中药熏洗联合生物反馈对直肠内脱垂吻合器痔上黏膜环切术术后临床疗效  

Clinical effects of Chinese medicine fumigation combined with biofeedback on intrarectal prolapse after procedure for prolapse and hemorrhoids

作　　者：陈勇[1] 黄璇[1] 高献明[1] 扶立华 叶玲[1] CHEN Yong;HUANG Xuan;GAO Xian-ming;FU Li-hua;YE Ling(Anorectal Department,The Second People's Hospital Affiliated to Fuijian University of Traditional Chinese Medicine,Fuzhou 350003,China;Surgery Department,East Second Ring Branch of The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350009,China)

机构地区：[1]福建中医药大学附属第二人民医院肛肠科,福州350003 [2]福建中医药大学附属第二人民医院东二环分院外科,福州350009

出　　处：《中华中医药杂志》2021年第2期1192-1196,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：福建省康复产业研究院技术创新平台项目(No.2015Y2001-72)。

摘　　要：目的:探究中药熏洗联合生物反馈对直肠内脱垂(IRP)吻合器痔上黏膜环切术(PPH)术后患者生活质量的改善及对直肠黏膜瞬时受体电位通道蛋白V1(TRPV1)、瞬时受体电位通道蛋白A1(TRPA1)的影响。方法:选取2018年3月至2019年9月福建中医药大学附属第二人民医院103例行PPH术的IRP患者,将其随机分为观察组(52例)和对照组(51例)。两组术前均使用生物反馈治疗,术后观察组予中药熏洗疗法,对照组予高锰酸钾溶液坐浴。比较术前7d、术后7d两组直肠黏膜TRPV1、TRPA1表达水平;比较术后两组并发症发生率;比较术前7d、术后30d两组生活质量评分。结果:术后7d两组直肠黏膜TRPV1、TRPA1蛋白相对表达量均低于治疗前,且观察组均低于对照组(P<0.01);术后观察组并发症总发生率低于对照组(P<0.01);术后30d两组SF-36评分均高于治疗前,且观察组高于对照组(P<0.01)。结论:IRP患者在行PPH术前予生物反馈治疗联合术后中药熏洗可降低直肠黏膜TRPV1、TRPA1表达水平,减少术后并发症,显著改善IRP患者术后生活质量。Objective:To investigate the effects of Chinese medicine fumigation combined with biofeedback on the quality of life and transient receptor potential channel protein V1(TRPV1)and transient receptor potential channel protein A1(TRPA1)of rectal mucosa of patients with intrarectal prolapse(IRP)after procedure for prolapse and hemorrhoids(PPH).Methods:A total of 103 patients with IRP who underwent PPH surgery in the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from March 2018 to September 2019 were selected and divided into an observation group(52 cases)and a control group(51 cases)by simple randomization.Both groups were treated with biofeedback therapy before operation,the observation group was treated with Chinese medicine fumigation for postoperative,while the control group was treated with potassium permanganate bath for postoperative.The levels of TRPV1 and TRPA1 in rectal mucosa on 7 days before operation and 7 days after operation of the two groups were compared.The incidence of complications of the two groups were compared after surgery.The quality of life scores before surgery 7 days and 30 days after surgery of the two groups were compared.Results:The relative expression levels of TRPV1 and TRPA1 protein in rectal mucosa of two groups were lower than those before treatment on 7 days after operation,which of the observation group were lower than those of the control group(P<0.01).The incidence of complications of the observation group was lower than that of the control group(P<0.01).The SF-36 scores of two groups were higher than those before treatment at 30 days after operation,which of the observation group was higher than that of the control group(P<0.01).Conclusion:Chinese medicine fumigation combined with biofeedback in perioperative period can reduce the expression levels of TRPV1 and TRPA1 in the rectal mucosa,reduce complications,obviously improve the quality of life of patients with IRP after PPH.

关 键 词：中药熏洗 生物反馈 直肠内脱垂 吻合器痔上黏膜环切术(PPH) 外治法 苦参汤 

分 类 号：R657.18[医药卫生—外科学]