可控式低温冷疗法对围生期急性痔病患者疼痛及炎症因子的影响  

Effects of Controlled Cryotherapy on Pain and Inflammatory Factors in Patients with Acute Hemorrhoids in Perinatal Period

作　　者：刘松 王霆 靳剑 LIU Song;WANG Ting;JIN Jian(Department of General Surgery,the Affiliated Hospital of Hebei Medical University/the People′s Hospital of Langfang City,Langfang 065000,China)

机构地区：[1]河北医科大学附属医院、廊坊市人民医院普外科,河北廊坊065000

出　　处：《医学综述》2022年第20期4140-4144,共5页Medical Recapitulate

基　　金：河北省省级科技计划自筹经费项目(162777136)。

摘　　要：目的探究可控式低温冷疗法对围生期急性痔病患者疼痛及炎症因子的影响。方法选取2018年9月至2019年9月廊坊市人民医院普外科收治的86例围生期急性痔病患者,按照治疗方法不同分为对照组(高锰酸钾温水坐浴)和观察组(可控式低温冷疗),每组43例。比较两组肛门水肿率、视觉模拟评分法(VAS)评分、血清炎症因子[白细胞介素(IL)-6、IL-17和肿瘤坏死因子-α(TNF-α)]水平、疼痛介质[前列腺素E_(2)(PGE_(2))、多巴胺、5-羟色胺(5-HT)、P物质]水平及治疗效果。结果治疗后,观察组肛门水肿率低于对照组[27.91%(12/43)比62.79%(27/43)](χ^(2)=10.556,P=0.001),观察组肛门水肿程度低于对照组(Z=3.487,P<0.001)。治疗后,两组肛门水肿评分、VAS评分、IL-6、IL-17、TNF-α、PGE_(2)、多巴胺、5-HT及P物质水平均较治疗前降低,且观察组低于对照组[(1.21±0.32)分比(1.62±0.43)分、(2.97±0.75)分比(4.18±1.10)分、(40.3±7.0)μmol/L比(53.5±8.0)μmol/L、(49.2±7.3)μmol/L比(58.7±8.3)μmol/L、(2.52±0.42)μmol/L比(3.93±0.57)μmol/L、(42.1±11.8)μg/L比(80.2±13.9)μg/L、(2.76±0.66)μg/L比(5.33±0.80)μg/L、(60±9)μg/L比(135±20)μg/L、(26.5±5.9)μg/L比(62.5±12.5)μg/L](P<0.01)。观察组治疗总有效率高于对照组[97.67%(42/43)比74.42%(32/43)](χ^(2)=9.685,P=0.002),观察组疗效优于对照组(Z=2.102,P=0.036)。结论可控式低温冷疗可有效降低围生期急性痔病患者疼痛介质及炎症因子水平,缓解患者疼痛,减轻炎症反应。Objective To explore the effects of controlled cryotherapy on pain mediators and inflammatory factors in the treatment of acute hemorrhoids in perinatal period.Methods A total of 86 patients with acute hemorrhoids in perinatal period admitted to the People′s Hospital of Langfang City from Sep.2018 to Sep.2019 were included.According to the treatment method,they were divided into a control group(potassium permanganate warm water solution sit-bath)and an observation group(controlled cryotherapy),with 43 cases in each group.The anal edema rate,visual analogue score(VAS),levels of serum inflammatory factors[interleukin(IL)-6,IL-17,tumor necrosis factor-α(TNF-α)],levels of pain mediators[prostaglandin E_(2)(PGE_(2)),dopamine,5-hydroxytryptamine(5-HT),substance P]and the therapeutic effects were compared between the two groups.Results After treatment,the anal edema rate in the observation group was lower than that in the control group[27.91%(12/43)vs 62.79%(27/43)](χ^(2)=10.556,P=0.001),and the degree of anal edema in the observation group was lower than that in the control group(Z=3.487,P<0.001).After treatment,the anal edema score,VAS score,the levels of IL-6,IL-17,TNF-α,PGE_(2),dopamine,5-HT and substance P in the two groups were lower than those before treatment,and the observation group were lower than the control group[(1.21±0.32)vs(1.62±0.43),(2.97±0.75)vs(4.18±1.10),(40.3±7.0)μmol/L vs(53.5±8.0)μmol/L,(49.2±7.3)μmol/L vs(58.7±8.3)μmol/L,(2.52±0.42)μmol/L vs(3.93±0.57)μmol/L,(42.1±11.8)μg/L vs(80.2±13.9)μg/L,(2.76±0.66)μg/L vs(5.33±0.80)μg/L,(60±9)μg/L vs(135±20)μg/L,(26.5±5.9)μg/L vs(62.5±12.5)μg/L](P<0.01).The total effective rate of the observation group was higher than that of the control group[97.67%(42/43)vs 74.42%(32/43)](χ^(2)=9.685,P=0.002),the curative effect of the observation group was better than that of the control group(Z=2.102,P=0.036).Conclusion The controlled cryotherapy can effectively reduce the levels of pain mediators and inflammatory factors in patien

关 键 词：急性痔病 围生期 可控式低温冷疗 高锰酸钾坐浴 疼痛介质 炎症因子 

分 类 号：R714.7[医药卫生—妇产科学]