龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响  

Healing Effect of Longxuejie Capsule and Jiuhua Ointment Treatment on Wound After Mixed Hemorrhoid Surgery and Its Effect on Neovascularization

作　　者：陈莹璐[1] 钟传篪 徐月[1] 陈霞[1] 

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中国实验方剂学杂志》2017年第8期178-183,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：重庆市卫生和计计划生育委员会医学科研计划项目(20142069)

摘　　要：目的:观察龙血竭胶囊合九华膏对环状混合痔术后恢复的疗效,及其对创面和血清血管内皮生长因子的影响。方法:将190例患者根据入院先后顺序,随机按数字表法分为对照组和观察组各95例。两组患者均行分段多层次弧切缝合加注射术,术后常规进行抗生素静脉滴注预防感染;并内服芪蓉润肠口服液,20 mL/次,3次/d,便后采用苦参汤伤口清洗。对照组采用马应龙麝香痔疮膏涂抹肛门,以无菌纱布覆盖创面,1 g/次,1~2次/d。观察组以龙血竭胶囊合九华膏涂抹肛门,以无菌纱布覆盖创面,1 g/次,1~2次/d。两组疗程均为10 d。记录术后第3,10天创面的疼痛、水肿、创面渗液、创面面积和创面肉芽组织情况,记录创面愈合时间;评价术后10 d创面毛细血管含量,采用免疫组化评价创面血管内皮生长因子(VEGF),碱性成纤维生长因子(b FGF)表达情况;检测治疗前后血清血小板源性生长因子(PDFG),血管内皮生长因子(VEGF),碱性成纤维生长因子(b FGF)。结果:术后10 d,观察组临床疗效总有效率为91.58%,优于对照组的77.89%(χ~2=6.877,P<0.01);观察组在术后3 d和10 d疼痛、水肿、创面渗液、创面面积和创面肉芽组织评分均低于同期对照组(P<0.01);观察组创面平均愈合时间为(11.5±2.1)d,低于对照组的(13.7±2.5)d,比较差异有统计学意义(P<0.01);观察组创面毛细血管数目多于对照组(P<0.01),观察组创面VEGF和b FGF表达的MOD值高于对照组(P<0.01);治疗后观察组患者血清PDFG,VEGF和b FGF水平均高于对照组,差异有统计学意义(P<0.01)。治疗过程中未发现与龙血竭联合九华膏相关不良反应。结论:采用龙血竭胶囊合九华膏治疗环状混合痔术后创面的治疗,能促进创面的修复,缩短愈合时间,其作用机制可能与调节血清和创面VEGF,PDFG,b FGF等因子表达,促进创面毛细管血管形成,促使肉芽组织生长与修复有关。Objective： To observe the effect of Longxuejie capsule and Jiuhua ointment on the recovery after mixed hemorrhoid surgery, and the wound and serum vascular endothelial growth factor. Method： One hundred and ninety patients were randomly divided into control group （95 cases） and observation group （95 cases） by random number table. Both groups＇ patients got segmented multi-layer arc-cut suture surgery. After the surgery, intravenous dripping of antibiotics was provided for prevention of infection. The patients took Qirong Runchang oral solution, 20 mL/time, 3 times/day. After defecation, Kushen soup was used for cleaning the wound. Patients in control group used Mayinglong hemorrhoids ointment at anus, 1 g/time, 1-2 time/day, the wound was covered with sterile gauze. Patients in observation group got Longxuejie capsule and Jiuhua ointment 1 g/time, 1-2 time/day, the wound was covered with sterile gauze. The course of treatment was 10 days. At the 3^th and 10^th after surgery, pain, edema, wound exudates, wound area and wound granulation tissue were recorded. At the 10th after surgery, wound capillary content was evaluated, and expression of wound＇s vascular endothelial growth factor （VEGF） and basic fibroblast growth factor （bFGF） were evaluated by immunohistochemistry. And levels of serum platelet-derived growth factor （PDFG） , VEGF and bFGF before and after treatment were detected. Result： At the 10^th day after surgery, the total effective rate in observation was 91.58% , which was superior to 77.89% in control group （χ^2 = 6. 877, P 〈 0.01 ）. At the 3^th and 10^th day after the surgery, scores of pain, edema, wound exudates, wound area and wound granulation tissue were all lower than those in control group （P 〈 0.01 ）. Mean healing time of wound was （11.5 ± 2. 1 ） days, which was less than （13.7±2.5） days in control group, with statistically significant difference （P 〈 0.01 ）. At the 10^th day after treatment, expression of wound＇s vascular endothelia

关 键 词：环状混合痔 龙血竭胶囊 九华膏 创面修复 血管内皮生长因子 碱性成纤维生长因子 血小板源性生长因子 血管形成 

分 类 号：R24[医药卫生—中医临床基础] R287[医药卫生—中医学]