黄连膏外敷联合止痛如神汤内服对中青年痔疮患者术后疼痛水肿、创面愈合及炎症指标的影响

Effect of external application of Huanglian ointment combined with oral Zhitong Rushen Decoction on postoperative pain,edema,wound healing and inflammation indexes of middle-aged and young patients with hemorrhoids

目的观察黄连膏外敷结合止痛如神汤内服对中青年痔疮患者术后疼痛水肿、创面愈合及炎症指标的影响。方法选取2019年1—11月于南充市中心医院行手术治疗的中青年痔疮患者,按照随机数字表法分为2组。对照组97例术后给予黄连膏外敷治疗,直至创面完全愈合;联合组98例术后黄连膏外敷方法同对照组,同时给予止痛如神汤内服3周。比较2组术后1 d、7 d、3周创面疼痛、水肿、渗液、创面范围、肉芽组织现象评分,检测治疗前及治疗3周后血清白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、血管内皮生长因子(VEGF)、纤维连接蛋白(FN)水平,统计2组术后疼痛持续时间、创面恢复时间、住院时间及治疗3周后疗效。结果2组术后7 d创面疼痛、水肿、渗液、创面范围及肉芽组织现象评分均明显低于术后1 d(P均<0.05),术后3周明显低于术后7 d(P均<0.05),且联合组术后7 d、术后3周上述各项评分均明显低于同期对照组(P均<0.05)。治疗3周后,2组血清IL-6、TNF-α水平均明显降低(P均<0.05),VEGF、FN水平均明显升高(P均<0.05);治疗后联合组IL-6、TNF-α水平均明显低于对照组(P<0.05),VEGF、FN水平均明显高于对照组(P<0.05)。联合组术后疼痛持续时间、创面愈合时间、住院时间均显著短于对照组(P均<0.05)。治疗3周后,观察组总有效率为96.94%(95/98),明显高于对照组的87.63%(85/97)(P<0.05)。结论黄连膏外敷结合止痛如神汤内服可有效减轻中青年痔疮患者术后疼痛水肿,加快术后创面愈合,其作用机制可能与减轻机体炎症反应有关。

Objective It is to observe the effects of external application of Huanglian ointment combined with internal use of Zhitong Rushen Decoction on postoperative pain,edema,wound healing and inflammation indicators in young and middle-aged patients with hemorrhoids.Methods The young and middle-aged patients with hemorrhoids who underwent surgical treatment in Nanchong Central Hospital from January to November 2019 were divided into 2 groups according to the random number table method.The 97 cases in the control group were treated with external application of Huanglian Ointment after the operation until the wounds were completely healed;the 98 cases in the combined group were treated with external application of Huanglian ointment after the operation in the same way as the control group,and were treated with Zhitong Rushen Decoction for 3 weeks at the same time.The scores of wound pain,edema,exudation,wound area,and granulation tissue at 1d,7d,and 3 weeks after surgery were compared between the two groups,and the levels of serum IL-6 and TNF-α,vascular endothelial growth factor(VEGF),fibronectin(FN)were detected before treatment and 3 weeks after treatment in the two groups,the duration of postoperative pain,wound recovery time,hospital stay were recorded and their curative effect after 3 weeks of treatment were assessed in the two groups.Results The scores of wound pain,edema,exudation,wound area and granulation tissue in 7 days after operation were significantly lower than those in 1 day after operation in the two groups(all P<0.05),and the indexes in 3 weeks after operation were significantly lower than those in 7 days after operation(all P<0.05),and the above scores of the combined group were significantly lower than those of the control group at the same time(P<0.05).After 3 weeks of treatment,the levels of serum IL-6 and TNF-αin the two groups were significantly reduced(both P<0.05),and the levels of VEGF and FN were significantly increased(both P<0.05);the levels of IL-6 and TNF-αin the combined group were significantly lower and the levels of VEGF and FN were significantly higher after treatment than those in the control group(all P<0.05).The duration of postoperative pain,wound healing time,and hospital stay in the combined group were significantly shorter than those in the control group(all P<0.05).After 3 weeks of treatment,the total effective rate of the observation group was 96.94%(95/98),which was significantly higher than that 87.63%(85/97)of the control group(P<0.05).Conclusion External application of Huanglian ointment combined with Zhitong Rushen Decoction can effectively relieve postoperative pain and swelling,and speed up postoperative wound healing in young and middle-aged hemorrhoid patients,the mechanism may be related to reducing the body’s inflammatory reaction.