分期中药熏洗对混合痔术后创面愈合的干预研究

目的：探讨分期辨证应用中药熏洗对混合痔术后创面的影响及安全性评价。方法：80 例混合痔术后患者随机分为治疗组和对照组各 40 例。对照组应用康复新液熏洗，治疗组按疮疡祛腐期、生肌长肉期和收口敛皮期三个阶段辨证应用中药四黄祛毒汤加味熏洗。观察两组患者术后平均出院时间和平均创面完全愈合时间，以及术后创面恢复过程中第 5 天、第 10 天和第 15 天时，患者疼痛评分，创面渗出情况，创面愈合情况评分，并观察不良反应。结果：治疗组出院时间和创面完全愈合时间均短于对照组（P<0.05）。治疗组术后第 10 天较对照组疼痛评分明显降低（P<0.05）。治疗组术后第 10 天和第 15 天时创面愈合情况评分优于对照组（P<0.05）。术后第 10 天和第 15 天时，中度的创面渗出患者较轻度渗出患者的单位面积创面完全愈合时间短（P<0.05）。结论：分期辨证使用中药熏洗可有效促进混合痔术后创面愈合，且安全性好。维持中度创面渗出水平，保持创面湿润，可能更有利于创面愈合。

Clinical Study on Treatment of Postoperative Wound Healing of Mixed Hemorrhoids with Staged Application of Traditional Chinese Medicine Sitz Bath

Objective To explore the effect and safety of staged application of traditional Chinese medicine (TCM) sitz bath on postoperative wound healing of mixed hemorrhoids. Methods Totally 80 patients were randomly divided into treatment group and control group. The patients in control group were treated with Kangfuxin Liquid, and the treatment group divided into three stages with TCM sitz bath. The average postoperative discharge time and average healing time of the two groups were observed. After 5 d, 10 d and 15 d of wound healing, the pain score, wound exudation, wound healing score, and adverse reactions were observed. Results The time of discharge and time of wound healing in the treatment group were shorter than those in the control group (P<0.05). The pain score of the treatment group was significantly lower than that of the control group on day 10 after operation (P<0.05). The healing rate of the treatment group was higher than that of the control group on day 10 and 15 after operation (P<0.05). After 10 d and 15 d of operation, the patients with moderate wound exudation had shorter wound healing time than those with mild exudation (P<0.05). Conclusion Using TCM sitz bath with staged application can effectively promote wound healing after mixed hemorrhoids operation, with good safety. Maintaining moderate wound exudation level and keeping the wound moist may be more conducive to wound healing.