加减乙字汤保留灌肠联合内镜下硬化术治疗Ⅰ~Ⅲ度内痔的临床效果  

Clinical effect of modified Yizi Decoction enema combined with endoscopic sclerotherapy in the treatment of gradeⅠ-Ⅲinternal hemorrhoids

作　　者：姚晶晶 王再见 吴勇 李会霞 YAO Jingjing;WANG Zaijian;WU Yong;LI Huixia(The Third Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Spleen and Stomach,Beijing University of Chinese Medicine Third Hospital,Beijing 100029,China;Department of Gastroenterology,JingdongYumei Integrated Traditional Chinese and Western Medicine Nephropathy Hospital,Hebei Province,Sanhe 065201,China)

机构地区：[1]北京中医药大学第三临床医学院,北京100029 [2]北京中医药大学第三附属医院脾胃科,北京100029 [3]河北省京东誉美中西医结合肾病医院消化科,河北三河065201

出　　处：《中国医药导报》2022年第31期135-138,共4页China Medical Herald

基　　金：河北省中医药管理局中医药类科研计划项目(2021375)。

摘　　要：目的研究加减乙字汤灌肠联合内镜下硬化术治疗内痔的临床效果。方法选取2018年10月至2021年6月河北省京东誉美中西医结合肾病医院住院的100例Ⅰ~Ⅲ度内痔伴出血患者,按照随机数字表法将其分为两组,每组50例。对照组予以外科手术切除,试验组行内镜下硬化术,术后第2天加减乙字汤保留灌肠,比较两组住院天数、临床疗效;比较两组治疗前后症状积分及肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-10、IL-17水平。结果试验组住院天数短于对照组(P<0.05)。治疗后,两组出血、肛门坠胀不适和疼痛评分低于治疗前,且试验组低于对照组(P<0.05)。试验组总有效率高于对照组(P<0.05)。治疗后,两组IL-17和TNF-α水平低于治疗前,且试验组低于对照组(P<0.05);IL-10水平高于治疗前,且试验组高于对照组(P<0.05)。结论加减乙字汤灌肠联合内镜下硬化术治疗内痔可缩短患者住院天数,减轻便血、肛门坠胀不适和疼痛症状,其作用于IL-17、IL-10和TNF-α等炎症细胞因子发挥抗炎作用,值得临床推广。Objective To study the clinical effect of modified Yizi Decoction enema combined with endoscopic sclerotherapy in the treatment of internal hemorrhoids.Methods A total of 100 patients with gradeⅠ-Ⅲinternal hemorrhoids with bleeding who were hospitalized in Jingdong Yumei Integrated Traditional Chinese and Western Medicine Nephropathy Hospital of Hebei Province from October 2018 to June 2021 were selected.They were divided into two groups,with 50 cases in each group.The control group underwent surgical resection and the experimental group underwent endoscopic sclerosis,and the second day after surgery,modified Yizi Decoction enema was implemented.The length of hospital stay and clinical efficacy were compared between the two groups;the symptom scores and the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-10 and IL-17 before and after treatment were compared between the two groups.Results The length of hospital stay in experimental group was shorter than that in control group(P<0.05).After treatment,the scores of bleeding,anal distension discomfort,and pain in two groups were lower than those before treatment,and experimental group was lower than control group(P<0.05).The total effective rate of experimental group was higher than that of control group(P<0.05).After treatment,the levels of IL-17 and TNF-αin two groups were lower than those before treatment,and those in experimental group were lower than those in control group(P<0.05);the level of IL-10 was higher than that before treatment,and that in experimental group was higher than that in control group(P<0.05).Conclusion Modified Yizi decoction enema combined with endoscopic sclerosis in the treatment of internal hemorrhoids can shorten the length of hospital stay,reduce the symptoms of hematochezia,anal distension discomfort,and pain.It plays an anti-inflammatory effect on inflammatory cytokines such as IL-17,IL-10,and TNF-α,which is worthy of clinical promotion.

关 键 词：加减乙字汤 灌肠 内镜下硬化术 内痔 

分 类 号：R657.18[医药卫生—外科学]