黄蜂痔疮膏促进老年混合痔患者术后创面愈合的临床疗效及其作用机制  

Clinical Effects of Hornet Hemorrhoid Ointment in Promoting Postoperative Wound Healing in Elderly Patients with Mixed Hemorrhoids and Its Mechanism

作　　者：王立方 赵鹏飞[1] 尹晓辉 芦雪华 WANG Lifang;ZHAO Pengfei;YIN Xiaohui;LU Xuehua(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院,河北石家庄050000

出　　处：《西部中医药》2023年第12期117-120,共4页Western Journal of Traditional Chinese Medicine

基　　金：河北省2021年度中医药类科研指令性计划课题(2021239)。

摘　　要：目的:探讨黄蜂痔疮膏对老年混合痔患者术后创面愈合的影响,并分析其作用机制。方法:选取90例老年混合痔术后患者,采用随机数表法分为对照组和观察组,每组45例。两组术后均采用高锰酸钾水溶液(1∶5000)坐浴治疗,对照组给予马应龙麝香痔疮膏外涂,观察组给予黄蜂痔疮膏外涂,两组均每日早晚各涂1次,连续治疗21天。比较两组术后创面疼痛程度、肛缘水肿程度、创面愈合情况及血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、纤维连接蛋白(fibronectin,FN)水平,评估治疗效果。结果:两组术后1、3、5、7天创面视觉模拟评分量表(visual analogue scale,VAS)评分及肛缘水肿程度评分比较,差异均无统计学意义(P>0.05)。观察组术后肉芽组织与创面相平时间、创面愈合时间较对照组缩短(P<0.05)。术后21天,观察组总有效率高于对照组(P<0.05)。术后7、21天,观察组血清VEGF、FN水平高于对照组(P<0.05)。结论:黄蜂痔疮膏在缓解老年混合痔患者术后创面疼痛及肛缘水肿方面效果与马应龙痔疮膏相当,在促进创面愈合方面效果更优,其作用机制可能是黄蜂痔疮膏可清热燥湿、活血化瘀,从而改善血清VEGF、FN水平、促进血管新生。Objective:To discuss the influence of hornet hemorrhoid ointment on postoperative wound healing in elderly patients with mixed hemorrhoids,and analyze its mechanism.Methods:All 90 patients were allocated to the control group and the observation group using random number table method with 45 cases in each group.Both groups were treated by sitz bath with potassium permanganate solution(1:5000)after the operation,the control group accepted Mayinglong musk hemorrhoids ointment for external application,and the observation group hornet hemorrhoid ointment for external use,both groups were applied for once in the morning and evening each day,for 21 days consecutively.To compare pain degrees of postoperative wound,perianal edema degree,wound healing conditions,and the levels of VEGF and FN between both groups,to assess therapeutic effects.Results:The difference had no statistical meaning in VAS and perianal edema degree between both groups one,three,five and seven days after the surgery(P>0.05).The observation group was shorter than the control group in postoperative time for granulation tissue to be level with the wound,and wound healing time(P<0.05).Total effective rate of the observation group was higher than that of the control group 21 days after the surgery(P<0.05).The levels of serum VEGF and FN of the observation group were higher than these of the control group 7 and 21 days after the surgery(P<0.05).Conclusion:Hornet hemorrhoid ointment is equivalent to Mayinglong musk hemorrhoids ointment in relieving postoperative wound pain and perianal edema in elderly patients with mixed hemorrhoids,and better than Mayinglong musk hemorrhoids ointment in promoting wound healing,and its mechanism might be that hornet hemorrhoid ointment could clear heat and dry dampness,promote blood circulation and remove blood stasis,thereby improving the levels of serum VEGF and FN and promoting the angiogenesis.

关 键 词：混合痔 老年 黄蜂痔疮膏 创面愈合 作用机制 临床疗效 

分 类 号：R657.18[医药卫生—外科学]