[1]陶晓春,梁宏涛,姚一博,等.拖线疗法治疗难愈性窦瘘疗效观察及医患评价调查[J].西部中医药,2021,34(03):116-121.[doi:10.12174/j.issn.2096-9600.2021.03.30]
　TAO Xiaochun,LIANG Hongtao,YAO Yibo,et al.Clinical Observation on Thread-dragging Therapy in the Treatment of Refractory Sinus Tracts and Investigation into Doctor-patients Evaluation[J].Western Journal of Traditional Chinese Medicine,2021,34(03):116-121.[doi:10.12174/j.issn.2096-9600.2021.03.30]
点击复制

拖线疗法治疗难愈性窦瘘疗效观察及医患评价调查
分享到：

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
34
期数:
2021年03期
页码:
116-121
栏目:
出版日期:
2021-03-15

文章信息/Info

Title:
Clinical Observation on Thread-dragging Therapy in the Treatment of Refractory Sinus Tracts and Investigation into Doctor-patients Evaluation
作者:
陶晓春1, 梁宏涛1, 姚一博1, 张强1, 王琛1, 王波2, 陆金根1
1.上海中医药大学附属龙华医院肛肠科，上海 200032
2.上海好卓数据服务有限公司
Author(s):
TAO Xiaochun1, LIANG Hongtao1, YAO Yibo1, ZHANG Qiang1, WANG Chen1, WANG Bo2, LU Jingen1
1.Anorectal Department, Longhua Hospital Shanghai University of TCM, Shanghai 200032
2.Shanghai Haozhuo Data Service Co., Ltd
关键词:
窦瘘; 难愈性; 拖线疗法; 临床疗效; 医患评价; 调查
Keywords:
sinus tracts;  refractory; thread-dragging therapy; clinical effects; doctor-patients evaluation; investigation
分类号:
R657
DOI:
10.12174/j.issn.2096-9600.2021.03.30
摘要:
目的观察拖线疗法治疗难愈性窦瘘的临床疗效，同时调查医生和患者对该项技术的评价情况。 方法采用多中心、前瞻性、随机对照的试验设计方法观察两组患者主要疗效指标（治愈率、愈合时间）以及次要疗效指标（分泌物量、脓腐量、肉芽生长量、上皮生长量等）中医症状与术后患者疼痛评分；并在出院时对医生和患者分别进行问卷调查，综合评价拖线技术。 结果本研究共纳入患者360例，实际完成观察320例。拖线疗法组（治疗组）163例窦瘘在中乳腺部位36例，肛周部位83例，皮肤部位44例；切开疗法组（对照组）157例中窦瘘在乳腺部位35例，肛周部位85例，皮肤部位37例。两组患者术后3个月最终随访均全部治愈，两组治愈率比较差异无统计学意义（P＞0.05）；但治疗组创面愈合时间短于对照组，差异具有统计学意义（P＜0.05）。干预后两组中医症状改善情况各随访时间点比较差异具有统计学意义（P＜0.05）；治疗组术后创面总体分泌物量多于对照组，术后2周内差异最明显；治疗组术后创面总体肉芽及上皮生长量优于对照组，术后1周至术后4周内差异最明显；术后疼痛评分治疗组低于对照组，差异具有统计学意义（P＜0.05）。医生群体认为两种手术方式在技术掌握难易度、可操作性、成熟度、稳定性、安全性等方面比较差异无统计学意义（P＞0.05），但肛肠及皮肤组研究人员认为拖线疗法相比切开法更易实现操作的规范化及标准化。皮肤及肛肠部位窦瘘患者对拖线疗法的满意度及接受度更高（P＜0.05），同时，肛肠部位患者更愿意将拖线疗法向其他患者推荐（P＜0.05）；拖线疗法相比切开疗法不增加患者医疗经济负担（P＞0.05）。 结论拖线疗法治疗难愈性窦瘘具有愈合快、疼痛轻、疗效确切等优点，同时拖线疗法在标准化操作方面具有优势，患者的满意度、接受度更好。
Abstract:
ObjectiveTo observe clinical effects of thread-dragging therapy in the treatment of refractory sinus tracts and investigate the doctor and patient's evaluation of the technology. MethodsMulticenter, randomized, randomized controlled trial design method was used to observe the indexes of main outcome measures: healing rate, healing time, and secondary outcome measures: secretion volume, pus amount, granulation growth, epithelial growth and others, TCM symptoms and postoperative pain scores, the doctors and the patients when discharged were surveyed using questionnaire to generally evaluate thread-dragging technology. ResultsAll 360 patients were included in the study, and actually 320 patients were observed. Among 163 patients in thread-dragging therapy group (the treatment group), 36 patients around mammary gland, 83 patients around perianal part and 44 skin; among 157 patients in incision therapy group(the control group), 35 patients mammary gland, 85 perianal part and 37 skin. Consequently, all the patients in both groups healed in the three-month follow-up after the operation, and the difference had no statistical meaning in cure rate between both groups(P>0.05); while the treatment group was shorter than the control group in wound healing time, and the difference had statistical meaning(P<0.05). The differences had statistical meaning in TCM symptoms in both groups before and after the intervention at different time points(P<0.05); the treatment group was more than the control group in total secretion volume after the operation, the difference was the most notable two weeks after the operation; the treatment group was superior to the control group in total granulation growth and epithelial growth, the difference the most remarkable one to four weeks after the operation; lower than the control group in postoperative pain scores, and the difference had statistical meaning (P<0.05). Doctors thought that the difference had no statistical meaning in technical mastering, operability, maturity, stability, safety and others of two surgical methods (P>0.05), but anorectal and skin researchers thought that thread-dragging therapy could easily realize operation normalization and standardization compared with incision therapy. The sufferers of skin and anorectal sinus fistula showed higher satisfaction degree and acceptability for thread-dragging therapy(P<0.05), simultaneously, anorectal sufferers are willing to recommend the thread-dragging therapy to others (P<0.05); and the therapy won't increase medical economic burden of the patients compared with incision therapy (P>0.05). ConclusionThread-dragging therapy owns the advantages of fast healing, mild pain, definite effects and others in the treatment of refractory sinus tracts, meanwhile the therapy possesses the advantages in standardized operation, and the patients show better satisfaction degree and acceptability.

相似文献/References:

[1]刘建平,白梅花.生肌玉红膏治疗难愈性创面36例[J].西部中医药,2018,31(08):118.
　LIU Jianping,BAI Meihua.ShengJi YuHong Ointment in Treating 36 Cases of Refractory Wound[J].Western Journal of Traditional Chinese Medicine,2018,31(03):118.

备注/Memo

备注/Memo:
陶晓春（1988—），女，硕士学位，主治医师。研究方向：肛肠疾病的预防与治疗。国家自然科学基金（81603624）；国家十二五科技支撑计划项目（2015BAI04B01）；陆金根全国名老中医药专家传承工作室（国中医药人教发（2016）42号）；第六批全国老中医药专家学术经验继承人（国中医药办人教发（2017）125号）；上海市进一步加快中医药事业发展三年行动计划（2018—2020年）资助项目（ZY（2018-2020）-CCCX-1007）；上海中医药大学附属龙华医院科技创新项目（KY1792）；上海中
更新日期/Last Update: 2021-03-05