槐花消痔汤联合马应龙痔疮膏外敷治疗痔疮的疗效及对血清炎症因子、5-HT水平的影响

Clinical Efficacy of Using Huaihua Xiaozhi Decoction Combined with External Application of Mayinglong Hemorrhoid Ointment in the Treatment of Hemorrhoids and Its Effects on Levels of Serum Inflammatory Factors and 5-HT

目的:观察槐花消痔汤口服联合马应龙痔疮膏外敷治疗痔疮的疗效及对血清炎症因子、5-羟色胺(5-HT)水平的影响。方法:选取2016年12月~2018年12月于我院接受治疗的80例痔疮患者为受试对象,随机数字表法分为观察组与对照组各40例。对照组予以高锰酸钾溶液熏洗治疗,观察组在其基础上使用槐花消痔汤口服联合马应龙痔疮膏外敷治疗。比较两组患者短期(7d内)临床疗效,治疗前及治疗7d后的中医证候积分、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)]、疼痛相关因子[β-内啡肽(β-EP)、5-HT]水平变化,并记录两组治疗前、随访6个月后的生活质量[健康促进生活方式量表(HPLP-II)]变化及随访过程中的不良反应与复发情况。结果:经治疗,观察组总有效率为92.50%,对照组为75.00%,差异有统计学意义(P<0.05),且临床疗效各级别占比比较有统计学意义(P<0.05);治疗7d后,两组的中医证候积分(血随便下、便时肿物脱出、小便短赤、肛缘水肿、肛门瘙痒)、IL-6、TNF-α、CRP水平较治疗前均显著降低(P均<0.05),且观察组明显低于对照组(P均<0.05);治疗7d后,两组患者HPLP-II量表(精神成长、营养状态、社会关系、躯体运动、压力调节能力、自我实现)各维度评分较治疗前均有显著提升(P均<0.05),且观察组明显高于对照组(P<0.05);随访过程中,观察组复发率为5.00%,而对照组为22.50%,两组之间比较有统计学意义(χ^(2)=5.165,P<0.05)。结论:槐花消痔汤口服联合马应龙痔疮膏外敷治疗确可明显改善痔疮患者临床症状,提高临床疗效,且还可有效缓解肛门疼痛的同时降低炎性因子水平,有利于生活质量的提高。

Objective:To investigate the efficacy of using Huaihua Xiaozhi Decoction oral administration combined with external application of Mayinglong Hemorrhoid Ointment in the treatment of hemorrhoids and its influence on the levels of serum inflammatory factors and 5-hydroxytryptamine(5-HT).Methods:Eighty patients with hemorrhoids who were treated in our hospital from December 2016to December 2018were selected as subjects,and they were divided into observation group and controlled group according to the random number table method,with 40cases in each group.The controlled group was given Potassium Permanganate Solution for fumigation,and the observation group was additionally given oral administration of Huaihua Xiaozhi Decoction combined with external application of Mayinglong Hemorrhoid Ointment on the basis of the controlled group.The short-term(within 7d)clinical efficacy,and TCM syndromes scores,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor(TNF-α),C-reactive protein(CRP)]and pain-related factors[β-endorphin(β-EP),5-HT]before treatment and after 7d of treatment were compared between the two groups,and the quality of life[Health-Promoting Lifestyle Profile(HPLP-II)]before treatment and after 6months of follow-up and adverse reactions and recurrence during follow-up were recorded in the two groups.Results:After treatment,the total effective rate was 92.50%in the observation group and 75.00%in the controlled group(P<0.05),and there was a statistically significant difference in the proportion of clinical efficacy grading(P<0.05).After 7d of treatment,the scores of TCM syndromes(blood in stool,goiter prolapse at bowel movement,scanty dark urine,edema of anal edge,anal itching)and levels of IL-6,TNF-αand CRP in the two groups were significantly lower than those before treatment(all P<0.05),and the scores and levels in the observation group were significantly lower than those in the controlled group(all P<0.05).After 7d of treatment,the scores of dimensions(mental growth,nutritional status,social relations,physical exercise,pressure regulation ability,self-actualization)of HPLP-II scale in the two groups were significantly improved compared with those before treatment(all P<0.05),and the scores in the observation group were significantly higher than those in the controlled group(P<0.05).During follow-up,the recurrence rate was 5.00%in the observation group and was 22.50%in the controlled group(χ^(2)=5.165,P<0.05).Conclusion:Oral administration of Huaihua Xiaozhi Decoction combined with external application of Mayinglong Hemorrhoid Ointment can obviously improve the clinical symptoms and enhance the clinical efficacy of patients with hemorrhoids.It can also effectively relieve anal pain while reducing the levels of inflammatory factors,and it is conducive to improving the quality of life.