【摘要】：目的:研究中藥外用膏劑分期換藥在促進低位肛周膿腫一期根治術術后患者創(chuàng)面愈合的療效。材料與方法:本研究采用隨機對照實驗的設計方法。將40例于我院行肛周膿腫一期根治術的患者隨機分為2組,每組20例。治療組在常規(guī)治療的基礎上于術后第1d起用三種中藥外用膏劑(水調膏、油調膏、一效膏)依次分期換藥治療。對照組在常規(guī)治療的基礎上于術后第1d用凡士林紗條聯合雷夫奴爾紗條換藥治療。觀察兩組間創(chuàng)面的愈合情況及安全性指標,對術后第3d、7d、10d第一次換藥時創(chuàng)面肉芽生長、疼痛、滲液及分泌物情況做量化積分并進行記錄,并對創(chuàng)面愈合時間做記錄。用SPSS17.0統(tǒng)計學軟件對兩組的創(chuàng)面肉芽生長、疼痛、滲液及分泌物積分及創(chuàng)面愈合時間進行統(tǒng)計分析。結果:1.治療前兩組間患者的性別、年齡、病程具有可比性(P0.05)。2.術后第3d,肉芽生長積分、疼痛積分、創(chuàng)面滲液及分泌物積分比較上差異沒有統(tǒng)計學意義(P0.05)。3.術后第7d、10d,兩組間肉芽生長積分比較有統(tǒng)計學意(P0.05),并且治療組藥物在促進肉芽生長方面優(yōu)于對照組。術后第7d、10d,兩組間疼痛積分比較沒有統(tǒng)計學意義(P0.05),提示兩組在緩解創(chuàng)面疼痛方面效果差異性不明顯。術后第7d,兩組間創(chuàng)面滲液及分泌物積分比較差異有統(tǒng)計學意義(P0.05),且治療組創(chuàng)面滲液及分泌物量大于對照組。術后第10d,組間創(chuàng)面滲液及分泌物積分比較沒有統(tǒng)計學意義(P0.05),提示兩組在創(chuàng)面滲液及分泌物差異不明顯。4.兩組在創(chuàng)面愈合時間方面差異有統(tǒng)計學意義(P0.05),并且治療組在促進創(chuàng)面愈合時間上快于對照組。5.兩組在安全性指標觀測中未發(fā)生不良反應。結論:1.兩組換藥法在促進低位肛周膿腫一期根治術術后患者創(chuàng)面愈合方面均有效。2.治療組在創(chuàng)面肉芽生長、愈合時間方面優(yōu)于對照組,在疼痛方面兩組間無差異。提示中藥外用膏劑分期換藥對行低位肛周膿腫一期根治術患者的創(chuàng)面有促進愈合作用,但對緩解術后創(chuàng)面疼痛的療效不明確。3.在術后第7d,治療組創(chuàng)面的滲液及分泌物積分大于對照組,進一步驗證了中醫(yī)學“煨膿長肉”理論。4.中藥外用膏劑分期換藥在安全性指標觀測中未發(fā)生不良反應,提示中藥外用膏劑分期換藥方案安全可靠。
[Abstract]:Objective: to study the effect of external Chinese medicine plaster on promoting wound healing of patients with low perianal abscess after one-stage radical operation. Materials and methods: a randomized controlled trial was used in this study. Forty patients undergoing one stage radical resection of perianal abscess in our hospital were randomly divided into 2 groups with 20 cases in each group. On the first day after operation, the treatment group was treated with three kinds of traditional Chinese medicine plaster (Shuijiao ointment, Youjiao ointment, Yixiao ointment). The control group was treated with vaseline gauze combined with Rayvnur gauze on the first day after operation on the basis of routine treatment. The wound healing and safety indexes were observed. The granulation growth, pain, exudation and secretion of the wound were quantified and recorded on the 3rd day, 7th day and 10th day after operation, and the healing time of the wound was recorded. The granulation growth, pain, exudation, secretion and wound healing time of the two groups were analyzed by SPSS17.0 software. The result is 1: 1. The sex, age and course of disease were comparable between the two groups before treatment (P0.05). On the 3rd day after operation, there was no significant difference in granulation growth score, pain score, wound exudate and secretion score (P0.05). The granulation growth score of the two groups was significantly higher than that of the control group on the 7th and 10th day after operation (P0.05), and the drug in the treatment group was superior to the control group in promoting the granulation growth. There was no significant difference in pain scores between the two groups on the 7th day after operation (P0.05), suggesting that there was no significant difference in pain relief between the two groups. On the 7th day after operation, the difference of wound exudate and secretion between the two groups was statistically significant (P0.05), and the amount of wound exudate and secretion in the treatment group was higher than that in the control group. On the 10th day after operation, there was no significant difference in the score of wound exudate and secretion between the two groups (P0.05), suggesting that there was no significant difference between the two groups in wound exudate and secretion. 4. The difference between the two groups in wound healing time was statistically significant (P0.05), and the treatment group in promoting wound healing time faster than the control group. 5. 5. There was no adverse reaction in the observation of safety index between the two groups. Conclusion 1. The two groups were effective in promoting the wound healing of patients with low perianal abscess after one stage radical operation. The granulation growth and healing time of the treatment group were better than that of the control group, but there was no difference in pain between the two groups. The results suggest that the external application of Chinese medicine plaster can promote wound healing in patients with low perianal abscess by stages, but the curative effect on relieving postoperative wound pain is not clear. 3. On the 7th day after operation, the score of exudation and secretion in the treatment group was higher than that in the control group, which further verified the theory of "simmering pus and long meat" in traditional Chinese medicine. There was no adverse reaction in the observation of safety index of external Chinese medicine plaster by stages, which suggested that the plan of Chinese traditional medicine external plaster change by stages was safe and reliable.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R266
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本文編號：2236082