Clinical observation of Qingjie-Painong decoction combined with debridement drainage in the treatment of perianal necrotizing fasciitis

Abstract

Objective To observe the clinical effect of Qingjie-Painong decoction combined with debridement drainage in the treatment of perianal necrotizing fasciitis. Methods A total of 78 patients with perianal necrosis fasciitis were randomly divided into two groups, 39 patients in each group. The two groups received the basic treatment of anti-infection, and the control group was treated with debridement drainage, and the treatment group applied the Qingjie-Painong decoction combined with debridement drainage treatment. Both groups were treated for 14 days. Before and after treatment, systemic symptom score, lesion range score, perianal pain score were assessed. The levels of WBC, hs-CRP, IL-6 and TNF-α were measured and the clinical efficacy was evaluated after treatment. Results The total effective rate was 94.88% (37/39) in the treatment group and 82.05% (32/39) in the control group. The total effective rate of the two groups was statistically significant (Z=-2.099, P=0.036). After treatment, the Systemic symptom (0.21 ± 0.05 vs. 0.98 ± 0.17, t=-2.601), Lesion range (0.57 ± 0.23 vs. 1.08 ± 0.40, t=-2.270), Perianal pain (0.92 ± 0.35 vs. 1.77 ± 0.49, t=-3.493) in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the WBC (6.25 ×109/L ± 2.08 ×109/L vs. 10.98 ×109/L ± 2.72 ×109/L, t=-3.829), CRP (11.20 ± 2.41 mg/L vs. 23.34 ± 4.39 mg/L, t=-2.162), IL-6 (13.03 ± 3.36 pg/ml vs. 24.69 ± 4.52 pg/ml, t=-2.297), TNF-α (8.33 ± 3.16 ng/ml vs. 14.93 ± 3.80 ng/ml, t=-3.340) in the treatment group were significantly lower than those in the control group (P<0.05). Conclusions The Qingjie-Painong decoction combined with debridement drainage in the treatment of perianal necrotizing fasciitis can significantly reduce the body's inflammatory status, improve systemic symptoms, reduce the scope of the lesion, reduce perianal pain, and improve clinical efficacy. Key words: Fasciitis, necrotizing; Proctorectal diseases; Debridement; Drainage; Qingjie-Painong decoction