中药熏洗坐浴、耳穴埋籽联合红光照射对混合痔术后肛周疼痛、创面愈合的影响及机制初探

Efficacy of TCM fumigation and sitting bath,ear points pressing therapy plus red light irradiation on perianal pain and wound healing of patients with mixed hemorrhoids after operation

目的:观察中药熏洗坐浴、耳穴埋籽联合红光照射治疗混合痔术后患者的效果。方法:选取2018年3月-2020年3月就诊于江苏省南通市海安市中医院的200例混合痔术后患者,按照随机数字表法分为对照组、观察组,各100例。对照组患者术后给予高锰酸钾溶液坐浴,并给予红光照射;观察组患者在红光照射基础上给予中药熏洗坐浴与耳穴埋籽协同治疗,连续治疗7 d。比较患者术后创面痛感、创面愈合时间、术后7 d愈合率、术后并发症、生活质量变化,检测血清中创面愈合相关因子[碱性成纤维生长因子(basic Fibroblast Growth Factor,bFGF)、白细胞介素-1β(Interleukin-1β,IL-1β)]水平。结果:经治疗后,两组患者的术后疼痛有所减轻,术后3 d、术后7 d组间比较,以观察组患者的视觉模拟评分法(Visual Analogue Scale,VAS)评分显著低于对照组(P<0.05);观察组患者术后的创面愈合更好,创面愈合更快,术后7 d创面愈合率与对照组相比显著升高(P<0.05);观察组、对照组的术后并发症发生率比较,观察组术后并发症更少(P<0.05);术后3个月,观察组患者的生活质量综合评定问卷(Generic Quality Of Life Inventory-74,GQOLI-74)评分显著高于对照组(P<0.05);观察组患者术后7 d血清中bFGF水平显著高于对照组,IL-1β水平显著低于对照组(P<0.05)。结论:中药熏洗坐浴、耳穴埋籽联合红光照射利于减轻混合痔术后患者的创面痛感,促进创面愈合,减少术后并发症的发生,显著提高生活质量,其起效可能与调控血清中血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)、白细胞介素-1(Interleukin-1,IL-1)水平以促进血管新生、减轻炎症损伤有关。

Objective:To observe efficacy of TCM fumigation and sitting bath,ear points pressing therapy plus red light irradiation on mixed hemorrhoids.Methods:200 cases from March 2018 to March 2020 were divided into the control group and the observation group,100 patients in each group.Patients in the control group were given potassium permanganate solution and red light irradiation after surgery.In the observation group,patients were treated by TCM fumigation and sitting bath and ear points pressing therapy on the basis of red light irradiation for 7 days.Results:After treatment,the postoperative pain in the two groups was reduced,and VAS score in the observation group was significantly lower than the control group(P<0.05).In the observation group,the postoperative wound healing was better and faster.The wound healing rate in the observation group on the 7 th day after surgery was significantly higher than the control group(P<0.05).Comparing the incidence of postoperative complications between the two groups,the observation group had fewer postoperative complications(P<0.05).Three months after the operation,the GQOL-74 score in the observation group was significantly higher than the control group(P<0.05).The serum level of bFGF in the observation group was significantly higher than the control group,and the level of IL-1β was significantly lower than that the control group(P<0.05).Conclusion:The combination of TCM fumigation and sitting bath,ear points pressing therapy and red light irradiation can alleviate the wound pain of patients after mixed hemorrhoids surgery,promote the wound healing,reduce the occurrence of postoperative complications,and significantly improve the quality of life.Its effect may be related to the regulation of serum VEGF and IL-1β levels to promote angiogenesis and reduce inflammatory damage.