| 引用本文: |
王东宏,胡响当,刘洁.凉血地黄汤联合消痔栓治疗混合痔术后并发症疗效观察及对创面愈合、炎症因子的影响[J].湖南中医药大学学报,2022,42(3):465-470[点击复制] |
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| 凉血地黄汤联合消痔栓治疗混合痔术后并发症疗效观察及对创面愈合、炎症因子的影响 |
| 王东宏,胡响当,刘洁 |
| (新疆医科大学附属中医医院, 新疆 乌鲁木齐 830000;湖南中医药大学第二附属医院, 湖南 长沙 410005) |
| 摘要: |
| 目的 观察凉血地黄汤联合消痔栓治疗混合痔术后患者出血、疼痛、肛门水肿疗效观察及对创面愈合、炎症因子的影响。方法 选取2020年1月至12月，新疆医科大学附属中医医院收治的160例混合痔术后患者，随机分为对照组和观察组，各80例。对照组给予常规护理、生理盐水、消痔栓，观察组在对照组基础上给予凉血地黄汤，治疗14 d。比较两组患者术后第2、7、14天出血、疼痛、肛门水肿的变化及治疗前后两组患者临床疗效、血液流变学指标（全血黏度、血浆黏度、红细胞聚集指数）及创面愈合相关指标[血清表皮生长因子（epidermal growth factor, EGF）、转化生长因子-β（transforming growth factor-beta, TGF-β）、Ⅰ型胶原蛋白（collagen Ⅰ, COL-Ⅰ ）水平及炎症因子肿瘤坏死因子-ɑ（tumor necrosis factor, TNF-ɑ）、白细胞介素-6（interleukin-6, IL-6）、白细胞介素-8（interleukin-8, IL-8）]水平的差异性及创面愈合时间差异。结果 治疗后观察组总有效率（98.75%）高于对照组（92.50%），差异无统计学意义（P>0.05）。术后第7天，两组出血、疼痛评分均明显低于术后第2天（P<0.05）；观察组水肿评分明显低于术后第2天（P<0.05）；对照组水肿评分与术后第2天比较，差异无统计学意义（P>0.05）。术后第14天，两组出血、疼痛评分均明显低于术后第7天（P<0.05）；观察组水肿评分明显低于术后第7天（P<0.05）；对照组水肿评分与术后第7天比较，差异无统计学意义（P>0.05）。术后第2天，两组出血、疼痛、水肿评分比较，差异无统计学意义（P>0.05）。术后第7天，观察组疼痛评分低于对照组（P<0.05）。术后第7、14天，观察组出血、水肿评分均明显低于同期对照组（P<0.05）。术后第14天，两组疼痛评分比较，差异无统计学意义（P>0.05）。治疗后，两组患者全血黏度、血浆黏度、红细胞聚集指数、TNF-ɑ、IL-6、IL-8水平较治疗前均下降，且观察组低于对照组（P<0.05）；治疗后两组患者EGF、TGF-β、COL-Ⅰ水平均高于治疗前（P<0.05），且观察组高于对照组（P<0.05）。观察组平均创面愈合时间短于对照组（P<0.05）。结论 凉血地黄汤联合消痔栓可明显改善混合痔术后并发症，降低炎症因子水平，促进创面愈合。其促进创面愈合机制可能与降低血液流变学指标、升高血清EGF、TGF-β、COL-Ⅰ水平有关。 |
| 关键词: 凉血地黄汤 混合痔 术后并发症 血液流变学 炎症因子 创面愈合 |
| DOI：10.3969/j.issn.1674-070X.2022.03.022 |
| 投稿时间：2021-06-08 |
| 基金项目:湖南省中医药科研计划项目（201982）；湖南省中医药防治肛肠疾病重点研究室基金资助（湘中医药函[2020]51号）。 |
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| Observation of curative effect of Liangxue Dihuang Decoction combined with Xiaozhi Suppository in treating postoperative complications of mixed hemorrhoids and its influence on wound healing and inflammatory factors |
| WANG Donghong,HU Xiangdang,LIU Jie |
| (The Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, Xinjiang 830000, China;The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410005, China) |
| Abstract: |
| Objective To observe the curative effect of Liangxue Dihuang Decoction combined with Xiaozhi Suppository on bleeding, pain and anal edema in patients with mixed hemorrhoids after operation, and its effect on wound healing and inflammatory factors. Methods 160 postoperative patients with mixed hemorrhoids treated in The Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2020 to December 2020 were randomly divided into control group and observation group, 80 cases in each group. The control group was given routine nursing, normal saline combined with Xiaozhi Suppository, and the observation group was treated with Liangxue Dihuang Decoction on the basis of the control group for 14 days. The changes of bleeding, pain and anal edema on the 2nd, 7th and 14th day after operation were compared, the clinical efficacy, blood rheology indexes (whole blood viscosity, plasma viscosity and red blood cell aggregation index), and the differences in wound healing related indexes [serum epidermal growth factor (EGF), transforming growth factor-beta (TGF-β), collagen Ⅰ (COL-Ⅰ) levels and inflammatory factors tumor necrosis factor (TNF-ɑ), interleukin-6 (IL-6) and interleukin-8 (IL-8)] levels, and difference in wound healing time were compared. Results After treatment, the total effective rate of the observation group (98.75%) was higher than that of the control group (92.50%), there was no significant difference (P>0.05). On the 7th day after operation, bleeding and the pain scores of the two groups were lower than those on the 2nd day after operation (P<0.05); the edema score in the observation group was significantly lower than that on the 2nd day after operation (P<0.05); there was no significant difference in the edema score of the control group on the 2nd day after operation. On the 14th day after operation, bleeding and pain scores in both groups were significantly lower than those on the 7th day after operation (P<0.05); the edema score of observation group was significantly lower than that of 7th day after operation (P<0.05), there was no significant difference in the edema score in the control group on the 7th day after operation (P>0.05). On the 2nd day after operation, there were no significant differences in bleeding, pain and edema scores between the two groups (P>0.05). On the 7th day after operation, the pain score of observation group was lower than that of control group (P<0.05). On the 7th and 14th day after operation, the scores of bleeding and edema in observation group were significantly lower than those in control group (P<0.05). On the 14th day after operation, there was no significant difference in pain scores between the two groups (P>0.05). After treatment, the levels of whole blood viscosity, plasma viscosity, erythrocyte aggregation index, TNF-ɑ, IL-6 and IL-8 in two groups were decreased compared with before treatment, and the observation group was lower than the control group (P<0.05). After treatment, the levels of EGF, TGF-β and COL-Ⅰ in two groups were higher than before treatment (P<0.05), and the observation group was higher than the control group (P<0.05). The average wound healing time of the observation group was shorter than that of the control group (P<0.05). Conclusion Liangxue Dihuang Decoction combined with Xiaozhi Suppository can significantly improve the postoperative complications of mixed hemorrhoids, reduce the level of inflammatory factors and promote wound healing. The mechanism of promoting wound healing may be related to reducing hemorheological indexes and increasing serum EGF and TGF-β, COL-Ⅰ level. |
| Key words: Liangxue Dihuang Decoction mixed hemorrhoids postoperative complications hemorheology inflammatory factors wound healing |
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