拔毒生肌散用于肛肠疾病术后换药的临床观察

摘要

目的:探索拔毒生肌散用于肛肠疾病术后换药的疗效与安全性.方法:共纳入肛瘘、肛周脓肿术后患者19例,包括迁延1个月不愈者7例(A组),感染性创面者12例(B组). 2组患者均采用拔毒生肌散与凡士林1:9混匀,涂抹于无菌纱条,在常规消毒清创后,进行填塞或外敷,1次/d,连续7 d.观察2组有效率,对比治疗前后创面面积、脓性分泌物、局部疼痛瘙痒,监测不良反应.结果:2 组患者均取得了较理想的疗效,总有效率95.7%,其中A组(86.7%)有优于B组(100.0%)的趋势(P＞0.05);治疗后创面面积显著缩小(P＜0.05),脓腐评分显著降低(P＜0.05),局部疼痛评分、瘙痒评分未显著降低(P＞0.05).未发现药物不良反应.结论:拔毒生肌散用于肛肠疾病术后难愈性创面和感染性创面的换药有效安全,值得进一步研究.%Objective:To explore the efficacy and safety of Badu Shengji powder for dressing replacement after anorectal diseases . Methods:A total of 19 patients with anal fistula and perianal abscess in our hospital from April 2017 to August 2017 were included and divided into group A or group B according to their different conditions .There were 7 cases who delayed wound healing for one month assigned to group A ,and 12 cases with infected wounds were assigned to group B.All of the patients were stuffed or covered with the sterilized gauze which infiltrationed with Badu Shengji powder and Vaseline mixed in ratio of 1:9.After routine disinfection and removal of the clinging skin ,padding or external application was performed ,once a day for 7 days.The effective rate,the wound area,the score of pus secretion,the score of local pain and itch ,the liver and kidney function and the side effects were observed be－fore and after treatment in the two groups.Results:Both groups had an ideal curative effect ,and the total effective rate was 95.7%. The group A (86.7%) had a tendency to had superior curative effect than group B (100%) (P＞0.05); the area of wound sur－face decreased significantly (P＜0.05),The purulent rot score was significantly reduced (P＜0.05),and the local pain and pruri－tus score did not decrease significantly (P＞0.05).No adverse reactions were found ,and liver and kidney functions were not foun－ded abnormal.Conclusion:It is effective and safe for the dressing replacement of the refractory wounds and infected wounds after the operation of anorectal diseases.It is worth to expand the sample size,prolong the observation time ,and conduct the randomized controlled trial further more.