中药熏洗与贴敷结合手术治疗肛周脓肿临床研究

目的：评价中药熏洗与贴敷结合手术治疗肛周脓肿的临床疗效。方法将符合入选标准的140例肛周脓肿患者采用随机数字表法分为2组，每组70例。对照组依据患者的病情选择不同的手术方式，术后在常规抗感染治疗同时配合高锰酸钾溶液(1︰5000)坐浴；观察组在对照组基础上配合中药熏洗与贴敷。2组均治疗1个月，随访3个月。观察患者伤口的红肿消失、腐肉脱落及愈合时间，以及疼痛程度的改善情况，评价临床疗效，记录随访期间的感染与复发情况。结果观察组总有效率为100.0%(70/70)、对照组为91.4%(64/70)，2组比较差异有统计学意义(χ2＝4.322，P＝0.037)。治疗后第3、7天，观察组不同疼痛等级患者的分布情况优于对照组(Z值分别为9.742、16.860，P值分别为0.008、0.001)。治疗后，观察组红肿消退时间(4.9±0.7)d 比(6.1±0.7)d，t＝10.142]、腐肉脱落时间(3.8±0.5)d 比(4.2±0.4)d，t＝5.227]、切口愈合时间(22.1±4.0)d比(26.9±4.0)d，t＝7.099]均低于对照组(P＜0.01)。随访期间，观察组继发感染4例(5.7%)、复发2例(2.9%)，对照组分别为20例(28.6%)、6例(8.6%)，2组继发感染率、复发率比较，差异均有统计学意义(χ2值分别为6.092、8.934，P值分别为0.034、0.001)。结论中药熏洗与贴敷结合手术治疗可促进肛周脓肿患者伤口愈合，降低继发感染与复发率。

Effect of traditional Chinese medicine fumigation and herbal plaster for the patients with perianal abscess

Objective To evaluate the clinical effect of traditional Chinese medicine fumigation and herbal plaster for the patients with anal abscess. Methods A total of 140 patients with anal abscess were randomly divided into 2 groups, 70 in each group. The control group were treated with different operation methods according to the patient's health condition. the Potassium Permanganate solution (1:5 000) bath was used after surgery in the conventional anti anti-infection treatment; and the observation group were treated with herbal fumigation and plaster on the basis of the control group. The wound was treated in the both groups in the following 3 months after operation. The wound swelling disappearance, carrion shedding and healing time, pain relief, medical records of infection and recurrence were measured after the treatment and follow-up period. Results The total effective rate of the observation group was 100% (70/70), and the control group was 91.4% (64/70). The difference between the 2 groups was statistically significant (χ2=4.322,P=0.037). After 3, 7 days, the pain relief in the observation group was better than that in the control group (Z=9.742, 16.860,P=0.008, 0.001). After treatment, the observation group swelling (4.9 ± 0.7 dvs. 6.1 ± 0.7 d,t=10.142), carrion shedding time (3.8 ± 0.5 dvs. 4.2 ± 0.4 d,t=5.227), the wound healing time (22.1 ± 4.0 dvs. 26.9 ± 4.0 d,t=7.099) were lower than those in the control group (P<0.01). During follow-up, 4 cases (5.7%) with secondary infection and 2 cases (2.9%) with recurrence were in the observation group, but 20 cases (28.6%) and 6 cases (8.6%) in the control group.There were significantly difference of the secondary infection and recurrence between two groups (χ2= 6.092,8.934,P= 0.034, 0.001). 2 groups of secondary infection, the differences were statistically significant. Conclusions The combination of traditional Chinese medicine fumigation and herbal plaster could improve the wound healing time, reduce the secondary infection and recurrence rates of patients with anal abscess.