益气健脾汤加减联合拖线引流治疗泛发性肛周脓肿临床研究

目的:观察益气健脾汤加减联合拖线引流疗法治疗泛发性肛周脓肿的临床疗效。方法:选取102例泛发性肛周脓肿患者为研究对象,按照随机数表法分为研究组与对照组各51例。对照组实施局部切开引流,研究组采取益气健脾汤加减联合拖线引流疗法。比较两组患者在治疗前及治疗2周后,其中医症候(肛周肿痛、创面焮热、溃后伤口不敛)积分变化; 记录两组患者创面愈合时间、术后2周内复发率及成瘘率差异; 分析两组患者在术后1 d、术后1周及术后2周时,其疼痛程度数字评分法(NRS)]及肛门功能(Wexner量表)评分变化。结果:治疗2周后,两组患者中医症候积分低于治疗前(P<0.05),且研究组低于对照组(P<0.05); 研究组创面愈合时间短于对照组(P<0.05),且术后2周内复发率及成瘘率均较对照组低(P<0.05); 术后1 d时,两组患者NRS、Wexner评分比较差异无统计学意义(P>0.05),术后1周及术后2周时,两组患者肛门NRS、Wexner评分均较术后1 d时降低(P<0.05),且研究组较对照组低(P<0.05)。结论:益气健脾汤加减联合拖线引流疗法可缓解泛发性肛周脓肿患者疾病症状,加快创面愈合速度并降低复发率、成瘘率,改善患者疼痛程度与肛门功能。

Clinical study on modified Yiqi Jianpi decoction combined with thread-dragging drainage therapy in the treatment of generalized perianal abscess

Objective:To study modified Yiqi Jianpi decoction combined with thread-dragging drainage therapy in the treatment of generalized perianal abscess.Methods:A total of 102 patients with generalized perianal abscess were selected as the research subjects,and they were divided into study group and control group according to the random number table method,with 51 cases in each group.Control group received local incision and drainage,and study group was given modified Yiqi Jianpi decoction combined with thread-dragging drainage therapy.The scores of TCM symptoms(perianal swelling and pain,wound hotness,wound non-healing after ulceration)were compared between the two groups of patients before treatment and after 2 weeks of treatment.The wound healing time and the recurrence rate and fistulization rate within 2 weeks after surgery were recorded in the two groups of patients.The pain level Numeric Rating Scale(NRS)] and anal function score(Wexner scale)were analyzed in the two groups at 1 d,1 week and 2 weeks after surgery.Results:After 2 weeks of treatment,the TCM syndromes scores of the two groups were lower than those before treatment(P<0.05),and the scores of study group were lower than those in control group(P<0.05).The wound healing time of study group was shorter than that in control group(P<0.05),and the recurrence rate and fistulization rate within 2 weeks after surgery were lower than those in control group(P<0.05).At 1 d after surgery,there were no significant differences in the scores of NRS and Wexner between the two groups(P>0.05),and at 1 week after surgery and at 2 weeks after surgery,the scores of anal NRS and Wexner in the two groups of patients were lower than those at 1 d after surgery(P<0.05),and the scores of study group were lower than those in control group(P<0.05).Conclusion: Modified Yiqi Jianpi decoction combined with thread-dragging drainage therapy can relieve the disease symptoms,speed up wound healing and reduce the recurrence rate and fistulization rate,and improve the pain level and anal function of patients with generalized perianal abscess.