医科大学朱宪彝纪念医院外科、泌尿外科及天津中医药大学第一附属医院中医外科2021年10月—2023年12月收治的糖尿病会阴部脓肿患者70例，按就诊次序随机分为两组，每组各35例。切开组采用切开排脓治疗填塞无菌纱条；火针组采用火针烙法排脓治疗脓腔内松散填塞地榆油敷料，持续干预2周为1个疗程，评价临床疗效、炎症因子、疼痛视觉模拟评分(VAS)、生活质量。并对比两组治疗结束后伤口愈合时间、换药次数、愈合后瘢痕情况及痊愈后3个月的随访情况。结果:治疗2周，火针组总有效率为97.15%，高于切开组的85.71%；火针组血清炎症因子指标(C反应蛋白、白细胞介素-6、肿瘤坏死因子-α)低于切开组，差异有统计学意义(P ＜0.05)。治疗3 d、1周、2周，火针组VAS评分低于切开组，差异有统计学意义(P ＜0.05)。治疗2周火针组生活质量评分优于切开组，差异有统计学意义(P ＜0.05)。治疗结束时，火针组的疮口愈合时间短于切开组，愈合后瘢痕情况优于切开组，差异有统计学意义(P ＜0.05)。两组痊愈后3个月的随访情况无统计学差异。结论:基于火针烙法洞式引流联合地榆油纱条填塞可以提高糖尿病会阴部脓肿的疗效，减轻疼痛，提高生活质量，缩短疮口愈合时间，瘢痕小且外观改变少。 |
| 关键词: 阴部脓肿 中医外治 火针烙法 地榆 疮疡 糖尿病 |
| DOI：10.3969/j.issn.1007-6948.2025.05.018 |
| 投稿时间：2025-01-05 |
| 基金项目:天津市卫生健康委、天津市中医药管理局中医、中西医结合科研项目(2021175)；天津市医学重点学科(专科)建设项目(TJYXZDXK-032A) |
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| Efficacy of fire-needle cautery fenestration drainage combined with sanguisorba oil dressing packing in the treatment of diabetic perineal abscesses |
| ZHOU Jin,XU Min,HU Cheng-xiao |
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| Abstract: |
| Objective To evaluate the effect of fire needle cauterization combined with Sanguisorba officinalis oil dressing in the treatment of diabetic perineal abscess. Methods 70 cases of diabetic perineal abscess diagnosed and treated were selected, and the data were collected. They were randomly divided into two groups according to the order of treatment, with equal proportion grouping structure. The control group (35 cases) was treated with incision and drainage to fill aseptic gauze; The observation group (35 cases) used fire needle cautery to expel pus to treat loose filling of Sanguisorba officinalis oil dressing in pus cavity, and continued intervention for 2 weeks as a course of treatment, and evaluated the clinical efficacy, inflammatory factors, visual analogue scale (VAS) of pain and quality of life. The wound healing time, dressing change times, scar after healing and 3 months follow-up after recovery were compared. Results After two weeks of treatment, the total effective rate was 97.15% in the observation group and 85.71% in the control group. Serum inflammatory factors (CRP, IL-6, TNF-α) in the observation group were lower than those in the control group, and the difference was statistically significant (P <0.05). The VAS score in the observation group was lower than that in the control group at the 3rd, 1st and 2nd week of treatment, and the difference was statistically significant (P <0.05). After 2 weeks of treatment, the quality of life score of the observation group was better than that of the control group, and the difference was statistically significant (P <0.05). Conclusion The combined application of fire-needle cautery fenestration drainage and Sanguisorba oil gauze packing demonstrates enhanced therapeutic efficacy in managing diabetic perineal abscesses. This integrated approach persistently alleviates pain, improves quality of life, shortens wound healing duration, while achieving minimal scarring and reduced aesthetic alterations. |
| Key words: Perineal abscess external treatment of traditional Chinese medicine fire needle cauterization sanguisorba ulcer diabetes |
