止痛如神汤外洗对湿热下注型混合痔外剥内扎术后患者的影响

Effect of External Washing of Zhitong Rushen Decoction(止痛如神汤)on Patients after External Stripping and Internal Ligation of Damp Heat Type Mixed Hemorrhoid

目的:探讨止痛如神汤外洗对湿热下注型混合痔外剥内扎术(M-MH)后患者的临床疗效及对血管内皮细胞生长因子(VEGF)及其受体(VEGFR-2)的影响。方法:选取海安市中医院肛肠科湿热下注型混合痔患者66例,按照随机数字表法分为观察组及对照组各33例。在常规M-MH术治疗基础上,对照组采用清水外用熏洗治疗,观察组采用止痛如神汤外用熏洗治疗。观察并记录两组患者的疼痛程度、水肿程度,在治疗第1、4、7、10天对创面进行评价,在治疗第7天及第14天检测VEGF、VEGFR-2的表达水平。结果:治疗后,观察组患者疼痛缓解程度优于对照组(P<0.05),术后创面水肿缓解程度优于对照组(P<0.05);观察组总有效率为93.94%,对照组总有效率为75.76%,差异有统计学意义(P<0.05)。治疗后,第7天和第14天观察组VEGF、VEGFR-2表达水平均高于对照组(P<0.05),且观察组第14天VEGF、VEGFR-2表达水平均优于第7天(P<0.05)。结论:止痛如神汤外用熏洗可以有效缓解混合痔湿热下注型M-MH术后患者肛门部疼痛,加快水肿消退,升高术后创面VEGF、VEGFR-2的表达,加快治愈速度,提高患者术后满意度。

Objective:To investigate the clinical effect of external washing of Zhitong Rushen Decoction(止痛如神汤)on patients with mixed hemorrhoid after external stripping and internal ligation(M-MH)and its effect on vascular endothelial growth factor(VEGF)and its receptor(VEGFR-2).Methods:A total of 66 patients with damp heat type mixed hemorrhoid in Anorectal Department of Hai’an Hospital of Traditional Chinese Medicine were randomly divided into the observation group and the control group,with 33 cases in each group.On the basis of routine M-MH treatment,the control group was treated with external fumigation with clear water,and the observation group was treated with external fumigation with Zhitong Rushen Decoction.The degree of pain and edema in the two groups were observed and recorded.The wounds were evaluated on the 1st,4th,7th and 10th day of treatment,and the expression levels of VEGF and VEGFR-2 were detected on the 7th and 14th day of treatment.Results:After treatment,the degree of pain relief in the observation group was better than that in the control group(P<0.05),and the degree of postoperative wound edema relief in the observation group was better than that in the control group(P<0.05).The total effective rate was 93.94%in the observation group and 75.76%in the control group(P<0.05).After treatment,the expression levels of VEGF and VEGFR-2 in the observation group on the 7th and 14th day were higher than those in the control group(P<0.05),and the expression levels of VEGF and VEGFR-2 in the observation group on the 14th day were better than those on the 7th day(P<0.05).Conclusions:External fumigation of Zhitong Rushen Decoction can effectively alleviate the anal pain of M-MH patients with mixed hemorrhoid of damp heat type,accelerate the regression of edema,increase the expression of VEGF and VEGFR-2 on the postoperative wound,accelerate the cure speed and improve the postoperative satisfaction of patients.