中药熏洗对痔疮术后创面水肿、疼痛及炎症反应的影响  

Effects of Chinese Herbal Fumigation and Washing on Wound Edema,Pain,and Inflammatory Responses After Surgery for Hemorrhoids

作　　者：廖秋萍 陈玉叶[1] 余桂林 LIAO Qiuping;CHEN Yuye;YU Guilin

机构地区：[1]丽水市中心医院肛肠外科,浙江丽水323000

出　　处：《新中医》2023年第12期177-180,共4页New Chinese Medicine

摘　　要：目的:观察中药熏洗对痔疮湿热下注证患者术后创面水肿、疼痛及炎症反应的影响。方法:选取94例行吻合器痔上黏膜环状切除术(PPH)治疗的痔疮湿热下注证患者,采用随机数字表法分为中药熏洗组和常规组各47例,其中常规组剔除1例,最终纳入46例。2组术后均静脉滴注抗生素3 d。常规组术后予以0.9%氯化钠溶液冲洗创面,中药熏洗组术后使用熏洗1号方熏洗创面,清创后2组均用康复新液外敷,治疗14 d。比较2组创面水肿、创面渗液消失时间,创面愈合率,术后各时间段疼痛视觉模拟评分法(VAS)评分,以及治疗前后血清白细胞介素-1β(IL-1β)、C-反应蛋白(CRP)水平。结果:治疗后,中药熏洗组创面水肿消失、创面渗液消失时间均短于常规组(P<0.05)。治疗14 d后,中药熏洗组创面愈合率87.23%,高于常规组63.04%(P<0.05)。术后1 d、2 d,2组VAS评分同期比较,差异均无统计学意义(P>0.05)。术后3 d、5 d、7 d、14 d,中药熏洗组VAS评分均低于同期常规组(P<0.05)。治疗14 d后,2组血清IL-1β、CRP水平均较治疗前降低(P<0.05),中药熏洗组血清IL-1β、CRP水平均低于常规组(P<0.05)。结论:痔疮湿热下注证患者PPH术后进行中药熏洗,可有效缓解其创面水肿、疼痛,减轻炎症反应。Objective:To observe the effect of Chinese herbal fumigation and washing on wound edema,pain,and inflammatory responses in patients with damp-heat pouring downward syndrome and after surgery for hemorrhoids.Methods:A total of 94 cases of patients with hemorrhoids with damp-heat pouring downward syndrome undergoing the procedure for prolapse and hemorrhoids(PPH)were selected and divided into the Chinese herbal fumigation and washing group and the routine group according to the random number table method,with 47 cases in each group.Among them,1 case was excluded from the routine group and 46 cases were ultimately included.After the surgery,both groups received intravenous drip antibiotics for 3 days,the routine group was given wound flushing with 0.9%sodium chloride solution,and the Chinese herbal fumigation and washing group was given wound cleaning with No.1 Prescription for fumigation and washing.After debridement,both groups were treated with the external application with Kangfuxin Liquid.The treatment in the two groups lasted for 14 days.The disappearance time of wound edema and wound exudation,the wound healing rate,the Visual Analogue Scale(VAS)scores of pain at each time point after surgery,and the levels of interleukin-1β(IL-1β)and C-reactive protein(CRP)in serum were compared before and after treatment between the two groups.Results:The disappearance time of wound edema and wound exudation in the Chinese herbal fumigation and washinggroup were shorter than those in the routine group(P<0.05).After a 14-day treatment,the wound healingrate was 87.23%in the Chinese herbal fumigation and washing group,higher than that of 63.04%in theroutine group(P<0.05).After 1 day and 2 days of the surgery,there was no significant difference beingfound in the comparison of VAS scores between the two groups in the same period(P>0.05).After 3,5,7,and 14 days of the surgery,VAS scores in the Chinese herbal fumigation and washing group were lowerthan those in the routine group in the same period(P<0.05).After a 14-day treatmen

关 键 词：痔疮 湿热下注证 吻合器痔上黏膜环状切除术 中药熏洗 水肿 疼痛 炎症指标 

分 类 号：R657.18[医药卫生—外科学] R244.9[医药卫生—临床医学]