复方黄柏涂液联合微波治疗对肛肠手术患者术后疼痛情况与创面愈合效果的影响  

Influence of compound huangbai solution combined with microwave therapy on postoperative pain status and wound healing effect in patients with anorectal surgery

作　　者：杨稀 谌春 曾伟[1] 唐勤富 童忠满 Yang Xi;Chen Chun;Zeng Wei;Tang Qin-fu;Tong Zhong-man(Department of Anal and Intestinal Medicine,Leshan Hospital of Traditional Chinese Medicine,Leshan 614000,China;Department of Critical Care Medicine,Jingyan County Hospital of Traditional Chinese Medicine,Leshan 613199,China)

机构地区：[1]乐山市中医医院肛肠科,乐山614000 [2]井研县中医医院重症医学科,乐山613199

出　　处：《中国药物应用与监测》2025年第1期61-65,共5页Chinese Journal of Drug Application and Monitoring

基　　金：乐山市科技计划项目(20ZDYJ0106)。

摘　　要：目的探究复方黄柏涂液联合微波照射治疗对肛肠手术患者术后疼痛情况、创面愈合及肉芽组织血管内皮细胞生长因子受体2(VEGFR-2)、血管内皮生长因子(VEGF)表达的影响。方法纳入乐山市中医医院于2022年8月至2024年8月收治的134例行肛肠手术的患者,根据随机数字表法将其分为复方组和微波组,各67例。微波组术后接受微波照射治疗,复方组术后接受复方黄柏涂液+微波照射治疗。对比两组临床疗效,创面愈合情况,术后1、7、14 d的疼痛程度[视觉模拟量表(VAS)],术后1、7 d肉芽组织VEGFR-2、VEGF表达水平,并统计不良反应发生情况。结果术后14 d,复方组总有效率95.52%(64/67)高于微波组85.07%(57/67),差异有统计学意义(χ^(2)=4.174,P<0.05);复方组术后7、14 d创面肉芽颜色评分[(2.04±0.33)分、(0.48±0.06)分]均低于微波组[(2.46±0.40)分、(0.56±0.07)分],差异均有统计学意义(t=6.630、7.103,均P<0.001);复方组术后7、14 d创面面积[(3.21±0.51)cm^(2)、(1.02±0.20)cm^(2)]均低于微波组[(3.49±0.55)cm^(2)、(1.33±0.31)cm^(2)],差异均有统计学意义(t=3.056、7.100,均P<0.05);复方组水肿消退时间和创面愈合时间[(7.65±1.08)d、(15.23±2.14)d]均少于微波组[(9.12±1.28)d、(18.25±2.42)d],差异均有统计学意义(t=7.184、7.652,均P<0.001);复方组术后7、14 d VAS评分[(2.32±0.47)、(1.28±0.23)分]均低于微波组[(2.90±0.54)、(1.74±0.34)分],差异均有统计学意义(t=6.632、9.173,均P<0.001);术后7 d,复方组肉芽组织VEGFR-2、VEGF表达水平[(183.38±16.82)pg·mL^(-1)、(160.21±14.70)pg·mL^(-1)]高于微波组[(168.65±15.47)pg·mL^(-1)、(145.95±13.39)pg·mL^(-1)],差异均有统计学意义(t=5.276、5.870,均P<0.001);复方组和微波组不良反应发生率分别为7.47%(5/67)、4.47%(3/67),组间差异无统计学意义(χ^(2)=0.133,P>0.05)。结论复方黄柏涂液联合微波治疗能提高肛肠手术患者的临床疗效,加快术后创面愈合,减轻术后�Objective To investigate the impact of compound huangbai solution combined with microwave irradiation therapy on postoperative pain status,wound healing and expressions of vascular endothelial growth factor receptor 2(VEGFR-2)and vascular endothelial growth factor(VEGF)in granulation tissue of patients undergoing anorectal surgery.Methods A total of 134 patients receiving anorectal surgery in Leshan Hospital of Traditional Chinese Medicine from August 2022 to August 2024 were enrolled in this study.According to the random number table method,they were divided into the compound group and microwave group,with 67 in each group.The patients in the microwave group were treated with microwave irradiation after surgery while those in the compound group received compound huangbai solution+microwave irradiation after surgery.The clinical efficacy,wound healing status,pain status(visual analogue scale(VAS))on day 1,7 and 14 after surgery and expression levels of VEGFR-2 and VEGF in granulation tissue on day 1 and 7 after surgery were compared between the two groups.Meanwhile,the adverse reactions were counted.Results On day 14 after surgery,the total effective rate in the compound group was 95.52%(64/67)and its was higher than that of 85.07%(57/67)in the microwave group(χ^(2)=4.174,P<0.05).The wound granulation color scores on day 7 and 14 after surgery in the compound group were(2.04±0.33)points and(0.48±0.06)points and they were lower than those of(2.46±0.40)and(0.56±0.07)points in the microwave group(t=6.630,7.103,both P<0.001).The wound area scores in the compound group on day 7 and 14 after surgery were(3.21±0.51)points and(1.02±0.20)points,which were lower than those of(3.49±0.55)points and(1.33±0.31)points in the microwave group(t=3.056,7.100,both P<0.05).The edema regression time and wound healing time in the compound group were(7.65±1.08)d and(15.23±2.14)d and they were shorter than those of(9.12±1.28)d and(18.25±2.42)d in the microwave group(t=7.184,7.652,both P<0.001).The VAS scores in the compound

关 键 词：复方黄柏涂液 微波治疗 肛肠手术 术后疼痛 创面愈合 

分 类 号：R657.1[医药卫生—外科学]