Clinical Study On The Treatment Of Perianal Fistulizing Crohn’s Disease With The TCM Seton Therapy Based On The Thought Of "Saving The Body And Few Losses"

Objective:In this paper,based on the idea of "saving body and few losses" of Professor Ch en Minfan,a master of traditional Chinese medicine,the TCM seton therapy of traditi onal Chinese medicine combined with biological agents is used to treat perianal fistuli zing Crohn’s Disease,which proves the safety and effectiveness of this operation,in order to seek a more universal treatment for this kind of diseases and improve the qu ality of life of patients.Methods:Twenty-nine patients with perianal fistulizing Crohn’s Disease who met the inclusion criteria were screened out from the inpatients in our anorectal department from March 2021 to March 2022.They were randomly divided into control group and treatment group.The treatment group was treated with the TCM seton therapye,the control group was treated with relaxation thread-drawing and drainage,and the two groups were treated with sufficient course of biological preparation after operation.Crohn’s disease activity index(CDAI),perianal Crohn’s disease activity index(PDAI),Cleveland fecal incontinence score(CCF-FIS)and anal dynamics.The changes of each index before operation,one month after operation and three months after operation were compared between the two groups,and the therapeutic effect was evaluated.Results:1.Baseline data: There is no statistical difference in gender,age,BMI,preoperative PDAI,CDAI,CCF-FIS scores and anorectal pressure measurement indexes between the two groups,which are comparable.2.Evaluation of curative effect and recurrence: The fistula closure rate in the treatment group was 87.5%,while that in the control group was 43.8%;There was no recurrence in the treatment group and 1 case in the control group,with a recurrence rate of 6.25%.3.CDAI score: The average value of CDAI score in the two groups decreased with the increase of treatment time,and there was statistical significance in the comparison between the two groups,with the most obvious decrease one month after operation,and there was no significant difference between the two groups after treatment.4.PDAI score: The average value of PDAI score in the two groups decreased with the increase of treatment time,and there was statistical significance in the comparison between the two groups,with the most obvious decrease at 3 months after operation.There was significant difference in PDAI score between the two groups at 1 month and 3 months after operation,and the PDAI score of the treatment group was significantly lower than that of the control group.5.CCF-FIS score: The average CCF-FIS score in the two groups decreased with the increase of treatment time,and there was statistical significance in the comparison between the two groups,with the most obvious decrease at 3 months after operation.There was no significant difference in the degree of decline between the two groups after treatment.6.There was no significant difference in anal resting pressure and anal maximum systolic pressure in the control group before and after treatment.The above two indexes in the treatment group were statistically significant before and after treatment,but not in the control group.7.The intra-group comparison of sphincter length before and after treatment in the control group has no statistical significance,while the intra-group comparison of sphincter length before and after treatment in the treatment group has statistical significance,and it also has statistical significance compared with that in the control group.8.The initial sensory capacity and maximum sensory capacity of the control group and the treatment group before and after treatment were higher than those before operation,and the intra-group comparison between the two groups was statistically significant,but there was no statistical significance between the two groups.Conclusion:From the results of this study,it can be seen that the TCM seton therapy combi ned with infliximab in treating perianal fistulizing Crohn’s Disease has a high cure rat e and low recurrence rate,and the PDAI and CDAI scores after treatment are obvious ly reduced,without causing great damage to the anal sphincter.It is an effective and safe treatment method,which can preserve the anal function while achieving high heal ing rate and low recurrence rate,and is worthy of promotion and implementation in clinic.