参茋槐榆汤治疗痔疮患者的临床疗效及对中医证候的影响

Effects of Yiqi Anxue Decoction on Hemorrhoids and the Influence of Traditional Chinese Medicine Syndrome of Patients with Hemorrhoids

目的探讨参茋槐榆汤治疗痔疮患者的临床疗效及对中医证候的影响。方法选取2018年7月至2019年6月湖南中医药大学第一附属医院收治的96例痔疮患者作为研究对象,按照随机数字表法分为观察组(n=50)和对照组(n=46)。观察组患者采用参茋槐榆汤治疗,对照组患者采用槐榆丸治疗。比较两组临床疗效、中医证候评分、5-羟色胺(5-HT)、β-内源性阿片肽(β-EP)、免疫功能、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)及不良反应。结果观察组治疗有效率为94.00%,显著高于对照组的67.39%,差异有统计学意义(P<0.05)。治疗后观察组各项临床症状评分显著低于对照组[(1.58±0.38)分比(2.01±0.49)分,(1.58±0.67)分比(1.92±0.70)分,(1.53±0.50)分比(1.80±0.71)分,(1.60±0.52)分比(2.01±0.56)分,(1.49±0.22)分比(0.73±0.30)分,(1.57±0.36)分比(2.06±0.41)分](P<0.05)。治疗后观察组5-HT、β-EP水平显著低于对照组[(159.23±10.72)ng/L比(178.34±15.58)ng/L,(60.67±7.58)ng/L比(73.50±9.03)ng/L](P<0.05)。治疗后观察组肠道内免疫球蛋白A(IgA)、分泌型免疫球蛋白A(SIgA)、免疫球蛋白M(IgM)显著高于对照组[(2.30±0.42)g/L比(1.45±0.31)g/L,(16.03±3.27)g/L比(10.72±2.01)g/L,(1.36±0.20)g/L比(0.89±0.18)g/L](P<0.05)。治疗后观察组IL-6、IL-1、TNF-α水平显著低于对照组[(9.23±1.72)ng/L比(17.34±2.58)ng/L,(4.67±0.58)ng/L比(9.26±1.37)ng/L,(1.49±0.32)ng/L比(3.45±0.78)ng/L](P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论参茋槐榆汤治疗痔疮临床效果显著,可显著改善患者的临床症状,止血止痛,促进血液循环,抑制炎症介质释放,增强免疫功能,安全可靠。

Objective To explore the clinical observation of Yiqi Anxue Decoction on hemorrhoids and the influence of TCM Syndrome.Methods A total of 96 patients with hemorrhoids admitted to First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from July 2018 to June 2019 were selected as research objects.According to random number tabble,they were divided into an observation group(n=50)and a control group(n=46).The patients in the observation group were treated with Yiqi Anxue Decoction.The patients in the control group were treated with Fujiao Pills.The therapeutic effect,clinical symptom score,levels of 5-hydroxytryptamine(5-HT),β-endogenous opioid peptide(β-EP),immune function,levels of Interleukin-6(IL-6),Interleukin-1(IL-1),tumor necrosis factor(TNF-α)and adverse reactions were compared between the 2 groups.Results The effective rate of treatment in the observation group was 94.00%,which was significantly higher than 67.39%in the control group,and the difference was statistically significant(P<0.05).After treatment,the clinical symptom scores of the observation group were significantly lower than those of the control group[(1.58±0.38)points(2.01±0.49)points,(1.58±0.67)points(1.92±0.70)points,(1.53±0.50)points(1.80±0.71)points,(1.60±0.52)points(2.01±0.56)points,(1.49±0.22)points(0.73±0.30)points,(1.57±0.36)points(2.06±0.41)points](P<0.05).After treatment,the 5-HT andβ-EP levels of the observation group were significantly lower than those of the control group[(159.23±10.72)ng/L ratio(178.34±15.58)ng/L,(60.67±7.58)ng/L ratio(73.50±9.03)ng/L](P<0.05).After treatment,the intestinal immunoglobulin A(IgA),secretory immunoglobulin A(SIgA),and immunoglobulin M(IgM)in the observation group were significantly higher than those in the control group[(2.30±0.42)g/L ratio(1.45±0.31)G/L,(16.03±3.27)g/L ratio(10.72±2.01)g/L,(1.36±0.20)g/L ratio(0.89±0.18)g/L](P<0.05).After treatment,the levels of IL-6,IL-1 and TNF-αin the observation group were significantly lower than those in the control group[(9.23±1.72)ng/L ratio(17.34±2.58)ng/L,(4.67±0.58)ng/L ratio(9.26±1.37)ng/L,(1.49±0.32)ng/L ratio(3.45±0.78)ng/L](P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Yiqi Anxue Decoction has a significant clinical effect on hemorrhoids,which can significantly improve the clinical symptoms of patients,stop bleeding and relieve pain,promote blood circulation,inhibit the release of inflammatory media,enhance immune function.It is safe and reliable.