| Objective:To investigate the clinical characteristics,diagnosis and treatment of Crohn’s disease with perianal fistula.2.Objective to investigate the related risk factors of Crohn’s anal fistula wound healing and the intervention effect of traditional Chinese medicine.Methods:from October 1,2009 to December 1,2020,patients with CD anal fistula were collected and analyzed retrospectively.Result:(1)The ratio of male to female was 2.48:1,and the average age was 30.16± 11.75 years old,ranging from 12 to 65 years old;(2)CD patients were concentrated in Jiangsu Province(127 cases)and Anhui Province(31 cases).28.2%of the patients lived in other places for a long time;The average body mass index of male patients with CD was 20.59±3.8kg/m2,and that of female patients was 20.15±3.6kg/m2;(3)There were 72 patients with perianal operation history,27 patients with abdominal operation history and 10 patients with appendectomy history,accounting for 41.38%,15.52%and 5.75%respectively;(4)There were 10.34%irregular diet,more high-fat diet,more protein and carbohydrate intolerance;(5)The average age of diagnosis was(25.53 ± 7.48)years.The most common type was type B1;(6)The TCM syndrome types of upper large intestine damp heat syndrome were the most,followed by spleen deficiency and damp excess syndrome,liver depression and spleen deficiency syndrome,spleen stomach deficiency and cold syndrome,qi stagnation and blood stasis syndrome;(7)The first symptom of nearly one patient with CD was perianal lesions,followed by abnormal stool and abdominal pain and diarrhea;the most common extraintestinal manifestations were hepatobiliary diseases;the most common complication was anemia,followed by intestinal obstruction;(8)There are many anal fistula in one low position,most of which are intersphincteric fistula or trans sphincter fistula,and the most of which are 6 points in lithotomy position;(9)In terms of treatment,anal fistula resection is the main treatment,mesalazine combined with intestinal flora is the main treatment in western medicine,and oral administration combined with external fumigation is the main treatment in traditional Chinese medicine;(10)The wound healing of Crohn’s anal fistula is related to Hb,ESR and anal fistula classification.The lower Hb is,the more difficult the wound healing is;the higher ESR is,the more difficult the wound healing is;the wound healing rate of high anal fistula is lower than that of low anal fistula.Conclusion:1.The general situation and clinical characteristics of patients with Crohn’s anal fistula in this study are basically consistent with the research reports at home and abroad,but there are some differences,which are related to the factors such as region,sample size,the detail of doctor’s history collection,etc.2.It was found that Hb,ESR and anal fistula classification were related to the wound healing of Crohn’s anal fistula.Clinical treatment should focus on these factors and implement treatment measures according to their characteristics to increase the probability of wound healing.3.Traditional Chinese medicine has a certain curative effect in the treatment of Crohn’s anal fistula,which needs further clinical observation. |
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