益气提升方联合选择性痔上黏膜切除钉合术治疗Ⅲ度脱垂性内痔的临床疗效

Clinical Efficacy of Qi-Boosting and Anus-Lifting Prescription Combined with Tissue-Selecting Therapy Stapler in the Treatment of Third Degree Prolapsed Internal Hemorrhoids

目的:观察益气提升方联合选择性痔上黏膜切除钉合术(tissue-selecting therapy stapler,TST)治疗Ⅲ度脱垂性内痔的临床疗效及对患者外周血Th1/Th2的影响。方法:选取2015年5月至2017年8月本院收治的Ⅲ度脱垂性内痔患者80例为研究对象,均符合Ⅲ度脱垂性内痔诊断标准,随机分为观察组与对照组,每组40例。两组患者均行TST手术治疗,对照组术后给予草木犀流浸液片口服治疗,观察组术后给予益气提升方治疗,观察两组患者临床疗效、疼痛VAS评分,采用酶联免疫吸附法检测2组患者Th1细胞因子(IL-2、IFN-γ)、Th2细胞因子(IL-4、IL-10)水平。结果:观察组有效率97.50%,对照组有效率92.50%,两组有效率比较,差异无统计学意义(P>0.05);两组患者术后第5天及术后第7天VAS评分均低于术后第1天,且观察组VAS评分低于对照组,差异有统计学意义(P<0.05);观察组术后第7天IL-2、IFN-γ水平高于对照组,差异有统计学意义(P<0.05);两组患者IL-4、IL-10水平比较,无统计学差异(P>0.05)。结论:益气提升方联合TST治疗Ⅲ度脱垂性内痔效果确切,可减轻患者术后疼痛,能够提高Th1细胞因子水平,平衡体内Th1/Th2。

Objective: To observe the clinical efficacy of Qi-Boosting and Anus-Lifting Prescription combined with tissue-selecting therapy stapler ( TST) in the treatment of third degree prolapsed internal hemorrhoids and its influence on Th1 /Th2 in peripheral blood of patients. Methods: Eighty patients with prolapsed internal hemorrhoids of degree III admitted to our hospital from May 2015 to August 2017 were selected as the research objects. They all met the diagnostic criteria of prolapsed internal hemorrhoids of degree III,and were randomly divided into the observation group and the control group,with 40 cases in each group. All the patients in the two groups were treated with TST. The ones in the control group were additionally treated with herbaceous rhinoceros infusion tablets for oral administration after operation. The ones in the observation group were additionally treated with Qi- Boosting and Anus-Lifting Prescription. The clinical efficacy and pain VAS scores of the two groups were observed. The levels of Th1 cytokines ( IL-2,IFN-γ),Th2 cytokines ( IL-4,IL-10) in the two groups were detected by enzyme-linked immunosorbent assay. Results: The effective rate of observation group was 97. 50%,and that of control group was 92. 50%. There was no significant difference between the two groups ( P > 0. 05). The VAS scores of the two groups on the 5th day and 7th day after operation were lower than those on the 1st day after operation,and the VAS scores of observation group were lower than those of control group,and all the differences were statistically significant ( P < 0. 05). The levels of IL-2 and IFN-γof the observation group on the 7th day after operation were higher than those of the control group,. and all the differences were statistically significant ( P < 0. 05). However,there was no significant difference in the levels of IL-4 and IL-10 between the two groups ( P > 0. 05). Conclusion: Qi-Boosting and Anus-Lifting Prescription combined with TST has a remarkable efficacy on third degree prolapsed internal hemorrhoids,can alleviate postoperative pain,increase Th1 cytokine level and balance Th1 /Th2 in vivo.