解毒生肌汤雾化熏洗与麻仁软胶囊联用治疗混合痔术后疼痛水肿临床研究

Clinical study on the treatment of postoperative pain and edema caused by mixed hemorrhoids by atomization fumigation and washing of Jiedu-Shengji Decoction combined with Maren soft capsule

目的评价解毒生肌汤雾化熏洗与麻仁软胶囊联用治疗混合痔术后疼痛水肿的临床疗效。方法将符合入选标准的2017年1月-2019年1月安徽省庐江县人民医院110例环状混合痔患者按随机数字表法分为2组,每组55例。2组均行混合痔外剥内扎术,对照组于术后给予麻仁软胶囊治疗,研究组在对照组基础上联用解毒生肌汤雾化熏洗。2组均连续治疗14 d。采用VAS量表评价肛门疼痛程度,观察肛门水肿情况并进行评分;采用ELISA法检测血清VEGF、碱性成纤维生长因子(basic fibroblast growth factor,bFGF)及血小板源性生长因子(platelet-derived growth factor,PDGF)水平;观察并记录术后14 d并发症发生情况,评价临床疗效。结果研究组总有效率为92.7%(51/55)、对照组为74.6%(41/55),2组比较差异有统计学意义(χ2=6.643,P<0.01)。研究组VAS评分、肛门水肿评分术后7 d(t值分别为9.144、8.541)、14 d(t值分别为13.720、12.819)均低于对照组(P<0.01);研究组VEGF、bFGF、PDGF水平术后7 d(t值分别为7.491、2.972、5.170)、14 d(t值分别为6.117、3.031、4.599)均高于对照组(P<0.01)。研究组术后并发症发生率为7.3%(4/55),对照组为3.6%(2/55),2组比较差异无统计学意义(χ2=0.705,P=0.401)。结论解毒生肌汤雾化熏洗联合麻仁软胶囊可明显改善混合痔术后疼痛水肿患者的临床症状,加速新生血管形成,促进创面愈合,减少并发症。

Objective To evaluate the clinical effect of Jiedu-Shengji Decoction combined with Maren soft capsule in the treatment of postoperative pain and edema of mixed hemorrhoids.Methods 110 patients with circular mixed hemorrhoids in the People's Hospitalof Lujiang County from January 2017 to January 2019 who met the inclusion criteria were divided into two groups according to the random number table method,with 55 patients in each group.Both groups were treated with external dissection and internal ligation operation of mixed hemorrhoids.The control group was treated with Maren soft capsule after the operation.The study group was treated with atomization fumigation and washing of Jiedu-Shengji Decoction on the basis of the control group.Both groups were treated for 14 days.VAS was used to evaluate the degree of anal pain.The anal edema was observed and graded.Serum levels of VEGF,basic fibroblast growth factor(bFGF)and platelet-derived growth factor(PDGF)were measured by ELISA.14 days after the operation,to observe and evaluate the complications,the clinical effect was evaluated.Results The total effective rate of the study group was 92.7%(51/55),and that of the control group was 74.6%(41/55),the difference was statistically significant(χ2=6.643,P<0.01).The VAS score and anal edema score of the study group on the 7 d(t values were 9.144 and 8.541,respectively,all Ps<0.01)and 14 d(t values were 13.720 and 12.819,respectively,all Ps<0.01)after operation were significantly lower than those of the control group.The level of VEGF,bFGF and PDGF in the study group on the 7 d(t values were 7.491,2.972 and 5.170,respectively,all Ps<0.01)and 14 d(t values were 6.117,3.031 and 4.599,respectively,all Ps<0.01)after operation were significantly higher than those in the control group.The incidence of postoperative complications was 7.3%(4/55)in the study group and 3.6%(2/55)in the control group,there was no significant difference between the two groups(χ2=0.705,P=0.401).Conclusions The clinical effect of atomization fumigation and washing of Jiedu-Shengji Decoction combined with Maren soft capsule in the treatment of postoperative pain and edema of mixed hemorrhoids is significant,which can significantly improve symptoms,accelerate the formation of new blood vessels,promote wound healing,and have fewer complications.