临床误诊误治2024,Vol.37Issue(18) :95-100.DOI:10.3969/j.issn.1002-3429.2024.18.016

肛肠熏洗1号方治疗混合痔术后肛缘水肿的临床效果及对创面愈合的影响

Clinical Efficacy of the No.1 Formula for Anorectal Fumigation and Wash-ing in the Treatment of Anal Margin Edema after Operation for Mixed Hemorrhoids and Its Impact on Wound Healing

李孜睿 闫小磊 张弘强 王峰 马洁 郑碧荣
临床误诊误治2024,Vol.37Issue(18) :95-100.DOI:10.3969/j.issn.1002-3429.2024.18.016

肛肠熏洗1号方治疗混合痔术后肛缘水肿的临床效果及对创面愈合的影响

Clinical Efficacy of the No.1 Formula for Anorectal Fumigation and Wash-ing in the Treatment of Anal Margin Edema after Operation for Mixed Hemorrhoids and Its Impact on Wound Healing

李孜睿 1闫小磊 1张弘强 1王峰 1马洁 1郑碧荣1
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作者信息

  • 1. 067000 河北 承德,承德市中医院中医外科
  • 折叠

摘要

目的 探究肛肠熏洗1 号方治疗混合痔术后肛缘水肿的临床效果及对创面愈合的影响.方法 选择2023 年6 至12 月收治的混合痔术后肛缘水肿患者100 例,依据随机数字表法分为对照组和观察组,每组50 例.2 组患者均给予术后常规治疗,对照组术后予以高锰酸钾溶液熏洗,观察组术后予以自拟肛肠熏洗1 号方熏洗.比较2 组临床疗效,观察2 组术后1、3、5、7d肛缘水肿评分及术后疼痛情况,术后1、7d血清炎性指标[白细胞介素-6(IL-6)、淀粉样蛋白A(SAA)及肿瘤坏死因子-α(TNF-α)]、创面愈合相关指标[血管内皮生长因子(VEGF)、碱性成纤维生长因子(bFGF)、转化生长因子-β(TGF-β)、Ⅰ型胶原]水平,记录治疗过程不良事件发生情况.结果 观察组总有效率[96.00%(48/50)]高于对照组[80.00%(40/50)],差异有统计学意义(P<0.01).2 组术后 3、5、7d肛缘水肿评分及疼痛视觉模拟评分法评分均低于术后1d,且观察组低于对照组(P<0.05,P<0.01).术后7d,2 组血清IL-6、SAA及TNF-α水平均较术后1d明显降低,且观察组低于对照组(P<0.05,P<0.01).术后7d,2 组血清bFGF、VEGF、Ⅰ型胶原及TGF-β水平较术后1d升高,且观察组高于对照组(P<0.05,P<0.01).2 组患者在治疗过程中均未出现不良事件.结论 混合痔术后肛缘水肿患者应用肛肠熏洗1 号方熏洗可有效缓解肛缘水肿及疼痛程度,抑制机体炎性因子分泌,且促进新生血管形成,缩短创面愈合时间.

Abstract

Objective To explore the clinical efficacy of No.1 formula for anorectal fumigation and washing in the treatment of anal margin edema after operation for mixed hemorrhoids and its impact on wound healing.Methods A total of 100 patients with anal margin edema after operation for mixed hemorrhoids from June 2023 to December 2023 were selected and divided into control group(n=50)and observation group(n=50)according to random number table method.All pa-tients in the two groups were given postoperative routine treatment,the control group was given postoperative potassium per-manganate solution for fumigation and washing,and the observation group was given postoperative fumigation sitbath with self-designed No.1 formula for anorectal fumigation and washing.The clinical efficacy of the two groups was compared,and the postoperative anal margin edema and postoperative pain were observed at 1,3,5 and 7 d after operation in the two groups.Se-rum inflammatory indicators[interleukin-6(IL-6),serum amyloid A(SAA)and tumor necrosis factor-α(TNF-α)],wound healing-related indicators[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),transforming growth factor-β(TGF-β),collagen typeⅠ]levels were compared at 1 and 7 d after operation,and the occurrence of adverse events during treatment was recorded.Results The total effective rate of the observation group[96.00%(48/50)]was higher than that of the control group[80.00%(40/50)],showing significant differences(P<0.01).The scores of anal margin edema and visual analogue scale(VAS)pain score were lower in the two groups at 3,5 and 7 d after operation than those at 1 d after operation,which were lower in the observation group than in the control group(P<0.05,P<0.01).Ser-um levels of IL-6,SAA and TNF-α in the two groups were significantly lower than those at 1 d after operation,which were lower in the observation group than in the control group(P<0.05,P<0.01).Serum levels of bFGF,VEGF,collagen type I and TGF-β in the two groups were increased at 7 d after operation,which were higher in the observation group than in the control group(P<0.05,P<0.01).There were no adverse events during treatment in both groups.Conclusion For pa-tients with anal margin edema after operation for mixed hemorrhoids,No.1 formula for anorectal fumigation and washing can effectively relieve anal margin edema and pain,inhibit the secretion of inflammatory factors in the body,promote the formation of new blood vessels,and shorten the healing time of the wound.

关键词

/肛缘水肿/熏洗1号方/白细胞介素-6/血清淀粉样蛋白A/血管内皮生长因子类/转化生长因子-β/疼痛

Key words

Hemorrhoids/Anal margin edema/No.1 formula for fumigation and washing/Interleukin-6/Serum am-yloid A/Vascular endothelial growth factor/Transforming growth factor-β/Pain

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基金项目

2023年上半年度承德市科技局计划项目(202301A022)

出版年

2024
临床误诊误治
解放军白求恩国际和平医院

临床误诊误治

CSTPCD
影响因子:0.914
ISSN:1002-3429
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