Research Progress on Promoting Wound Healing after Anal Fistula Surgery by External Treatment of Traditional Chinese Medicine/ZHAOLei，ZHANG Yang.//Medical Innovationof China，2025，22（18）： 179-183

[Abstract]Anal fistula is a common disease in the anorectal department.At present，the main treatment method is surgery.Slow wound healing and long recovery time after surgery are urgent problems for anorectal doctors.In recent years，external treatment of traditional Chinese medicine have been widelyapplied in the field of postoperativerehabilitationofanalfistuladuetotheirremarkabletherapeutic efectsandrelativelyfewadverse reactions.Thisarticlereviews the literatureontheapplicationof external treatmentoftraditional Chinese medicine afteranal fistulasurgery in the past five years，discussesand evaluates from both clinical research and animal experiments，hoping to further promote the application of external treatmentof traditional Chinese medicine after anal fistula surgery.

[Key Words]AnalfistulaPostoperative woundExternal treatment of traditional Chinese medicine

First-author'saddress：NanjingUniversityof Chinese Medicine，Nanjing21oooo，China

doi：10.3969/j.issn.1674-4985.2025.18.040

肛瘘是肛肠科常见疾病，是指肛管、直肠与周围皮肤形成的瘘管，主要临床表现为肛门肿痛、破溃流脓等。中医认为肛瘘的形成与肛痈溃后余毒未清、痈久不愈、外感风湿热邪、饮食不节、情志内伤、房劳过度及气血不足等有关。目前的主要治疗方法为手术，但术后由于余毒未清、正气不足，使得创面愈合缓慢，恢复期较长[]。中医外治以其显著的疗效和较少的不良反应广泛地应用于肛瘘术后创面的恢复治疗中。本文现从临床研究和动物实验两方面论述近5年来中医外治促进肛瘘术后创面愈合的研究进展。

1 临床研究

1.1 中药熏洗

中药熏洗是用药物煎水后熏蒸洗涤臀部，清洁创面，该法有利于去除毒邪，加快局部血液循环，以此促进创面愈合。《理瀹骈文》中有：“外治之理，即内治之理；外治之药，即内治之药。所异者法耳。”外治法与内治法用药途径不同，而方药理论无明显不同。常用的熏洗方有：止痛如神汤、仙方活命饮、苦参汤等，使用的药物以清热解毒、消肿止痛、活血生肌、敛疮收涩为主。在此用药理念的指导下，研究者们开展了多项研究。如肛肠坐浴方（马齿苋、地肤子、地榆、明矾、瓦松、蒲公英、芒硝、侧柏叶、枳壳）银黄清热汤（黄芩、黄连、金银花、甘草、黄柏、知母、当归、土茯苓、赤芍、生地、苦参）、三黄汤（黄芩、忍冬藤、黄柏、薄荷、黄连）肛门洗剂（五倍子、桑寄生、苦参、黄柏、明矾等）、祛毒汤（蒲公英、黄柏、连翘、金银花、地榆、苦参、当归）等[2，研究发现中药熏洗可直达病灶，减少创面分泌物，减轻炎症反应，提高生长因子水平，促进局部血液循环，有利于创面愈合。……