苦参汤坐浴联合复方盐酸利多卡因注射液局部注射治疗急性肛裂临床观察

Clinical observation of sophora flavescentis decoction sitz bath combined with compound lidocaine hydrochloride local injection on acute anal fissure

目的观察苦参汤坐浴联合复方盐酸利多卡因注射液局部注射治疗急性肛裂的临床疗效。方法将124例急性肛裂患者按照随机数字表法分为2组。2组均予基础治疗。对照组62例加用复方盐酸利多卡因注射液局部注射治疗;治疗组62例在对照组治疗基础上加用苦参汤坐浴。2组均治疗1周。比较2组临床疗效,比较2组症状缓解时间,观察2组治疗前后中医证候积分及疼痛视觉模拟评分法(VAS)评分变化,观察2组治疗前后创面愈合情况,检测治疗前后炎症因子水平。结果治疗组总有效率93.55%,对照组总有效率80.65%,治疗组临床疗效优于对照组(P<0.05)。治疗组疼痛缓解时间、肛裂愈合时间、便秘缓解时间及出血消失时间均较对照组提前(P<0.05)。2组治疗后中医证候积分及疼痛VAS评分均较本组治疗前降低(P<0.05),治疗后治疗组中医证候积分及疼痛VAS评分低于对照组(P<0.05)。2组治疗后创面宽度评分、创面渗液评分及创面肉芽评分均较本组治疗前降低(P<0.05),治疗后治疗组创面宽度评分、创面渗液评分及创面肉芽评分均低于对照组(P<0.05)。2组治疗后肿瘤坏死因子α(TNF-α)、前列腺素E2(PGE2)及白细胞介素6(IL-6)水平均较本组治疗前降低(P<0.05),治疗后治疗组TNF-α、PGE2及IL-6水平均低于对照组(P<0.05)。结论苦参汤坐浴联合复方盐酸利多卡因注射液局部注射可有效减轻急性肛裂患者疼痛程度,促进创面愈合,提高疗效。

Objective To observe the clinical effects of sophora flavescentis decoction sitz bath combined with compound lidocaine hydrochloride local injection on acute anal fissure.Methods 124 patients with acute anal fissure were randomly divided into two groups according to the random number table method.Both groups received basic treatment.62 cases in control group were treated by local injection of compound lidocaine hydrochloride injection.62 cases in treatment group were treated by sophora flavescentis decoction sitz bath on the basis of the control group.Both groups were treated for 1 week.The clinical efficacy and the time of symptom remission were compared between the two groups.The TCM syndrome scores,pain visual analogue scale(VAS)scores,wound healing and the levels of inflammatory factors were observed before and after treatment in the two groups.Results The total effective rate was 93.55%in treatment group and 80.65%in control group.The clinical efficacy of the treatment group was better than that of the control group(P<0.05).The pain relief time,anal fissure healing time,constipation remission time and bleeding disappearance time were all significantly advanced in treatment group compared with control group(P<0.05).The TCM syndrome scores and VAS scores of the two groups after treatment were lower than those before treatment(P<0.05).The TCM syndrome scores and VAS scores of the treatment group after treatment were lower than those of the control group(P<0.05).The wound width score,wound exudate score,and granulation score of wounds after treatment in both groups were lower than those before treatment(P<0.05).After treatment,the wound width score,wound exudate score,and wound granulation score of the treatment group were lower than those of the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),prostaglandin E 2(PGE 2),and interleukin-6(IL-6)after treatment in the two groups were lower than before treatment in the two groups(P<0.05).After treatment,the levels of TNF-α,PGE 2 and IL-6 were lower than those of the control group(P<0.05).Conclusion Sophora flavescentis decoction sitz bath combined with compound lidocaine hydrochloride local injection can effectively relieve pain in patients with acute anal fissure,promote wound healing and improve curative effect.