消痔汤治疗混合痔术后便血机制研究

Mechanism of Action of Xiaozhi Decoction in Treatment of Postoperative Hematochezia in Mixed Hemorrhoids

目的观察消痔汤治疗混合痔术后便血的临床疗效,并初步探讨其作用机制。方法将60例混合痔术后便血患者随机分为治疗组和对照组各30例,术后第1天起,治疗组口服消痔汤,对照组口服迈之灵,疗程均为7d。观察患者创面止血疗效,比较两组患者凝血功能(凝血酶原时间、凝血酶时间、活化部分凝血活酶时间和纤维蛋白原含量)及血浆血栓素B2(thromboxane B2,TXB2)和6-酮-前列腺素F1α(6-keto-prostaglandin F1α)的含量。结果治疗组在改善创面出血方面优于对照组(P<0.05);与治疗前比较,两组治疗后凝血功能均无明显变化(P>0.05);与术前1天比较,术后第7天治疗组TXB2含量显著升高(P<0.05),6-keto-PGF1α含量显著降低(P<0.05);而对照组TXB2和6-keto-PGF1α含量较术前1天均无显著变化(P>0.05)。结论消痔汤口服能有效改善混合痔术后便血情况,其作用机制可能与调节TXB2和6-keto-PGF1α的含量有关。

Objective To observe the clinical effect of Xiaozhi Decoction in the treatment of postoperative hematochezia in mixed hemorrhoids and to preliminarily investigate its mechanism of action. Methods A total of 60 mixed hemorrhoids patients with postoperative hematochezia were randomly divided into treatment group and control group, with 30 patients in each group. Since the first day after surgery, the patients in the treatment group were given oral Xiaozhi Decoction, and those in the control group were given oral Aescuven forte; the course of treatment was 7 days for both groups. The therapeutic effect of wound hemostasis was observed, and coagulation function （prothrombin time, thrombin time, activated partial thromboplastin time, and the content of fibrinogen） and the plasma levels of thromboxane B2 （TXB2） and 6-keto-prostaglandin F1 alpha （6-keto-PGF1α） were compared between the two groups. Results The treatment group had a significantly better improvement in wound bleeding compared with the control group （P〈0.05）; The two groups showed no significant changes in coagulation function before and after treatment （P〉0.05）. On the 7th day after surgery, the treatment group had a significantly increased level of TXB2 and a significantly reduced level of 6-keto-PGF1α （both P〈0.05）; the control group showed no significant changes in the levels of TXB2 or 6-keto-PGF1α （both P〉0.05）. Conclusion Oral administration of Xiaozhi Decoction can effectively relieve postoperative bleeding in patients with mixed hemorrhoids, and the mechanism of action of Xiaozhi Decoction may be related to the regulation of the levels of TXB2 and 6-keto-PGF1α.