| Objective:By observing the clinical effect of Zhuyumieban Decoction on scar of the wounds after high complex anal fistula operation,the influence of instructor’s experience prescription on scar of the wounds after anal fistula surgery is further explored.Methods:A total of 40 patients with high-complexity anal fistula admitted to the anorectal outpatient department of Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2020 to November 2020 were selected.All the subjects were randomly divided into groups,and 40 cases were randomly generated by SAS simulation,numbered from 1 to 40.The random numbers were sealed with envelopes respectively.The researchers opened the random envelopes one by one according to the order of visiting the doctor to determine the group of the subjects,20 cases in the experimental group and 20 cases in the control group.The experimental group was given routine fumigation,washing and dressing change after surgery,and Zhuyumieban Decoction was added for internal administration 4 weeks later.The control group was given routine fumigation,washing and dressing change after surgery.Postoperative wound surface area,scar area,change rate of scar area,time to complete wound healing,Patient and Observer Scar Assessment Scale(POSAS)and Young’s modulus of scar were recorded in both groups.Aderse reactions were observed through follow-up.SPSS24.0 statistical software was used to analyze the data and evaluate the clinical effect of Zhuyu miban decoction on wound scar after high complexity anal fistula operation.Results:(1)There were no statistical differences in gender,age and wound surface area 2 days after operation between the two groups(P>0.05).(2)Taking the wound surface area 2 days after surgery as the baseline,there was no statistical difference in the wound surface area between the two groups at 4 weeks after surgery(P#>0.05),while the scar area of the experimental group at 14 and 18 weeks after surgery was significantly smaller than that of the control group(P*、P**<0.01).(3)Taking the wound surface area 2 days after surgery as the baseline,there was no statistical difference in the change rate of wound surface area 4 weeks after surgery between the two groups(P#>0.05),while the change rate of scar area in the experimental group at 14 and 18 weeks after surgery was significantly higher than that in the control group(P*、P**<0.01).(4)Comparison of the time of the total wound healing between the two groups showed that the time of the average wound healing of patients in the experimental group was(85.25±4.98)days,while that of patients in the control group was(89.20±6.73)days.The experimental group had shorter wound healing time,with statistical significance(P<0.05).(5)Comparison of scores of POSAS after scar formation in the two groups showed that POSAS scores in the experimental group at 14 and 18 weeks after surgery were significantly lower than those in the control group,with statistically significant differences(P#,P*<0.01).(6)The comparison of Young’s modulus of scar between the two groups showed a statistical difference between the experimental group and the control group 14 weeks after surgery(P#<0.05),and the experimental group was significantly lower than the control group 18 weeks after surgery(P*<0.01).(7)Safety indicators:One patient in the test group developed nasal blisters without itching around the body,and the blisters disappeared after drug withdrawal and anti-allergy treatment,and the patient had been removed from the study automatically.There were no other serious adverse events such as poisoning,shock and hospitalization.Conclusion:Zhuyumieban Decoction can promote wound healing,shrink scar,soften and disperse knot,induce scar softening,prevent abnormal scar,with good safety. |
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