| 摘要: |
| 目的:探究京万红软膏联合加减地榆槐角丸对痔疮手术患者术后水肿程度、血清血小板源性生长因子(PDFG)水平及创面分泌物评分的影响。方法:选取2019 年9 月—2020 年3 月在我院接受手术治疗的120 例混合痔患者，依据术后所用药物的不同，分为研究组、对照组各60 例。对照组术后给予常规换药(碘伏油纱条+ 止痛栓)治疗，研究组术后给予京万红软膏+ 加减地榆槐角丸治疗。比较两组临床疗效和创面恢复时间，观察治疗前后创面恢复情况、血清相关指标变化，并对治疗后不同时间点创面分泌物多少进行评分。结果:研究组总有效率(97%)显著高于对照组(83%)，差异有统计学意义(χ2=5.926，P ＜ 0.05)。研究组创面疼痛消失时间(8.24±1.67)d、水肿消失时间(10.56±2.21)d 及创面愈合时间(9.58±1.96)d 均明显短于对照组[ 创面疼痛消失时间(12.58±2.01)d、水肿消失时间(15.21±2.84)d 及创面愈合时间(13.74±2.32)d]，差异有统计学意义(t =12.864、10.009、10.610，P ＜ 0.05)。治疗后，两组患者创面疼痛、创面水肿和创面肉芽组织评分均较治疗前降低，血清PDFG、血管内皮生长因子(VEGF)水平均较治疗前升高(P ＜ 0.05)，且研究组创面疼痛(0.68±0.21)分、创面水肿(0.27±0.05)分及创面肉芽组织(0.30±0.08)分均远低于对照组[ 创面疼痛(1.51±0.36)分、创面水肿(0.93±0.26)分及创面肉芽组织(1.02±0.24)分]，差异有统计学意义(t =15.426、19.309、22.045，P ＜ 0.05)，血清PDFG(60.01±8.02)ng/L、VEGF(140.56±20.12)ng/L 水平均远高于对照组[ 血清PDFG(45.55±7.11)ng/L、VEGF(111.58±16.78)ng/L 水平]，差异有统计学意义(t =10.450、8.568，P ＜ 0.05)。另研究组治疗后不同时间点创面分泌物评分均明显低于对照组(P ＜ 0.05)。结论:京万红软膏联合加减地榆槐角丸用于痔疮患者术后效果显著，可明显改善患者临床症状，促进创面愈合，同时还能上调血清PDFG、VEGF 水平。 |
| 关键词: 京万红软膏 加减地榆槐角丸 痔疮 术后水肿程度 血小板源性生长因子 创面分泌物评分 |
| DOI：10.3969/j.issn.1007-6948.2021.06.014 |
| 投稿时间：2020-12-09 |
| 基金项目:河北省中医药管理局科研计划项目(2020457)；河北省中医药管理局科研计划项目(171461393) |
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| Effect of Jingwanhong Ointment Combined with Modified Diyu Huaijiao Pill on Postoperative Hemorrhoids |
| ZHANG Tian-peng,XU Wen-xuan,YANG Jie |
| The Second Department of Anorectum,Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei (050000), China |
| Abstract: |
| Objective To explore the effects of Jingwanhong Ointment combined with modified Diyu Huaijiao Pill on postoperative edema, serum platelet-derived growth factor (PDFG) level and wound secretion score in patients with hemorrhoids. Methods 1:1 matched case-control method was used to select 120 patients with mixed hemorrhoids., according to the different drugs used after operation. They were divided into study group (60 cases) and control group (60 cases). The control group was treated with routine dressing change (iodophor gauze + Zhitong Suppository) and the study group was treated with Jingwanhong Ointment +Modified Diyu Huaijiao Pill. The clinical effect and wound recovery time of the two groups were compared. The wound recovery and serum related indexes were observed before and after treatment and the amount of wound secretion at different time points after treatment was scored. Results The total effective rate of the study group (97%) was significantly higher than that of the control group (83%) (χ2=5.926, P < 0.05). The pain disappearance time (8.24±1.67) d, edema disappearance time (10.56±2.21) d and wound healing time (9.58±1.96) d in the study group were significantly shorter than those in the control group [wound pain disappearance time (12.58±2.01) d, edema disappearance time (15.21±2.84) d and wound healing time (13.74±2.32) d] (t = 12.864, 10.009, 10.610, P < 0.05). After treatment, the scores of pain, edema and granulation tissue in the two groups were lower than those before treatment and the levels of serum PDFG and vascular endothelial growth factor (VEGF) were higher than those before treatment (P < 0.05). At the same time, the scores of wound pain (0.68±0.21), wound edema (0.27±0.05) and wound granulation tissue (0.30±0.08) in the study group were significantly lower than those in the control group [wound pain (1.51±0.36), wound edema (0.93±0.26) and wound granulation tissue (1.02±0.24)] (t = 15.426, 19.309, 22.045, P < 0.05). The serum levels of PDFG (60.01 8.02) ng/L and VEGF (140.56±20.12) ng/L were significantly higher than those in the control group [serum levels of PDFG (45.55±7.11) ng/L and VEGF (111.58±16.78) ng/L] (t = 10.450, 8.568, P < 0.05). In addition, the score of wound secretion in the study group was significantly lower than that in the control group at different time points after treatment (P < 0.05). Conclusion Jingwanhong Ointment combined with modified Diyu Huaijiao Pill has a significant effect on hemorrhoids patients. It can significantly improve the clinical symptoms of patients with hemorrhoids, promote wound healing and increase the levels of serum PDFG and VEGF. |
| Key words: Jingwanhong Ointment modified Diyu Huaijiao Pill hemorrhoids degree of postoperative edema platelet-derived growth factor wound secretion score |
