Clinical Observation Of Fistula Laser Closure (FiLaC) With Clearing Heat And Promoting Diuresis For External Washing For Anal Fistula

Objective: Study the clinical efficacy and safety of Fi La C combined with Clearing heat and promoting diuresis for external washing in the treatment of anal fistula Methods: Randomized controlled trial(RCT)was used to select 60 patients with low simple anal fistula of damp-heat downward flow type from December 2017 to September 2018 in the anorectal department of Yueyang Hospital of Integrative Chinese & Western Medicine to Shanghai University of Traditional Chinese Medicine.they were randomly divided into experimental group and the control group with 30 patients in each group.the experimental group was treated with Fi La C combined with Clearing heat and promoting diuresis,while the control group was treated with Excision of anal fistula combined with Clearing heat and promoting diuresis and dampness-removing external washing formula for 6 months.The cure rate,operation time,hospitalization time,intraoperative blood loss,visual analogue scale(VAS),fecal incontinence severity index(FISI)and anorectal pressure of the two groups were observed,and SPSS 21.0 was used to analyze the results statistically.ResuIts:There were 30 cases in experimental group and 30 cases in control group group.The average ages of the two groups were(41.40±10.28),(40.10±11.13)(P>0.05),and the ratio of male to female was 5:1 and 4:1 respectively(P<0.01).the comparison of baseline data between the two groups had no statistical significance.There was no statistical difference in anorectal resting pressure and systolic pressure between the two groups in January,March and June after operation(P >0.05).The anorectal resting pressure in the anal fistula resection group 1 month after operation was statistically significant compared with that before operation(P=0.004).The operation time,intraoperative blood loss and hospitalization days of the two groups were statistically significant(P<0.01).The postoperative pain of the two groups was statistically significant at 1d,3d,7d and 14d(P<0.01).The cure rates of the two groups at 1 month,3 months and 6 months after operation were statistically significant(P<0.05).There was no significant difference in FISI scores between the two groups at 1 week,1 month,3 months and 6 months after operation(P>0.05).Conclusion: Compared with traditional anal fistula resection,Fi La C has the advantages of fast wound healing,short hospitalization time,mild postoperative painand good anal function protection.The clinical operation of laser closure of anal fistula is safe and effective,and is worthy of promotion.