董氏奇穴针刺结合中药坐浴对混合痔PPH术后创面愈合及相关指标的影响  

Effects of acupuncture at Dong’s extra-points combined with traditional Chinese medicine hip bath on wound healing and correlated indexes after PPH of mixed hemorrhoids

作　　者：盖娟娟[1] 曾科学[2] GAI Juanjuan;ZENG Kexue(Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,Guangdong,China;Guangdong Second Hospital of Traditional Chinese Medicine,Guangzhou 510095,Guangdong,China)

机构地区：[1]广东省中医院,广东广州510120 [2]广东省第二中医院,广东广州510095

出　　处：《现代中西医结合杂志》2020年第34期3771-3775,3815,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省中医药局科研课题(20121171)。

摘　　要：目的观察董氏奇穴针刺联合四磨汤合补中益气汤加减坐浴对环状混合痔吻合器痔上黏膜环切术(PPH)患者创面愈合及血清碱性成纤维生长因子(bFGF)、血管内皮生长因子(VEGF)的影响。方法选取2018年1月—2019年6月就诊于广东省中医院的118例混合痔行PPH术患者,按照随机数字表法分为对照组和观察组各59例。对照组患者术后给予高锰酸钾溶液治疗,观察组患者给予董氏奇穴针刺及四磨汤合补中益气汤加减坐浴治疗,2组均连续治疗7 d。比较2组患者术后创面愈合情况、创面疼痛VAS评分、症状缓解时间,检测2组患者术后1 d和术后7 d血清中bFGF、VEGF水平。结果观察组患者术后7 d创面愈合率为69.5%(41/59),对照组为45.8%(27/59),观察组显著高于对照组(P<0.05),且观察组患者创面愈合时间显著短于对照组(P<0.05);观察组患者术后各时间点VAS评分均明显低于对照组(P均<0.05),且肛门坠胀、疼痛缓解时间及肛门水肿、创面渗液消失时间均显著短于对照组(P均<0.05);观察组患者术后创面肉芽生长情况明显好于对照组(P<0.05),出血程度明显轻于对照组(P<0.05);2组患者术后7 d血清bFGF、VEGF水平均明显高于术后1 d(P均<0.05),且观察组均显著高于对照组(P均<0.05)。结论董氏奇穴针刺联合四磨汤合补中益气汤加减坐浴可促进混合痔PPH术后患者创面愈合,显著缓解术后肛门坠胀、疼痛、水肿等症状,机制可能与上调血清中bFGF、VEGF水平以促进血管新生有关。Objective It is to observe the Effects of acupuncture at Dong’s extra-points combined with hip bath with modified Simo Decoction and Buzhong Yiqi Decoction on wound healing and serum basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)in the patients after PPH of mixed hemorrhoids.Methods 118 patients with mixed hemorrhoids after PPH who were admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2018 to June 2019 were selected and divided into control group and observation group according to the random number table method,59 cases in each group.The patients in the control group were treated with hip bath with potassium permanganate solution after surgery.The patients in the observation group were treated with acupuncture at Dong’s extra-points combined with hip bath with modified Simo Decoction and Buzhong Yiqi Decoction,both groups were treated for 7 days.The wound healing,visual analogue scale(VAS)score of wound pain and the remission time of symptoms after surgery were compared between the two groups,and the levels of serum bFGF and VEGF were detected at one day and 7 days after surgery.Results The postoperative wound healing rate of the observation group was 69.5%(41/59),which was significantly higher than 45.8%(27/59)of the control group(P<0.05),and the wound healing time was significantly shorter than that of the control group(P<0.05).The VAS scores of patients in the observation group were significantly lower than those in the control group at all time points after surgery(all P<0.05),and the time of anal swelling,pain relief,anal edema,and wound exudate disappearance were significantly shorter than those in the control group(all P<0.05).The postoperative wound granulation growth of the observation group was significantly better than that of the control group(P<0.05),and the bleeding degree was significantly lighter than that of the control group(P<0.05);the serum bFGF and VEGF levels of the 2 groups were significantly higher at 7 days after

关 键 词：混合痔 董氏奇穴 中药坐浴 吻合器痔上黏膜环切术 碱性成纤维生长因子 血管内皮生长因子 

分 类 号：R657.1[医药卫生—外科学]