复方元胡巴布脐贴治疗重度痔术后疼痛40例疗效观察  

Compound Yuanhubabu Qitie in the Treatment of Postoperative Pain of Severe Hemorrhoids Patients:Effect Observation on 40 Cases

作　　者：陈烁 龚银银 颜景颖 汪慧敏 钟元帅 徐培青 艾小刚 CHEN Shuo;GONG Yin-yin;YAN Jing-ying;WANG Hui-min;ZHONG Yuan-shuai;XU Pei-qing;AI Xiao-gang(Shenzhen Hospital of Beijing TCM Univeristy,Shenzhen.Guangdong 518100;Operating Room,the 2nd Peoples Hospital of Shenzhen City,Guangdong 518035;Guangzhou TCM University,Guangzhou,Guangdong 510404)

机构地区：[1]北京中医药大学深圳医院(龙岗),广东深圳518100 [2]广东省深圳市第二人民医院手术室,广东深圳518035 [3]广州中医药大学,广东广州510404

出　　处：《中国肛肠病杂志》2021年第9期11-14,共4页Chinese Journal of Coloproctology

基　　金：广东省深圳市龙岗区科技创新局课题(LGKCYLWS2019000439)。

摘　　要：为探讨复方元胡巴布脐贴治疗重度痔Milligan-Morgan(MM)术后疼痛的效果,将80例重度痔患者随机分成观察组和对照组,各40例,均腰麻下行MM术治疗。观察组手术结束时给予复方元胡巴布脐贴肚脐贴敷,对照组于手术结束时创缘注射亚甲蓝混合液,其他治疗相同。评测2组术后疼痛(VAS)评分、血清中白细胞介素1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)水平、追加止痛药物、水肿和安全性。结果显示,术后72h,2组血清IL-1、IL-6、TNF-α水平均低于本组治疗前,且观察组低于对照组(P <0.05)。术后6h、12h、24h和48h,观察组VAS评分均显著高于对照组(P <0.05);术后72h,2组VAS评分比较,差异无统计学意义(P>0.05),观察组追加止痛药物例数显著少于对照组(P <0.05);术后24h和48h,观察组水肿评分明显高于对照组(P <0.05);治疗期间观察组不良反应发生率明显低于对照组(P <0.05)。结果表明,复方元胡巴布脐贴用于重度痔MM术后,48h内对控制创口疼痛及水肿效果欠佳,之后效果逐渐显著,但安全性显著高于对照组;对炎性因子有明显抑制作用。This study was to investigate the efficacy of compound Yuanhubabu Qitie(TCM-sticking on naveal)in the treatment of pain after Milligan-Morgan(MM)procedure for servere hemorrhoids,randomly divided 80 servere hemorrhoids patients into two groups,40 cases for each,which they all received MM procedure under lumbar anesthesia;in observation group at the end of operation,TCM-sticking on patients’ navel,while in control group,at the end of operating into wound-edge injecting methylene blue mixture.Then,observed and compared both groups’ VAS ratings;levels of serum IL-1,IL-6,and TNF-α;added with analgesic;edema status,and safety.As results,both groups’ levels of IL-1,IL-6 and TNF-αat 72 hafter surgery were lower than before surgery,but observation group was more lower than control group(P <0.05);in VAS rating at 6,12,24 and 48 hafter surgery,in the case-numbers added with analgesic in the ratings on edema at 24 and 48 hafter surgery,as well as unward reaction incidence observation group was respectively and significantly higher,less,higher,as well as lower than control group(all,P <0.05).Only at72 hafter surgery both groups’ VAS ratings had no statistical difference(P >0.05).Resutls show that TCM-sticking on navel in controlling wound pain and edema has poor efficacy within 48 hrs after surgery,then,the efficacy gradually become significant,but its safety is greatly higher than that of control group,and has distinct inhibition on inflammatory factors.

关 键 词：混合痔 MILLIGAN-MORGAN 复方元胡巴布脐贴 镇痛 

分 类 号：R266[医药卫生—中医外科学]