苦参清热消肿止痛汤坐浴联合揿针疗法在混合痔术后患者中的应用效果  

Application effect of sitz bath with Kushen Qingre Xiaozhong Zhitong Decoction combined with thumb-tack needle therapy in patients with mixed hemorrhoid after surgery

作　　者：蔡娇娇 施捷 李晓军 CAI Jiaojiao;SHI Jie;LI Xiaojun(Department of Traditional Chinese Medicine Surgery,Chongming Hospital Affiliated to Shanghai University of Medicine&Health Science,Shanghai 202150,China)

机构地区：[1]上海健康医学院附属崇明医院中医外科,上海市202150

出　　处：《广西医学》2023年第22期2711-2716,2724,共7页Guangxi Medical Journal

基　　金：上海市崇明区“可持续发展科技创新行动计划”项目(CKY2021-11)。

摘　　要：目的 探讨苦参清热消肿止痛汤坐浴联合揿针疗法在混合痔术后患者中的应用效果。方法 将接受外科手术治疗的96例混合痔患者随机分为3组,每组32例。术后分别给予对照1组、对照2组、观察组苦参清热消肿止痛汤坐浴治疗、揿针治疗、苦参清热消肿止痛汤坐浴联合揿针治疗。比较3组患者术后康复指标、创面愈合率、术区水肿评分、疼痛视觉模拟量表(VAS)评分,治疗前后炎症指标[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8]、创面生长指标[成纤维细胞生长因子1(FGF-1)、血管内皮生长因子(VEGF)及VEGF受体2(VEGFR2)],以及术后并发症发生情况。结果 与对照1组和对照2组相比,观察组的术区水肿消失时间、疼痛消失时间、分泌物消失时间、住院时间及创面愈合时间更短,术后3 d、7 d的创面愈合率更高(P<0.05)。3组术后的术区水肿评分、疼痛VAS评分及血清IL-6、IL-8、TNF-α水平有随时间延长而降低的趋势,且观察组术后3 d、7 d的术区水肿评分、疼痛VAS评分低于对照1组和对照2组;术后3 d、7 d,对照2组、对照1组、观察组的血清IL-6、IL-8、TNF-α水平依次降低(P<0.05)。术后7 d,3组的创面肉芽组织中FGF-1、VEGF、VEGFR2水平较术后1 d升高,且观察组的上述指标高于对照1组和对照2组(P<0.05)。3组术后并发症总发生率差异无统计学意义(P>0.05)。结论 苦参清热消肿止痛汤坐浴联合揿针可有效缓解混合痔术后患者的疼痛和术区水肿,减轻炎症反应并增加创面生长因子的含量,从而促进创面愈合,加速术后康复进程,效果优于单一治疗。Objective To investigate the application effect of sitz bath with Kushen Qingre Xiaozhong Zhitong Decoction combined with thumb-tack needle therapy in patients with mixed hemorrhoid after surgery.Methods A total of 96 patients with mixed hemorrhoid undergoing surgical treatment were randomly divided into 3 groups,with 32 cases in each group.After surgery,sitz bath therapy with Kushen Qingre Xiaozhong Zhitong Decoction,thumb-tack needle therapy,and sitz bath with Kushen Qingre Xiaozhong Zhitong Decoction combined with thumb-tack needle therapy were given to the control group 1,the control group 2,and the observation group,respectively.The postoperative rehabilitation indicators,wound healing rate,operative area edema score,Visual Analogue Scale(VAS) score for pain,pre-and post-treatment inflammatory indices(tumor necrosis factor α [TNF-α],interleukin [IL]-6,IL-8),and wound growth indicators(fibroblast growth factor 1 [FGF-1],vascular endothelial growth factor [VEGF],VEGF receptor 2 [VEGFR2]),as well as the occurrence of postoperative complications were compared between patients of the three groups.Results The observation group exhibited shorter disappeared time to operative area edema,pain,and secretion,as well as shorter length of hospital stay and wound healing time,whereas a higher wound healing rate 3 and 7 days after surgery as compared with the control group 1 and the control group 2(P<0.05).The operative area edema score,VAS score for pain,and serum IL-6,IL-8,TNF-α levels of the three groups all depicted a decreasing trend with time prolonging,and the observation group yielded lower scores of edema in operative area and VAS for pain 3 and 7 days after operation as compared with the control groups 1 and 2;furthermore,levels of serum IL-6,IL-8 and TNF-α in the control group 2,the control group 1,and the observation group were decreased successively 3 and 7 days after surgery(P<0.05).After 7 days of operation,the levels of FGF-1,VEGF,and VEGFR2 of wound granulation tissues in the three groups were elevated

关 键 词：混合痔 术后 坐浴 苦参清热消肿止痛汤 揿针疗法 疼痛 水肿 炎症因子 生长因子 术后并发症 

分 类 号：R266[医药卫生—中医外科学]