【目的】 观察致康胶囊（由大黄、黄连、三七、白芷、阿胶、煅龙骨、白及、没药、海螵蛸、茜草、龙血竭等组成）外 用于高位肛周脓肿术后合并出血风险患者的临床疗效及安全性。【方法】 采用随机数字表法，将2024年1月至2024年12月昆 明医科大学第二附属医院收治的120例患有慢性稳定心绞痛需长期服用阿司匹林肠溶片的高位肛周脓肿术后合并出血风险患 者随机分为对照组和治疗组，每组各60例。对照组给予术后局部外用巴曲亭治疗，治疗组给予术后外用致康胶囊治疗，2组 患者的疗程均为7 d。观察2组患者术后第2、4、6天创面出血评分的变化情况，比较 2 组患者术后第 5 天的肛门疼痛、红 肿及创面渗液评分情况，并评价 2 组治疗方案的安全性。【结果】（1）创面出血评分方面，2组患者术后第 4天的创面出血 评分均较术后第2天降低（P＜0.05或P＜0.01），术后第6天又均较术后第4天降低（P＜0.01）；但2组患者在术后第2、4、6天的 创面出血评分比较，差异均无统计学意义（P＞0.05）。（2）肛门疼痛、红肿及创面渗液评分方面，治疗组患者术后第5天的肛门疼痛、红肿及创面渗液评分均较对照组明显降低，差异均有统计学意义（P＜0.05或P＜0.01）。（3）肛门创面愈合时间方面， 治疗组的平均肛门创面愈合时间为（16.821 ± 1.793）d，较对照组的（18.114 ± 2.632）d明显缩短，差异有统计学意义（P＜0.05）。 （4）安全性方面，治疗期间，2组患者均未出现明显的不良反应，具有较高的安全性。【结论】 致康胶囊创面外敷治疗高位肛 周脓肿术后合并出血风险患者的疗效确切，在减轻肛门疼痛、消肿、减少创面渗液及促进创面愈合方面均优于巴曲亭创面 外敷，且具有较高的安全性。

Objective To evaluate the clinical efficacy and safety of topical Zhikang Capsules （composed of Rhei Radix et Rhizoma，Coptidis Rhizoma，Notoginseng Radix et Rhizoma，Angelicae Dahuricae Radix，Asini Corii Colla， calcined Os Draconis， Bletillae Rhizoma， Myrrha， Endoconcha Sepiae， Rubia Radix et Rhizomae， Resina Draconis，etc.） in treating patients with risk of bleeding after operation for high perianal abscess. Methods The observation was conducted in 120 patients who took long-term oral use of Aspirin Enteric-Coated Tablets due to suffering from chronic stable angina and underwent operation for high perianal abscess in The Second Affiliated Hospital of Kunming Medical University from January 2024 to December 2024. The patients were divided into a control group and a treatment group using a randomized number table，with 60 cases in each group. The control group received postoperative topical Batracimab， while the treatment group received topical Zhikang Capsules. Both groups underwent a 7-day treatment course. Changes in the wound bleeding scores on postoperative days 2， 4，and 6 in the two groups were observed. The scores of anal pain，perianal congestion and swelling，and wound exudate on postoperative day 5 were compared between the two groups. After treatment，the safety of both regimens was evaluated. Results （1）Scores of wound bleeding in both groups were decreased significantly on postoperative day 4 compared to postoperative day 2（P＜0.05 or P＜0.01），and were further decreased on postoperative day 6 compared to postoperative day 4（P＜0.01）. However，no significant differences were observed between the two groups on postoperative days 2，4，or 6（P＞0.05）.（2） The treatment group exhibited significantly lower scores of anal pain，perianal congestion and swelling，and wound exudate than the control group on postoperative day 5（P＜0.05 or P＜0.01）.（3）The mean time for would healing in the treatment group was （16.821 ± 1.793） days， significantly shorter than that in the control group （18.114±2.632）days，and the difference was significant （P＜ 0.05）.（4） No significant adverse reactions occurred in either group during treatment， indicating a high safety profile. Conclusion Topical Zhikang Capsules demonstrate definite therapeutic efficacy and safety for patients complicated with risk of bleeding after operation for high perianal abscess， and exert stronger effects than Batracimab on alleviating anal pain，perianal swelling and wound exudate，and on accelerating wound healing.

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国家自然科学基金资助项目（编号：81704080）