锡类散联合红霉素软膏促进混合痔术后创面愈合的疗效及安全性分析OA

Objective To investigate the efficacy and safety of Xilei Powder combined with Erythromycin Ointment in promoting wound healing after mixed hemorrhoid surgery.Methods A total of 90 patients who underwent Milligan-Morgan hemorrhoidectomy(MMH)for mixed hemorrhoids were randomly divided into three groups at a ratio of 1∶1∶1,namely the experimental group(Xilei Powder-Erythromycin Ointment group),control group 1(Gangtai Ointment group)and control group 2(Erythromycin Ointment group),with 30 cases in each group.All patients received sitz bath with Compound Jingjie Formula for Fumigation and Washing after surgery,and then the corresponding drugs were applied to the wound surface with vaseline gauze for external application,once a day.The conditions of wound pain,wound exudation and granulation growth were observed on the 1st,7th and 14th days after surgery.The wound changes(reduction rate of external anal margin wound area,shortening rate of longitudinal diameter of internal anal margin wound)were measured on the 7th and 14th days after surgery.Wound pathological analysis was performed by sampling 11 cases on the 7th and 14th days,and the number of fibroblasts and new capillaries in the wound under the microscope was observed and counted.The healing time of internal anal margin wound was recorded and the clinical efficacy was evaluated on the 14th day after surgery.Adverse reactions were monitored throughout the trial.Results 1)Wound pain,exuda-tion and granulation growth:On the 7th and 14th days after surgery,the experimental group was superior to the two control groups in terms of wound pain and granulation growth(P<0.01 or P<0.05).On the 14th day after surgery,the experimental group was significantly better than both the control groups in terms of wound exudation(P<0.01 or P<0.05).On the 7th day after surgery,the experimental group was significantly supe-rior to the control group 2 in wound exudation(P<0.01).2)Wound changes:On the 7th and 14th days after surgery,the reduction rate of external anal margin wound area and the shortening rate of longitudinal diameter of internal anal margin wound in the experimental group were significantly better than those in both the control groups(P<0.01).3)Number of fibroblasts and new capillaries in the wound:On the 7th day after surgery,the number of fibroblasts in the experimental group was significantly better than that in both the control groups(P<0.05).The number of new capillaries in the experimental group was significantly higher than that in the control group 1(P<0.05),and higher than that in the control group 2 with no statistically significant difference(P>0.05).On the 14th day after surgery,the number of fibroblasts and new capillaries in the experimental group decreased significantly,while the two indicators in both the control groups remained at a high level.The number of fibroblasts and new capillaries in the experimental group were significantly superior to those in both the control groups(P<0.01).4)Comprehensive efficacy of internal anal margin wound and wound healing time on the 14th day after surgery:The clinical cure rate of the experimental group was significantly higher than that of both the control groups(P<0.01),and the healing time of internal anal margin wound in the experimen-tal group was significantly shorter than that of both the control groups(P<0.01).5)Adverse reactions:No serious drug-related adverse events occurred in the three groups of patients.Conclusion The application of Xilei Powder combined with Erythromycin Ointment on the wound after MMH for mixed hemorrhoids can effec-tively relieve postoperative pain and exudation,significantly promote granulation tissue growth,and accelerate wound healing.Its effect is superior to the separate application of Xilei Powder or Erythromycin Ointment,with good safety,which is worthy of clinical promotion and application.