發(fā)布時間：2018-01-06 23:30

  本文關鍵詞：芫花根水提取物對肛瘺術后疼痛、炎性反應與創(chuàng)面愈合影響的臨床研究　出處：《南京中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 芫花根水提取物 肛瘺 創(chuàng)傷修復

【摘要】：目的：從中藥芫花根藥材制備出水提取物,外用用于肛瘺術后創(chuàng)而,對照研究其對肛瘺術后疼痛、炎性反應與創(chuàng)而愈合的影響。方法：將2015年12月-2016年2月在江蘇省中醫(yī)院肛腸科住院的40例低位單純性肛瘺患者作為研究對象,隨機分為治療組和對照組,每組各20例。兩組患者術前準備一致,手術均采用低位肛瘺切開術,兩組患者術后一般治療、術后坐浴清洗處理均相同。但術后換藥時治療組以20%芫花根水提取物紗條(1ml藥液中含原藥材0.2g)填敷創(chuàng)面,對照組以黃芩油膏紗條填敷創(chuàng)面,每日換藥兩次。定期記錄術后肛門疼痛評分、創(chuàng)面分泌物變化情況、創(chuàng)而滲液印片中巨噬細胞數量、創(chuàng)面肉芽生長積分、創(chuàng)而愈合時間等,對各組數據進行統(tǒng)計學比較研究。數據分析采用SPSS19.0。結果：①創(chuàng)面分泌物評分比較：術后第3天治療組與對照組分泌物評分分別為：1.6±0.75、2.45±0.51,術后第7天治療組與對照組分泌物評分分別為：1.1±0.64、2.15±0.67,術后第10天治療組與對照組分泌物評分分別為：0.35±0.49、1.4±0.6,治療組優(yōu)于對照組,3個時間點組間分別比較有顯著性差異(P＜0.01)。②創(chuàng)面疼痛比較：術后第2天、第5天、第7天、第14天治療組疼痛評分分別為：3.65±0.81、4.65±0.67、2.65±0.75、0.6±0.68,對照組：4.65±0.99、5.9±0.91、4.9±0.71、1.75±0.97,治療組優(yōu)于對照組,4個時間點組間分別進行比較,均有統(tǒng)計學差異(P0.05)。③創(chuàng)而滲液印片巨噬細胞數量比較：在術后第3天、第7天,記錄創(chuàng)面滲液印片中巨噬細胞數量,對比發(fā)現,治療組術后第7、10天分別為7.25±2.29個/HP、3.95±1.85個/HP,對照組5.35±2.08個/HP、2.10±1.17個/HP,治療組優(yōu)于對照組,2個時間點組間比較均有統(tǒng)計學差異(P(0.05)。④創(chuàng)面肉芽生長情況比較：治療組與對照組術后第7天肉芽生長積分分別為：2.5±0.6、2.5±0.55,術后第10天分別為：1.55±0.6、1.55±0.51,術后第14天分別為：0.8±0.41、0.8±0.7,術后第7、10、14天兩組間比較并無統(tǒng)計學差異(P0.05)。⑤創(chuàng)面總愈合時間比較：治療組創(chuàng)面平均愈合時間(天)為：19.35±4.16,對照組平均愈合時間(天)：19.1±3.85,兩組經數據分析P0.05,無統(tǒng)計學差異。⑥總有效率：術后1月統(tǒng)計兩組患者總有效率均為100%。治療過程中,無不良事件的發(fā)生。結論：芫花根水提物能有效減少肛瘺術后創(chuàng)面滲液、緩解術后創(chuàng)面疼痛,并能在創(chuàng)面愈合早中期增加創(chuàng)面巨噬細胞數量,但加速創(chuàng)面修復功能不顯。
[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 鹵0.75. The score of secretion in the treatment group and the control group was 1. 1 鹵0. 64 鹵2. 15 鹵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 鹵0.49 鹵1.4 鹵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 鹵0.81 鹵0.67 鹵0.67 鹵0.67 鹵0.67 鹵0.68, and that of the control group was 4.65 鹵0.99. The treatment group was superior to the control group in terms of 5.9 鹵0.91U 4.9 鹵0.71U 1.75 鹵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 鹵2.29 / HP3. 95 鹵1. 85 / HPs were found in the treatment group and 5. 35 鹵2. 08 / Hp / HPs in the control group (P < 0. 05). 2.10 鹵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 鹵0.6 on the 7th day after operation. 2.5 鹵0.55, 1. 55 鹵0. 61.55 鹵0. 51 on the 10th day after operation, 0. 8 鹵0. 41 鹵0. 8 鹵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 鹵4.16, and that in the treatment group was 19.35 鹵4.16. The average healing time of the control group was 19.1 鹵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.
【學位授予單位】：南京中醫(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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