中药熏治联合高压氧对老年患者肛肠术后动力学及炎性反应递质的影响

Effects of Chinese Medicine Fumigation Combined with Hyperbaric Oxygenation on the Anorectal Dynamics and Inflammatory Cytokine of Elderly Patients after Anorectal Operation

目的:探讨中药熏治联合高压氧对老年患者肛肠术后动力学及炎性反应递质的影响。方法:选取2015年6月至2017年4月在济源市肿瘤医院行肛肠手术的老年患者132例,随机分为观察组与对照组,每组66例。对照组术后采用常规药物治疗,观察组在对照组的基础上采用中药熏治联合高压氧治疗,2组均连续治疗15 d。比较2组临床疗效、创面愈合状况及疼痛状况;统计2组治疗前后肛肠动力学指标及炎性反应递质水平。结果:治疗后观察组与对照组总有效率为分别为95.45%、84.85%,观察组显著高于对照组(P<0.05);观察组创面愈合时间、水肿消失时间及渗出物消失时间均明显短于对照组(P<0.05);与治疗前比较,治疗后2组疼痛数字评价量表(NRS)评分显著下降,且观察组明显低于对照组(P<0.05);与治疗前比较,治疗后2组直肠肛管抑制反射阈值(AIRT)、直肠静息压(RRP)水平均显著降低,但直肠最大耐受容量(MTV)、肛管蠕动波频率(APWF)、高压区长度(HPZ)、肛管最大收缩压(MSP)及肛管静息压(ARP)水平显著升高,且2组差异有统计学意义(P<0.05);与治疗前比较,治疗后2组血清中白细胞介素-6、-8(IL-6、IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及淀粉样蛋白(SAA)水平显著降低,且观察组明显低于对照组(P<0.05)。结论:中药熏治联合高压氧可明显改善老年患者肛肠术后动力学,降低炎性反应递质水平,促进创面愈合并缓解患者疼痛,临床疗效显著。

Objective： To explore the effects of Chinese medicine fumigation combined with hyperbaric oxygenation on the anorectal dynamics and inflammatory cytokine of elderly patients after anorectal operation. Methods： A total of 132 cases of elderly patients treated with anorectal operation from Jun 2015 to Apr 2017 in Jiyuan Cancer Hospital were selected and divided randomly into observation group and control group,with 66 cases in each group. Control group were treated with routine medicine,and observation group were treated with Chinese medicine fumigation combined with hyperbaric oxygenation on the basis of control group. Both groups were treated for 15 days continuously. The clinical efficacy,wound healing condition and pain condition of 2 groups were compared; Statistical analysis of the anorectal dynamics and inflammatory cytokine of 2 groups before and after treatment was performed. Results： The total effective rates of observation group and control group were respectively 95. 45%,84. 85% after treatment,and observation group was obviously higher than control group（ P 〈0. 05）. The times of wound healing,edema disappearing and exudate disappearing in observation group were obviously shorter than control group after treatment（ P 〈0. 01）. Compared with before treatment,the numeric rating scales（ NRS） scores of 2 groups decreased obviously after treatment,and observation group were obviously lower than control group（ P 〈0. 01）. Compared with before treatment,the levels of AIRT,RRP of 2 groups decreased obviously after treatment,but the levels of MTV,HPZ,APWF,MSP and ARP of 2 groups increased obviously after treatment. There was significant difference between 2 groups（ P 〈0. 05 or P 〈0. 01）. Compared with before treatment,the levels of serum IL-6,IL-8,TNF-α,CRP and SAA of 2 groups decreased obviously after treatment,and observation group was obviously lower than control group（ P 〈0. 01）. Conclusion： Chinese medicine fumigation combined with hyperbaric oxygenation can improve evidently the anorectal dynamics of elderly patients after anorectal operation,and reduce the level of inflammatory cytokine,promote the wound heal and relief the pain. The clinical efficacy is remarkable.