摘要
目的:探究大黄制剂对肛周脓肿患者术后创面菌群微生态的调节作用及对创面愈合的促进作用。方法:采用随机分组法将2020年1月—2021年12月普外科收治的120例肛周脓肿患者分为大黄制剂口服组(40例)、大黄制剂口服+熏洗组(40例)与常规对照组(40例);检测3组患者术前和术后1周CRP、IL-6、PCT水平变化,观察术后第1天和术后1周创面pH值、细菌培养情况、创面渗液情况和创面疼痛(VAS)评分,记录3组患者住院时间、抗生素使用时间和不反应发生情况。结果:术后1周口服+熏洗组与口服组CRP、IL-6、PCT水平较对照组显著降低(P<0.05),而且口服+熏洗组CRP和PCT水平较口服组显著降低(P<0.05);术后1周口服+熏洗组患者创面大肠埃希菌较口服组与对照组显著降低,而无菌生率则显著增加(P<0.05);3组患者术后1周的pH值无显著差异(P>0.05),但口服组+熏洗组渗液和VAS评分较口服组和对照组显著减轻或降低(P<0.05);口服+熏洗组住院时间、抗生素使用时间均显著低于口服组与对照组(P<0.05);口服组+熏洗组不良反应总发生率略低于对照组与口服组,但无显著差异(P=0.304)。结论:大黄制剂通过调整肛周脓肿术后创面的菌群微生态以促进创面修复,能够缩短住院时间和抗生素使用时间。
Objective:To explore the clinical effect of Rhubarb Preparation in regulating the postoperative wound microecology and promoting wound recovery in patients with perianal abscess.Methods:120 patients with perianal abscess in General Surgery Department of Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2020 to December 2021 were randomly divided into Rhubarb Preparation oral group(40 caese),Rhubarb Preparation oral+fumigation-washing group(40 cases)and conventional control group(40 cases).The serum CRP,IL-6,PCT were determined before and after treatment for 1 week,The wound pH value,bacterial culture,wound exudation and Visual Analogue Scale(VAS)score about pain at postoperative 1 day and 1 week were observed,The hospital stay length and antibiotic use time were recorded in all three groups,the total adverse reaction was recorded.Results:Serum CRP,IL-6 and PCT levels of oral+fumigation-washing group and oral group at 1 week after surgery were significantly decreased compared with control group(P<0.05),and the CRP and PCT levels of oral+fumigation-washing group were remarkably lower than those of oral group(P<0.05).At postoperative 1 week,Escherichia coli proportion in oral+fumigation-washing group was decreased and proportion of no bacterial growth was increased compared with oral group and control group,with statistical difference(all P<0.05).At postoperative 1-week,wound pH value demonstrated no statistical difference among three groups(P>0.05),while wound exudation and VAS score in oral+fumigation-washing group were lower than those in oral group and control group,with statistical difference(P<0.05).Hospital stay and antibiotic use time of the oral+fumigation-washing group were shortened compared with oral group and the control group,with statistical difference(all P<0.05).The total adverse reaction rate of oral+fumigation-washing group was slightly lower than that of oral group and control group,with no statistical difference(P=0.304).Conclusion:Rhubarb preparation can promote the postoperative wound recovery in patients with perianal abscess by regulating the microecology of wound flora,alleviate the pain degree,attenuate the exudation,shorten the length of hospital stay and the time of antibiotic use,save medical resources.
作者
朱宝成
沈卫星
章平
刘新育
崔恒官
ZHU Baocheng;SHEN Weixing;ZHANG Ping;LIU Xinyu;CUI Hengguan(Department of General Surgery,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700)
出处
《中国中医药科技》
CAS
2023年第5期841-844,共4页
Chinese Journal of Traditional Medical Science and Technology
基金
上海市中西医结合学会社区医学与健康管理研究基金项目(SQ17)。
关键词
大黄制剂
中药熏洗
肛周脓肿
创面菌群微生态
创面愈合
Rhubarb preparation
Chinese herbs fumigation-washing
perianal abscess
wound microbiota
wound recovery
