麻杏石甘汤联合消肿膏对混合痔术后肛门红肿程度、血清肿瘤 坏死因子α水平及不良反应影响

Effect of Maxing Shigan decoction and Xiaozhong ointment on anal swelling degree,serum TNF-αlevel and adverse reactions in patients with mixed hemorrhoids after operation

目的探究麻杏石甘汤联合消肿膏对混合痔病人术后肛门红肿程度、血清TNF-α水平及不良反应的影响。方法选取2013年5月至2014年7月来西安市中医医院接受治疗的混合痔术后病人64例。按随机数字表法将其分为对照组32例和试验组32例。两组病人均采用相同手术方式进行治疗。对照组采用消肿膏治疗,每日早晚换药,2次/日,持续治疗30 d;试验组在对照组基础上内服麻杏石甘汤治疗,水煎服,1剂/日,每剂300 mL,分早晚2次服用,一个疗程7 d,持续治疗4个疗程。记录两组混合痔术后病人中医证候积分、肛门水肿程度、疼痛程度、坠胀程度、创面出血及不良反应情况;采用酶联免疫吸附测定(ELISA)测定血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平。结果治疗后,对照组和试验组混合痔术后病人的临床总有效率分别为84.38%和96.88%,试验组高于对照组(P<0.05)。治疗前,两组混合痔术后病人中医证候积分、肛门水肿程度、疼痛程度、坠胀程度、创面出血比较差异无统计学意义(P>0.05)。治疗后,对照组和试验组混合痔术后病人肛门水肿程度、疼痛程度、坠胀程度、创面出血、TNF-α、IL-6水平均低于治疗前,试验组低于对照组(P<0.05)。治疗后,对照组和试验组混合痔术后病人的不良反应总发生率分别为28.13%和9.38%,试验组低于对照组(P<0.05)。结论麻杏石甘汤联合消肿膏有效改善混合痔病人术后肛门红肿程度,调节血清TNF-α水平,抑制炎性反应发生,降低不良反应发生率,具有一定推广价值。

Objective To explore the effect of Maxing Shigan decoction combined with Xiaozhong ointment on the degree of anal redness and swelling,serum TNF-αlevel and adverse reactions in patients with mixed hemorrhoids after operation.Methods A total of 64 patients with mixed hemorrhoids treated in Xi'an Traditional Chinese Medicine Hospital from May 2013 to July 2014 were select⁃ed,and were randomly divided into control group(32 cases)and experimental group(32 cases)according to the method of random num⁃ber table.Both groups were treated with the same operation.The control group was treated with Xiaozhong ointment,with dressing changed in the morning and evening,twice a day,for 30 days.On the basis of the control group,the experimental group was treated with Maxing Shigan decoction,1 dose per day,300 mL,per dose twice in the morning and evening,a course of 7 d,lasting for 4 cours⁃es.The scores of TCM syndromes,anal edema,pain,swelling,wound hemorrhage and adverse reactions were recorded in two groups af⁃ter operation of mixed hemorrhoids,and the levels of serum TNF-αand IL-6 were measured by ELISA.Results After treatment,the total effective rates of the patients in the control group and the experimental group after mixed hemorrhoids operation were 84.38%and 96.88%,respectively,and that of the experimental group was higher than that of the control group(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores,anal edema,pain,swelling and wound bleeding between the two groups(P>0.05).After treatment,the levels of anal edema,pain,swelling,wound hemorrhage,TNF-αand IL-6 in the control group and the experi⁃mental group were lower than those before treatment,while those in the experimental group were lower than those in the control group(P<0.05).After treatment,the total incidence of adverse reactions in the control group and the experimental group were 28.13%and 9.38%respectively,and the experimental group was lower than the control group(P<0.05).Conclusion Maxing Shigan decoction combined with Xiaozhong ointment can effectively improve the degree of anal redness and swelling,regulate the level of serum TNF-α,inhibit the occurrence of inflammatory reaction and reduce the incidence of adverse reactions in patients with mixed hemorrhoids after operation,which has certain popularization value.