促愈汤对环状混合痔术后新生血管、创面愈合的影响

Effect of Cuyu Decoction on Neovascularization and Wound Healing After Circumferential Mixed Hemorrhoids Operation

目的观察促愈汤对环状混合痔术后新生血管、创面愈合的影响。方法选取56例环状混合痔患者进行前瞻性研究,按随机数字表分为观察组与对照组,每组28例。两组均行混合痔外剥内扎术,对照组术后予九华膏局部涂抹联合痔炎冲洗灵坐浴治疗,观察组在对照组基础上加用促愈汤进行治疗,两组均治疗2周。比较两组创面愈合总有效率、术后当天与治疗2周的创面疼痛评分、创面出血评分、创面渗液评分、血清血管内皮生长因子(vascular endothelial growth factor, VEGF)、血小板源性生长因子(platelet-derived growth factor, PDGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor, bFGF)水平。结果观察组治疗总有效率为92.86%,显著高于对照组71.43%(P<0.05)。治疗2周后,两组创面疼痛、创面出血、创面渗液评分较术后当天均显著降低(P<0.05),且观察组显著低于对照组(P<0.01);两组血清VEGF、PDGF、bFGF水平较术后当天均显著升高(P<0.05),且观察组显著高于对照组(P<0.01)。结论促愈汤治疗环状混合痔术后患者有助于改善血液循环、促进新生血管形成与上皮组织增生,促进创面愈合,治疗效果理想。

Objective To observe the effect of Cuyu Decoction on neovascularization and wound healing after circumferential mixed hemorrhoids operation.Methods A total of 56 patients with circumferential mixed hemorrhoids were enrolled in the prospective study.The patients were divided into observation group and control group according to a random number table,with 28 cases in each group.Both groups underwent Milligan-Morgan hemorrhoidectomy.The control group was treated with local application of Jiuhua Plaster combined with a sitz bath with Zhiyan Chongxiling after the operation,and the observation group was treated with Cuyu Decoction in addition to the treatment for the control group.Both groups were treated for 2 weeks.The two groups were compared in terms of the overall response rate for wound healing,as well as wound pain score,wound bleeding score,wound exudate score,and serum levels of vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF),and basic fibroblast growth factor(bFGF)on the day after operation and after 2 weeks of treatment.Results The overall response rate of the observation group was significantly higher than that of the control group(92.86%vs 71.43%,P<0.05).After 2 weeks of treatment,the wound pain,wound bleeding,and wound exudate scores decreased significantly compared with those on the day after operation in both groups(P<0.05),and they were significantly lower in the observation group than in the control group(P<0.01);the serum levels of VEGF,PDGF,and bFGF increased significantly compared with those on the day after operation in both groups(P<0.05),and they were significantly higher in the observation group than in the control group(P<0.01).Conclusion Cuyu Decoction shows a favorable effect in the treatment of patients who have undergone a circumferential mixed hemorrhoids operation since it helps improve blood circulation,promote angiogenesis and epithelial proliferation,and facilitate wound healing.