荆芥连翘汤联合穴位按摩及地奥司明治疗非手术痔疮临床研究

Clinical Study on Jinjie Lianqiao Tang Combined with Point Tuina and Diosmin for Non-Operative Hemorrhoids

目的:观察荆芥连翘汤联合穴位按摩及地奥司明治疗非手术痔疮患者的临床效果。方法:选取94例非手术痔疮患者,按随机数字表法分为对照组与研究组各47例。对照组给予穴位按摩及地奥司明治疗,研究组在对照组基础上加用荆芥连翘汤治疗。比较2组临床疗效、症状体征转归时间及治疗前后中医证候积分、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、血管内皮生长因子(VEGF)、5-羟色胺(5-HT)水平。结果:研究组总有效率97.87%,高于对照组82.98%(P<0.05)。与同组治疗前比较,治疗后2组便血、肛门不适、疼痛、痔核脱出、肛门水肿等中医证候积分及血清TNF-α、IL-17、5-HT水平均降低(P<0.05),血清VEGF水平升高(P<0.05);与对照组治疗后比较,研究组便血、肛门不适、疼痛、痔核脱出、肛门水肿等中医证候积分及血清TNF-α、IL-17、5-HT水平均较低(P<0.05),血清VEGF水平较高(P<0.05)。研究组疼痛缓解时间、出血明显改善时间、水肿消失时间、痔核脱出消失时间均短于对照组(P<0.05)。结论:荆芥连翘汤联合穴位按摩及地奥司明治疗非手术痔疮患者可促进其症状体征改善,抑制炎症反应,调节VEGF、5-HT水平,提高临床疗效。

Objective:To observe the clinical effect of Jinjie Lianqiao tang combined with point tuina and diosmin on the treatment of non-operative hemorrhoids.Methods:A total of 94 patients with non-operative hemorrhoids were selected and divided into the control group and the study group by the random number table method,with 47 cases in each group.The control group was given point tuina and diosmin for treatment,and the study group was additionally treated with Jinjie Lianqiao tang based on the treatment of the control group.The Chinese medicine syndrome scores,and levels of tumor necrosis factor-α(TNF-α),interleukin-17(IL-17),vascular endothelial growth factor(VEGF),5-hydroxytryptamine(5-HT)before and after treatment and the clinical effects and turnaround time of symptoms and signs were compared between the two groups.Results:The total effective rate was 97.87%in the study group,higher than that of 82.98%in the control group(P<0.05).After treatment,when compared with those before treatment,the scores of Chinese medicine syndromes like blood in stool,anal discomfort,pain,hemorrhoid prolapse and anal edema,and levels of TNF-α,IL-17 and 5-HT in serum were decreased in both groups(P<0.05),while the VEGF level was increased(P<0.05).Compared with those in the control group after treatment,the scores of the above Chinese medicine syndromes and the levels of TNF-α,IL-17 and5-HT in the study group were lower than those in the control group(P<0.05),while the VEGF level was higher(P<0.05).The time of pain relief,time of bleeding improvement,disappearance time of edema and hemorrhoid prolapse in the study group were shorter than those in the control group(P<0.05).Conclusion:The therapy of Jinjie Lianqiao tang combined with point tuina and diosmin can promote the improvement of symptoms and signs of patients with non-operative hemorrhoids,inhibit inflammatory responses,regulate levels of VEGF and 5-HT,and improve the clinical effect.