| 摘要: |
| 目的 观察止痛如神汤加减方联合康复新液灌肠治疗气滞血瘀型混合痔术后肛门疼痛的临床效果。方法:选择2021年1月—2022年12月在崇州市人民医院收治的100例混合痔患者，按照随机数字表法分为A组、B组、C组三组。A组30例，予常规西医治疗；B组35例，在A组基础上予康复新液灌肠治疗；C组35例，在B组基础上予止痛如神汤加减方治疗。三组术后1、7 d均评价创面水肿、创面肉芽组织生长情况，通过数字疼痛评分法(NRS)评价肛门疼痛情况，记录三组患者肛门水肿消退时间、创面分泌物消失时间、创面愈合时间，检测三组肿瘤坏死因子α(TNF-α)、表皮生长因子(EGF)、β-内啡肽(β-EP)、白细胞介素-22(IL-22)、纤维连接蛋白(FN)、血管内皮生长因子(VEGF)水平，术前、术后1个月测量患者直肠肛管抑制反射阈值、肛管静息压、肛管高压带长度。结果:C组创面水肿、NRS评分较A组、B组低(P＜0.05)，创面肉芽组织生长评分较A组、B组高(P＜0.05)；C组创面分泌物消失时间、肛门水肿消退时间、创面愈合时间较A组、B组短(P＜0.05)；C组直肠肛管抑制反射阈值、肛管静息压较A组、B组高(P＜0.05)，C组肛管高压带长度较A组、B组短(P＜0.05)；C组TNF-α、IL-22水平较A组、B组低(P＜0.05)，C组β-EP、EGF、FN、VEGF水平较A组、B组高(P＜0.05)。结论:止痛如神汤加减方联合康复新液灌肠可抑制炎症因子水平，调节疼痛介质及EGF、FN、VEGF指标，缓解肛门疼痛，促进创面愈合，提升肛门功能。 |
| 关键词: 止痛如神汤加减方 康复新液灌肠 炎症因子 疼痛介质 |
| DOI：10.3969/j.issn.1007-6948.2024.02.001 |
| 投稿时间：2023-10-11 |
| 基金项目:四川省中医药管理局科研项目(2020LC0096) |
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| Clinical study on the treatment of postoperative anal pain of mixed hemorrhoids with Qi stagnation and blood stasis by Zhitong Rushen decoction modified combined with the enema of Kangfuxin liquid |
| GAO Fu-ming，ZHENG Pan，SUN Li-sha |
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| Abstract: |
| Objective To observe the clinical effect of Zhitong Rushen decoction modified combined with the enema of Kangfuxin liquid in the treatment of postoperative anal pain of mixed hemorrhoids with Qi stagnation and Blood stasis. Methods 100 patients with mixed hemorrhoids admitted in our hospital from January 2021 to December 2022 were selected and divided into three groups, Group A, Group B and Group C according to the randomized numerical table method. 30 cases in Group A were treated with conventional western medicine; 35 cases in Group B were treated with the enema of Kangfuxin liquid on the basis of Group A; 35 cases in Group C were treated with Zhitong Rushen decoction modified on the basis of Group B. On the 1st and 7th day after surgery, wound edema and granulation tissue growth were evaluated, and anal pain was evaluated by the Digital Pain Scale (NRS), and the time of anal edema resolution, wound secretion disappearance and wound healing in the three groups were recorded. The levels of tumor necrosis factor-α(TNF-α), epidermal growth factor (EGF), β-endorphin (β-EP), interleukin-22 (IL-22), fibronectin (FN) and NRS cular endothelial growth factor (VEGF) in the three groups were detected. The proctoanal inhibitory reflex threshold, anal resting pressure and anal high pressure band length were measured before and one month after operation. Results Group C had lower trabecular edema and NRS scores and higher trabecular granulation tissue growth scores than Groups A and B(P < 0.05); The time of wound secretion disappearing, anal edema subsiding and wound healing in group C were shorter than those in groups A and B (P < 0.05). The inhibitory reflex threshold and resting pressure of proctoanal canal in group C were higher than those in groups A and B (P < 0.05), and the length of high pressure band of proctoanal canal in group C was shorter than those in groups A and B (P < 0.05). The levels of TNF-α and IL-22 in group C were lower than those in groups A and B (P < 0.05), and the levels of β-EP, EGF, FN and VEGF were higher than those in groups A and B (P < 0.05). Conclusion Zhitong Rushen decoction modified combined with the enema of Kangfuxin liquid can inhibit the level of inflammatory factors, regulate pain mediators and EGF, FN, VEGF indicators, alleviate anal pain, promote wound healing, and improve anal function. |
| Key words: Zhitong Rushen decoction modified enema of Kangfuxin liquid inflammatory factors pain mediators |
