痔疮自动套扎术联合中药熏洗及九华膏换药对出血性内痔患者临床效果及炎症因子的影响  

Effects of RPH operation combined with traditional Chinese herbal fumigation and Jiuhua ointment dressing change on clinical effect and inflammatory factors in patients with hemorrhagic internal hemorrhoids

作　　者：邵秋香[1] 史亮亮 李晓华[1] 胡晓慧 马敬华 SHAO Qiu-xiang;SHI Liang-liang;LI Xiao-hua(Department of Anorectal,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou Hebei 061000,China;Department of Gynecology,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]河北省沧州中西医结合医院肛肠科,河北沧州061000 [2]河北省沧州中西医结合医院妇科,河北沧州061000

出　　处：《临床和实验医学杂志》2023年第24期2636-2641,共6页Journal of Clinical and Experimental Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2019306)。

摘　　要：目的研究痔疮自动套扎术(RPH)联合中药熏洗及九华膏换药对出血性内痔患者临床效果及炎症因子的影响。方法选取2019年8月至2020年8月河北省沧州中西医结合医院治疗的120例出血性内痔患者,按照随机数字表法分为对照组和观察组,各60例。对照组给予中药熏洗及九华膏换药,观察组给予RPH联合中药熏洗、九华膏换药。记录中医证候分数;使用全自动凝血分析仪检测凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG)水平;使用肛肠压力检测仪检测肛管静息压、肛管最大收缩压、肛管直径水平;采用酶联免疫吸附试验检测免疫球蛋白(Ig)A、IgM、IgG、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)水平;评价两组患者的临床疗效。结果治疗后,观察组便血、小便短赤、肛缘水肿、肛门坠胀中医证候积分水平分别为(1.03±0.85)、(0.41±0.33)、(0.59±0.11)、(0.68±0.29)分,均低于对照组[(2.97±1.04)、(1.45±1.14)、(1.68±0.95)、(1.69±1.05)分],差异均有统计学意义(P<0.05)。治疗后,观察组的APTT水平为(27.82±4.61)s,高于对照组[(23.29±4.92)s],TT、PT、FBG分别为(17.24±3.26)s、(12.83±1.37)s、(1.86±0.42)g/L,均低于对照组[(20.64±3.71)s、(14.69±1.64)s、(2.57±0.48)g/L],差异均有统计学意义(P<0.05)。治疗后,观察组的肛管静息压、肛管最大收缩压、肛管直径水平(74.19±17.13)mmHg、(122.19±21.74)mmHg、(2.10±0.24)cm,均低于对照组[(96.75±14.25)mmHg、(134.32±18.35)mmHg、(2.46±0.28)cm],差异均有统计学意义(P<0.05)。治疗后,观察组的IgA、IgM、IgG、TNF-α、IL-6、CRP水平(3.69±0.41)g/L、(1.62±0.36)g/L、(11.84±0.32)g/L、(19.82±2.12)pg/mL、(12.35±2.36)pg/mL、(20.34±2.19)mg/L,均高于对照组[(2.93±0.21)g/L、(1.14±0.21)g/L、(10.45±0.34)g/L、(26.19±2.36)pg/mL、(19.73±3.11)pg/mL、(26.85±3.74)mg/L],差异均有统计学意义(P<0.05)。观察组总有�Objective To study the clinical effect and inflammatory factors of patients with hemorrhagic internal hemorrhoids treated by ruiyun procedure hemorrhoids(RPH)combined with Chinese herbal fumigation and Jiuhua ointment dressing change.Methods A total of 120 patients with hemorrhagic internal hemorrhoids treated in Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from August 2019 to August 2020 were divided into control group and observation group according to the randon number table method,with 60 cases in each group.The control group was treated with Chinese herbal fumigation and Jiuhua ointment dressing change,while the observation group was treated with RPH combined with Chinese herbal fumigation and jiuhua ointment clressing change.TCM syndrome scores were record,the levels of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FBG)were detected by automatic coagulation analyzer.The rest pressure of anal canal,the maximum systolic pressure of anal canal and the diameter of anal canal were detected by anorectal pressure detector.Immunoglobulin(Ig)A,IgM and IgG levels,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),were detected by enzyme-linked immunosorbent assay.The clinical efficacy of two groups of patients was evaluated.Results After treatment,the score levels of blood in the stool,short and red urine,rectal edema,and anal distension in the observation group were(1.03±0.85),(0.41±0.33),(0.59±0.11),and(0.68±0.29)points,respectively,lower than those in the control group[(2.97±1.04),(1.45±1.14),(1.68±0.95),and(1.69±1.05)points],the differences were statistically significant(P<0.05).The APTT level in the observation group was(27.82±4.61)s,which was higher than that in the control group[(23.29±4.92)s].TT,PT,and FBG were(17.24±3.26)s,(12.83±1.37)s,and(1.86±0.42)g/L,respectively,which were lower than those in the control group[(20.64±3.71)s,(14.69±1.64)s,(2.57±0.48)g/L],the differences were statist

关 键 词：出血性内痔 痔疮自动套扎术 中药熏洗 炎症因子 临床效果 

分 类 号：R657.18[医药卫生—外科学]