美辛唑酮栓联合中药对肛乳头肥大患者中医证候积分及炎性因子的影响

Observation on Curative Effect of Mexinzodone Suppository Combined with Chinese Medicine Oral and External Washing in Patients with Anal Papilla Hypertrophy and Its Influence on TCM Syndrome Score

目的:探讨美辛唑酮栓联合中药内服外洗在肛乳头肥大患者中的疗效观察及对中医证候积分及炎性因子的影响。方法:选择2018年4月—2020年1月我院收治的肛乳头肥大患者124例为对象,随机数字表法分为两组,各62例。所有患者均拟行手术治疗,术后对照组采用美辛唑酮栓治疗,观察组在对照组基础上联合中药内服外洗治疗,1个月治疗后对患者效果进行评估并完成6个月随访,比较两组中医证候积分、炎性因子水平、不良反应发生率及复发率。结果:观察组治疗后1个月水肿(0.81±0.15)分、疼痛(0.94±0.18)分、肉芽形态(0.74±0.12)分、创面渗液(0.91±0.17)分、肛门下坠评分(0.71±0.11)分均低于对照组(t=8.012、6.396、7.889、6.846、6.921,P<0.001);观察组治疗后4周炎性因子IL-1(6.27±0.22)、IL-6(22.14±2.17)、TNF-α(13.25±1.09)及CRP水平(1.12±0.16)均低于对照组(t=8.112、7.295、9.341、7.934,P<0.001);两组治疗过程中恶心呕吐、血压波动及肝肾异常发生率分别为3.23%和4.84%,差异无统计意义(χ^(2)=0.208,P=0.648);两组疗程后1、3个月复发率差异无统计意义(χ^(2)=1.008、0.342,P=0.315、0.559);观察组疗程后6个月复发率低于对照组(χ^(2)=3.916,P=0.048)。结论:美辛唑酮栓联合中药内服外洗治疗肛乳头肥大患者能降低中医证候积分,能改善炎性因子水平,且未增加不良反应发生率,有助于降低复发率。

Objective To investigate the curative effect of mexinzodone suppository combined with traditional Chinese medicine oral and external washing in patients with anal papilla hypertrophy and its influence on TCM syndrome score.Methods 124 patients with anal papilla hypertrophy from April 2018 to January 2020 were randomly divided into two groups,62 cases in each group.All patients were planned to undergo surgical treatment.The control group was treated with methimazole suppository,while the observation group was treated with oral and external washing of traditional Chinese medicine on the basis of the control group.After one month of treatment,the effect of the patients was evaluated and 6-month follow-up was completed.TCM syndrome score,inflammatory factor level,anorectal motility level,incidence of adverse reactions and recurrence rate were compared between the two groups.Results One month after treatment,edema(0.81±0.15),pain(0.94±0.18),granulation morphology(0.74±0.12),wound exudate(0.91±0.17)and anal drop score(0.71±0.11)in the observation group were lower than those in the control group(t=8.012,6.396,7.889,6.846,6.921,all P<0.001).The IL-1(6.27±0.22)and IL-6(22.14±2.17)in the observation group after 4 weeks of treatment,the levels of TNF-α(13.25±1.09)and CRP(1.12±0.16)in the control group were lower than those in the control group(t=8.112,7.295,9.341,7.934,P<0.001).The incidence of nausea and vomiting,blood pressure fluctuation and abnormal liver and kidney in the two groups were 3.23%and 4.84%respectively,with no statistical significance(χ^(2)=0.208,P=0.648).The recurrence rates at 1 and 3 months after treatment in the two groups were not statistically significant(χ^(2)=1.008,0.342,P=0.315,0.559).The recurrence rate in the observation group was lower than that in the control group 6 months after treatment(χ^(2)=3.916,P=0.048).Conclusion It can reduce the TCM syndrome score,improve the level of inflammatory factors,improve the level of anorectal motility in patients with anal papilla hypertrophy,without increasing the incidence of adverse reactions,which is helpful to reduce the recurrence rate.