卯时雷火灸联合祛毒消肿汤熏洗对湿热下注型混合痔术后疼痛、水肿及创面愈合的干预作用  

Combined Maoshi thunder-fire moxibustion with Qudu Xiaozhong Decoction on postoperative pain,edema and wound healing of mixed hemorrhoids of damp heat type

作　　者：温丽辉 冯江雪[1] 陈雪清[1] 武玉娟[1] 高俊娈[1] 王立娜 WEN Lihui;FENG Jiangxue;CHEN Xueqing;WU Yujuan;GAO Junluan;WANG Lina(Department of Anorectal Medicine,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050011)

机构地区：[1]河北省中医院肛肠科,河北石家庄050011

出　　处：《河北中医》2022年第12期1973-1978,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2021年度中医药类科研计划课题(编号:2021017)。

摘　　要：目的观察卯时雷火灸联合祛毒消肿汤熏洗对湿热下注型混合痔术后疼痛、水肿及创面愈合的干预作用。方法将144例湿热下注型混合痔患者按照随机数字表法分为2组,均予外剥内扎手术,对照组73例术后予祛毒消肿汤熏洗治疗,治疗组71例在对照组治疗基础上加用卯时雷火灸,2组疗程均2周。比较2组术后疼痛视觉模拟评分(VAS)、水肿评分、创面面积、创面渗液评分、创面肉芽组织评分变化;比较2组术后血清炎症因子含量变化;比较2组术后第7 d创面肉芽组织相关细胞因子表达情况;观察2组不良反应发生情况。结果治疗组、对照组分别脱落6、8例,最终2组各65例完成临床试验。术后第2、7、14 d 2组疼痛VAS、水肿评分均逐渐降低(P<0.05),术后第14 d低于术后第2、7 d(P<0.05),术后第7 d低于术后第2 d(P<0.05);术后第7、14 d治疗组疼痛VAS、水肿评分均低于对照组(P<0.05)。术后第2、7、14 d 2组创面面积逐渐减小(P<0.05),创面渗液评分逐渐降低(P<0.05),术后第14 d创面面积小于术后第2、7 d(P<0.05),术后第7 d创面面积小于术后第2 d(P<0.05);术后第14 d创面渗液评分低于术后第2、7 d(P<0.05),术后第7 d创面渗液评分低于术后第2 d(P<0.05);术后第14 d 2组创面肉芽组织评分较本组术后第7 d降低(P<0.05);术后第7、14 d治疗组创面面积小于对照组(P<0.05),创面渗液评分、创面肉芽组织评分均低于对照组(P<0.05)。术后第14 d 2组血清白细胞介素(IL)-1β、IL-12、干扰素γ(IFN-γ)含量均较本组术后第2 d降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组术后第7 d创面肉芽组织CD68、血管内皮生长因子(VEGF)、碱性成纤维细胞因子(bFGF)表达阳性率评分均高于对照组(P<0.05)。治疗组不良反应发生率6.15%(4/65),对照组不良反应发生率18.46%(12/65),2组不良反应发生率比较差异有统计学意义(P<0.05)。结论卯时雷火灸联合祛毒消肿汤熏洗可缓Objective To investigate the intervention effect of Maoshi thunder-fire moxibustion combined with Qudu Xiaozhong Decoction on postoperative pain,edema and wound healing of mixed hemorrhoids of damp heat type.Methods Based on Milligan-Morgan hemorrhoidectomy,the control group(n=73,8 shedding)was treated with fumigation-washing therapy with Qudu Xiaozhong Decoction,and the treatment group(n=71,6 shedding)was additionally given Maoshi thunder-fire moxibustion.A 2-week treatment was performed,the aim was to compare the visual analogue scale(VAS),edema score,wound area,wound exudation score and wound granulation tissue score,postoperative inflammatory factors.Expression levels of cytokines associated with the wound granulation tissues on day 7 were compared.The adverse reactions were recorded.Results There were 65 cases in each of the two groups completed the clinical trial.VAS and edema scores on days 2,7 and 14 in both groups were gradually reduced(P<0.05).VAS and edema scores on day 14 were significantly lower than those of days 2 and 7,which on day 7 were significantly lower than those on day 2(P<0.05).VAS and edema scores on days 7 and 14 in the treatment group were significantly lower than those of the control group(P<0.05).Wound area and wound exudate score in both groups on days 2,7 and 14 were decreased,the wound area and wound exudate score on day 14 were significantly smaller than those on days 2 and 7,which on day 7 were significantly smaller than those on day 2(all P<0.05).The wound granulation tissue score in both groups on day 14 were decreased than those on day 7(P<0.05).Wound area on days 7 and 14 in the treatment group was significantly smaller than that of the control group,and would exudate score and wound granulation tissue score were significantly lower(all P<0.05).Serum levels of interleukin(IL)-1β,IL-12 and interferon-γ(IFN-γ)on day 14 in both groups were significantly lower than those on day 2(P<0.05),which were more pronounced in the treatment group(P<0.05).The rates of positive expression

关 键 词：痔 外科学 灸法 熏洗疗法 

分 类 号：R266.5[医药卫生—中医外科学] R245[医药卫生—中医学] R244