芫花根水提取物对肛瘘术后疼痛、炎性反应与创面愈合影响的临床研究

发布时间：2018-01-06 23:30

本文关键词：芫花根水提取物对肛瘘术后疼痛、炎性反应与创面愈合影响的临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：从中药芫花根药材制备出水提取物,外用用于肛瘘术后创而,对照研究其对肛瘘术后疼痛、炎性反应与创而愈合的影响。方法：将2015年12月-2016年2月在江苏省中医院肛肠科住院的40例低位单纯性肛瘘患者作为研究对象,随机分为治疗组和对照组,每组各20例。两组患者术前准备一致,手术均采用低位肛瘘切开术,两组患者术后一般治疗、术后坐浴清洗处理均相同。但术后换药时治疗组以20%芫花根水提取物纱条(1ml药液中含原药材0.2g)填敷创面,对照组以黄芩油膏纱条填敷创面,每日换药两次。定期记录术后肛门疼痛评分、创面分泌物变化情况、创而渗液印片中巨噬细胞数量、创面肉芽生长积分、创而愈合时间等,对各组数据进行统计学比较研究。数据分析采用SPSS19.0。结果：①创面分泌物评分比较：术后第3天治疗组与对照组分泌物评分分别为：1.6±0.75、2.45±0.51,术后第7天治疗组与对照组分泌物评分分别为：1.1±0.64、2.15±0.67,术后第10天治疗组与对照组分泌物评分分别为：0.35±0.49、1.4±0.6,治疗组优于对照组,3个时间点组间分别比较有显著性差异(P＜0.01)。②创面疼痛比较：术后第2天、第5天、第7天、第14天治疗组疼痛评分分别为：3.65±0.81、4.65±0.67、2.65±0.75、0.6±0.68,对照组：4.65±0.99、5.9±0.91、4.9±0.71、1.75±0.97,治疗组优于对照组,4个时间点组间分别进行比较,均有统计学差异(P0.05)。③创而渗液印片巨噬细胞数量比较：在术后第3天、第7天,记录创面渗液印片中巨噬细胞数量,对比发现,治疗组术后第7、10天分别为7.25±2.29个/HP、3.95±1.85个/HP,对照组5.35±2.08个/HP、2.10±1.17个/HP,治疗组优于对照组,2个时间点组间比较均有统计学差异(P(0.05)。④创面肉芽生长情况比较：治疗组与对照组术后第7天肉芽生长积分分别为：2.5±0.6、2.5±0.55,术后第10天分别为：1.55±0.6、1.55±0.51,术后第14天分别为：0.8±0.41、0.8±0.7,术后第7、10、14天两组间比较并无统计学差异(P0.05)。⑤创面总愈合时间比较：治疗组创面平均愈合时间(天)为：19.35±4.16,对照组平均愈合时间(天)：19.1±3.85,两组经数据分析P0.05,无统计学差异。⑥总有效率：术后1月统计两组患者总有效率均为100%。治疗过程中,无不良事件的发生。结论：芫花根水提物能有效减少肛瘘术后创面渗液、缓解术后创面疼痛,并能在创面愈合早中期增加创面巨噬细胞数量,但加速创面修复功能不显。
[Abstract]:Objective: to prepare the effluent extract from Daphne genkwa root for external use in the treatment of postoperative pain of anal fistula. Methods: from December 2015 to February 2016, 40 patients with low simple anal fistula in Department of anal and intestine, Jiangsu Provincial Hospital of traditional Chinese Medicine, were studied. Two groups were randomly divided into treatment group and control group with 20 cases in each group. The patients in the two groups had the same preparation before operation and all the patients were treated with low anal fistula incision. The patients in the two groups were treated generally after operation. The treatment was the same after operation, but the treatment group was filled with 20%% water extract gauze of Daphne genkwa root and the control group was filled with baicalin ointment gauze. Change medicine twice a day. Record the postoperative anal pain score, wound secretion changes, the number of macrophages in the wound exudate print, wound granulation growth score, wound healing time and so on. SPSS 19.00.Results the score of wound secretion in the treatment group and the control group were compared on the third day after operation: the scores of secretion in the treatment group and the control group were:. 1.6 卤0.75. The score of secretion in the treatment group and the control group was 1. 1 卤0. 64 卤2. 15 卤0. 67 on the 7th day after operation. On the 10th day after operation, the score of secretion in the treatment group and the control group was 0.35 卤0.49 卤1.4 卤0.6, respectively, which was superior to that in the control group. There were significant differences among the three time points (P < 0.01). 2 the pain of wound was compared on the 2nd, 5th, 7th day after operation. On the 14th day, the pain score of the treatment group was 3.65 卤0.81 卤0.67 卤0.67 卤0.67 卤0.67 卤0.68, and that of the control group was 4.65 卤0.99. The treatment group was superior to the control group in terms of 5.9 卤0.91U 4.9 卤0.71U 1.75 卤0.97, and the four time points were compared respectively. There were significant differences in the number of macrophages in the exudate impressions: on the 3rd and 7th day after operation, the number of macrophages in the wound exudate printing tablets was recorded, and the results were compared. On the 7th day after operation, 7.25 卤2.29 / HP3. 95 卤1. 85 / HPs were found in the treatment group and 5. 35 卤2. 08 / Hp / HPs in the control group (P < 0. 05). 2.10 卤1.17 HPs, the treatment group was superior to the control group. Comparison of granulation growth in two time points: the granulation growth score of the treatment group and the control group was 2.5 卤0.6 on the 7th day after operation. 2.5 卤0.55, 1. 55 卤0. 61.55 卤0. 51 on the 10th day after operation, 0. 8 卤0. 41 卤0. 8 卤0. 7 on the 14th day after operation, respectively. There was no statistical difference between the two groups in 10 days and 14 days. The average healing time of wounds in the treatment group was 19.35 卤4.16, and that in the treatment group was 19.35 卤4.16. The average healing time of the control group was 19.1 卤3.85, the two groups were analyzed by data (P0.05). There was no statistical difference in the total effective rate: on January, the total effective rate of the two groups was 100. Conclusion: water extract from the root of Daphne genkwa can effectively reduce the exudation of the wound after anal fistula, relieve the postoperative pain, and increase the number of macrophages in the early and middle stage of wound healing. But the function of accelerating wound repair was not obvious.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R266

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