大黄联合黄柏治疗湿热蕴结型混合痔的临床效果

Clinical effects of rhubarb combined with phellodendron in treatment of mixed hemorrhoids caused by damp-heat accumulation

目的探讨大黄联合黄柏治疗湿热蕴结型混合痔的临床效果。方法选取2017年1月-2018年10月沈阳市某医院肛肠科诊治的100例混合痔术后患者为研究对象,采用随机数字表法将患者分为对照组和观察组,每组50例。对照组患者给予基础性治疗,进行手术伤口清创,消毒等治疗;观察组患者在对照组治疗基础上给予大黄联合黄柏消痔栓治疗,每次1支,每日2次肛塞。比较治疗前及治疗15d时2组患者的视觉疼痛评分量表(VAS)评分、中医证候积分、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果治疗前,2组患者VAS评分及IL-6,TNF-α水平比较,差异无统计学意义(P>0.05);治疗后,2组患者VAS评分及IL-6,TNF-α水平低于治疗前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者便血、肛门肿物垂出、疼痛、水肿、渗出等中医证候主症积分比较,差异无统计学意义(P>0.05);治疗后,2组患者中医主症积分低于治疗前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者肛门灼热、肛门瘙痒、大便干、小便短赤、烦躁、失眠等中医证候次症积分比较,差异无统计学意义(P>0.05);治疗后,2组患者中医次症积分低于治疗前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。结论大黄与黄柏消痔栓联合基础性治疗可有效减轻机体炎性反应,改善局部水肿,并缓解疼痛便血等症状。

Objective To explore the clinical effects of rhubarb combined with phellodendron in treating mixed hemorrhoids caused by damp-heat accumulation.Methods A total of 100 postoperative patients with mixed hemorrhoids diagnosed and treated in the anorectal department of a hospital in Shenyang from January 2017 to October 2018 were selected as the research subjects.The patients were divided into a control group and a treatment group using a random number table,with fifty patients in each group.Patients in the control group were given basic treatment for surgical wound debridement and disinfection.In addition to this,patients in the treatment group were treated with rhubarb combined with phellodendron suppositories;one per time,and twice a day.The visual analogue scale(VAS)scores,scores for TCM symptoms and levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were compared before treatment and at day 15.Results Before treatment,there was no significant difference in VAS scores and IL-6,TNF-αlevels between the two groups(P>0.05).After treatment,the VAS scores and IL-6,TNF-αlevels in the two groups were lowered,and those in the treatment group were significantly lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the scores for primary TCM symptoms bloody stool,anal protrusion,pain,edema,and exudation between the two groups(P>0.05).After treatment,the scores for primary TCM symptoms in the two groups were lowered(P<0.05),and those in the treatment group were significantly lower than those in the control group.Before treatment,there was no significant difference in the scores for secondary TCM symptoms anal burning,itching,dry stool,short urination,irritability,and insomnia between the two groups(P>0.05).After treatment,the scores for secondary TCM symptoms in the two groups were lowered,and those in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Accompanying basic treatment with rhubarb combined with phellodendron suppositories can effectively reduce the body′s inflammatory response,improve local edema,and relieve pain,bloody stool,and other symptoms.