荆芥消肿止痛汤联合红外线治疗对肛肠病患者术后疼痛及创面修复的影响  

Effect of Jingji Xiaozhong Zhitong Decoction Combined with Infrared Therapy on Pain and Wound Repain in Patients after Anorectal Surgery

作　　者：杨胜邦 曾清泉 潘凯 兰方发 YANG Shengbang;ZENG Qingquan;PAN Kai;LAN Fangfa(Qiandongnan Prefecture Traditional Chinese Medicine Hospital,Kaili Guizhou China 556000)

机构地区：[1]黔东南州中医医院,贵州凯里556000

出　　处：《中医学报》2022年第6期1336-1342,共7页Acta Chinese Medicine

基　　金：全国中医药创新骨干人才项目{国中医药人教函[2019]128号}。

摘　　要：目的:探究荆芥消肿止痛汤联合红外线治疗对肛肠病患者术后的作用效果。方法:选取2020年1月至2021年1月于黔东南州中医医院就诊的肛肠病患者82例,随机分为对照组和观察组,每组41例。患者均进行手术治疗,术后对照组患者给予高锰酸钾溶液坐浴+红外线治疗,观察组患者给予荆芥消肿止痛汤坐浴+红外线治疗,观察并对比两组患者水肿、创面面积、创面渗液、创面肉芽组织情况;采用视觉模拟量表(visual analog scale,VAS)评估两组患者术后疼痛程度;根据水肿、创面面积、创面渗液、创面肉芽组织及疼痛程度情况评估两组患者的临床疗效;通过住院时间、创面愈合时间、疼痛消失时间、肛缘水肿消失时间、分泌物消失时间评估两组患者的康复进程;采用肛肠测压仪测定患者的肛肠动力学指标;ELISA法检测创面肉芽组织中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)及其受体2(VEGF receptor-2,VEGFR-2)、成纤维细胞生长因子-1(fibroblast growth factor-1,FGF-1)的水平。结果:与对照组比较,观察组患者的有效率显著升高(P<0.05);术后3 d、7 d,观察组患者的水肿情况、创面面积、创面渗液、创面肉芽组织及疼痛程度评分均显著降低(P<0.05);观察组患者的住院时间、创面愈合时间、疼痛消失时间、肛缘水肿消失时间及分泌物消失时间明显缩短(P<0.05);观察组患者直肠肛管抑制反射阈值(anorectal inhibitory reflex threshold,AIRT)、直肠静息压(resting rectal pressure,RRP)显著降低(P<0.05),直肠最大耐受容量(maximal tolerable rectal volume,MTV)、肛管最大收缩压(anal maximum systolic pressure,MSP)、肛管静息压(anal resting pressure,ARP)及高压区长度(high pressure zone,HPZ)明显升高(P<0.05);观察组患者创面肉芽组织中VEGF、VEGFR-2、FGF-1的水平显著升高(P<0.05);两组均未出现不良反应。结论:荆芥消肿止痛汤联合红外线治疗可有效�Objective:To explore the effect of Jingji Xiaozhong Zhitong Decoction combined with infrared therapy on pain and wound repain in patients after anorectal surgery.Methods:A total of 82 patients with anorectal disease from January 2020 to January 2021 were selected and randomly divided into control group and observation group,with 41 cases in each group.All patients underwent surgical treatment.After surgery,the control group was given potassium permanganate solution sitz bath+infrared treatment,and the observation group was given Jingji Xiaozhong Zhitong decoction sitz bath+infrared treatment.The edema,wound area,wound exudate,and wound granulation tissue was observed and compared between the two groups.Visual analog scale(VAS)was used to evaluate the postoperative pain degree of the two groups of patients.The clinical efficacy of the two groups was evaluated according to the edema,wound area,wound exudate,wound granulation tissue,and pain degree.The recovery process of the two groups of patients was evaluated by the length of hospitalization,wound healing time,pain disappearance time,anal marginal edema disappearance time,and secretion disappearance time.Anorectal manometer was used to measure the patient′s anorectal dynamics.ELISA method was used to detect the levels of vascular endothelial cell growth factor(VEGF)and its receptor 2(VEGFR-2)and fibroblast growth factor-1(FGF-1)in wound granulation tissues.Results:Compared with the control group,the total effective rate of patients in the observation group was significantly increased(P<0.05).At 3d and 7d after the operation,the edema,wound area,wound exudate,wound granulation tissue and pain score of the observation group were significantly decreased(P<0.05).The hospitalization time,wound healing time,pain disappearance time,anal marginal edema disappearance time,and secretion disappearance time of the observation group were significantly shortened(P<0.05).In the observation group,the anorectal inhibitory reflex threshold(AIRT),rectal resting pressure(RRP)were

关 键 词：荆芥消肿止痛汤 红外线 疼痛程度 肛肠病 VEGF VEGFR-2 FGF-1 

分 类 号：R274.9[医药卫生—中西医结合]