保脾固摄方联合肛泰栓治疗内痔脱垂患者痔核黏膜及便血症状疗效及对NO、ET-1、GMP-140的影响

he effect of Baopi Gushe Decoction combined with Gangtai suppository in the treatment of mucous membrane of hemorrhoids and blood in stool in patients with internal hemorrhoid prolapse and the effect on NO,ET-1 and GMP-140

目的:探讨保脾固摄方联合肛泰栓治疗内痔脱垂患者痔核黏膜及便血症状疗效及对NO、ET-1、GMP-140的影响。方法:选择2019年4月~2021年4月庐江县人民医院收治的要求保守治疗脱垂性内痔患者100例,随机数字表法分为对照组和观察组,各50例。对照组给予肛门后纳入肛泰栓治疗,观察组在肛门用药基础上给予保脾固摄方口服治疗。比较两组生活质量(SF-36)评分、症状、体征评分;检测一氧化氮(NO)、内皮素-1(ET-1)、α-颗粒膜蛋白-140(GMP-140)水平;并统计不良反应。结果:两组便血、坠痛、脱垂、痔核粘膜等症状、体征评分显著低于治疗前(P<0.05),同时观察组症状、体征评分较对照组更低(P<0.05)。对照组NO显著高于治疗前,ET-1显著低于治疗前(P<0.05),GMP-140与治疗前比较无统计学意义(P>0.05),同时观察组NO显著高于治疗前,ET-1、GMP-140显著低于治疗前(P<0.05),且观察组NO、ET-1、GMP-140改善程度大于对照组(P<0.05)。两组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、精神健康、情感职能等SF-36评分显著高于治疗前(P<0.05),同时观察组SF-36评分较对照组更高(P<0.05)。两组在皮疹、胃肠道反应、肛门不适等不良反应比较,无统计学意义(P>0.05)。结论:保脾固摄方联合肛泰栓保守治疗内痔脱垂可减轻便血、坠痛、脱垂、痔核粘膜等症状、体征,改善生活质量,可能与调节相关因子有关。

Objective:This study aimed to investigate the efficacy of the Baopi Gushe Decoction in combination with Gangtai suppository on the hemorrhoid mucosa and blood in stool in patients with internal hemorrhoid prolapse and nitric oxide(NO),endothelin-1(ET-1),α-granular membrane protein-140(GMP-140)levels.Methods:A total of 100 patients with prolapsed internal hemorrhoids requiring conservative treatment were randomly assigned to a control group(n=50)and an observation group(n=50)using a number table.The control group was treated with Gangtai suppository,and the observation group received oral Baopi Gushe Decoction in addition to the control group.Quality of life(SF-36)scores,symptom and sign scores,NO,ET-1,GMP-140 levels,and adverse reactions were compared between the two groups.Results:The scores of symptoms and signs of blood in the stool,falling pain,prolapse,and hemorrhoid mucosa were significantly lower in both groups after treatment(P<0.05).The symptom and sign scores in the observation group were significantly lower than those in the control group(P<0.05).In the control group,NO was significantly higher than before treatment,ET-1 was significantly lower than before treatment(P<0.05),and GMP-140 was not statistically significant compared to before treatment(P>0.05).In the observation group,NO was significantly higher than before treatment,and ET-1 and GMP-140 were significantly lower than before treatment(P<0.05).The improvement in NO,ET-1,and GMP-140 in the observation group was greater than that in the control group(P<0.05).The SF-36 scores of physical function,physical pain,general health status,energy,social function,mental health,and emotional function were significantly higher in both groups after treatment(P<0.05),and the SF-36 score in the observation group was higher than that in the control group(P<0.05).There was no statistically significant difference in adverse reactions such as skin rash,gastrointestinal reactions,and anal discomfort between the two groups(P>0.05).Conclusion:The combination of Baopi Gushe Decoction and Gangtai suppository for the conservative treatment of internal hemorrhoid prolapse can effectively relieve symptoms and signs of hemorrhoids,falling pain,prolapse,and hemorrhoid mucosa and improve the quality of life of patients.This may be related to the regulation of related factors.