标题：紫黄生肌膏促进高位复杂性肛瘘术后创面愈合的临床研究

      作者：何宗琦，文科，王晓鹏，甄曙光，孙薛亮，杨建华    (苏州市中医医院南京中医药大学苏州附属医院肛肠科，江苏 苏州 215009)

      卷次： 2018年29卷20期

      【摘要】 目的 观察紫黄生肌膏外敷伤口对高位复杂性肛瘘术后创面愈合的临床疗效及安全性。方法 采用队列研究方法将63例苏州市中医医院2015年1月至2017年8月间收治的高位复杂性肛瘘术后患者分为观察组(n=33)和对照组(n=33)，观察组换药时采用浸有紫黄生肌膏的纱布外敷创面，对照组应用凡士林纱布覆盖创面。通过观察术后不同时期患者创面愈合率、创面愈合时间、创面疼痛情况及治疗期间有无不良事件出现等评价紫黄生肌膏的临床疗效及安全性。结果 两组患者术后均随访6个月，63例患者肛瘘切口均在60 d内愈合，其中有2例复发；两组患者均完成全部随访观察指标，无不良事件发生。比较两组术后第 7天的主切口创面愈合率，观察组为(23±2.28)%，对照组为(21±1.14)%，差异无统计学意义(P>0.05)；观察组患者术后第14天和第30天的主切口创面愈合率分别为(51±4.45)%和(95±2.43)%，均明显高于对照组的(40±2.97)%和(82±4.15)%，差异均有统计学意义(P<0.05)；观察组患者术后第 1天的疼痛评分为(2.23±0.37)分，与对照组的(2.36±0.51)分比较差异无统计学意义(P>0.05)；观察组患者术后第7天的第14天的疼痛评分分别为(1.24±0.74)分和(0.51±0.32)分，明显低于对照组的(1.78±0.44)分和(1.06±0.83)分，差异均有统计学意义(P<0.05)；观察组患者术后主切口创面愈合时间为(36±1.74) d，明显短于对照组的(45±2.16) d，差异有统计学意义(P<0.05)。结论 高位复杂性肛瘘术后换药时应用紫黄生肌药膏能减轻患者术后伤口疼痛、促进创面愈合，能缩短创面愈合时间，且安全性好，值得临床推广应用。
      【关键词】 紫黄生肌膏；高位复杂性肛瘘；创面愈合
      【中图分类号】 R657.1+6 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2856—03

Clinical study on Zihuang Shengji Ointment in promoting postoperative wound healing of highly complicatedanal fistula.
HE Zong-qi, WEN Ke, WANG Xiao-peng, ZHEN Shu-guang, SUN Xue-liang, YANG Jian-hua. Departmentof Anorectal, Suzhou Hospital of Chinese Medicine, Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine,Suzhou 215009, Jiangsu, CHINA
【Abstract】 Objective To observe the clinical efficacy and safety of external application of Zihuang ShengjiOintment in the treatment of wound healing after high complex anal fistula. Methods A total of 63 patients withhigh-complex anal fistula, admitted to Suzhou Hospital of Chinese Medicine from January 2015 to August 2017, were di-vided into the observation group (n=33) and control group (n=30) by using the cohort study method. The gauze soakedwith Zihuang Shengji Ointment was used to the wound surface in the observation group, and Vaseline gauze was used inthe control group. The wound healing rate, wound healing time, wound pain and adverse events were observed to evalu-ate the clinical efficacy and safety of Zihuang Shengji Ointment during the treatment. Results All the patients were fol-lowed up for 6 months. All the 63 patients underwent anal fistula incision within 60 days, two of them relapsed. Allthe patients completed all follow-up observations and no adverse events occurred. The wound healing rate of the mainincision on the 7th day after operation in the observation group was (23 ± 2.28)% versus (21 ± 1.14)% in the controlgroup (P>0.05). The wound healing rates of the main incision on the 14th day and 30th day in the observation groupwere (51±4.45)% and (95±2.43)%, respectively, which were significantly higher than corresponding (40±2.97)% and(82±4.15)% of the control group (P<0.05). The pain scores on the 1st postoperative day in the observation group and thecontrol group were respectively (2.23±0.37) and (2.36±0.51), with no significant difference (P>0.05). The pain scores onthe 7th day and 14th day after operation in the observation group were (1.24±0.74) and (0.51±0.32), which were signifi-cantly lower than corresponding (1.78±0.44) and (1.06±0.83) in the control group (P<0.05). The average healing time ofthe observation group was (36±1.74) days versus (45±2.16) days of the control group (P<0.05). Conclusion ZihuangShengji Ointment can relieve postoperative pain, promote wound healing and shorten wound healing time afterhigh-complex anal fistula operation. It is worthy of clinical application.
      【Key words】 Zihuang Shengji Ointment; Highly complicated anal fistula; Wound healing·论 著·doi:10.3969/j.issn.1003-6350.2018.20.014基金项目：江苏省苏州市科技局应用基础研究项目(编号：SYS201574)