复方黄柏液对混合痔患者术后中医证候bFGF CD68及痔组织MVC的影响

Effect of compound Huangbai liquid on TCM syndrome,bFGF,CD68 and MVC in patients with mixed hemorrhoids after operation

目的 探讨复方黄柏液对混合痔患者术后中医证候、碱性成纤维细胞生长因子、分化群68及痔组织微血管数量的影响。方法 将行手术治疗的102例混合痔患者进行简单随机化分为两组,每组51例。两组均采取常规治疗,在此基础上对照组采取TDP照射,研究组采用TDP照射联合复方黄柏液治疗,连续治疗1周。比较两组临床疗效、临床症状缓解时间、创面愈合时间及治疗前后中医证候(便血、疼痛、坠胀)积分、碱性成纤维细胞生长因子水平、分化群68水平、痔组织微血管数量、疼痛介质(前列腺素2、一氧化氮、β-内啡肽)水平,治疗后3个月随访混合痔复发情况。结果 研究组治疗总有效率显著高于对照组(P<0.05),疼痛、出血、水肿、渗出物缓解时间及创面愈合时间显著短于对照组(P<0.01)。治疗后研究组便血、疼痛、坠胀积分显著低于对照组(P<0.01)。治疗后研究组血清碱性成纤维细胞生长因子水平显著高于对照组(P<0.01),分化群68水平显著低于对照组(P<0.01),两组痔组织微血管数量比较差异无统计学意义(P>0.05)。治疗后研究组疼痛介质(前列腺素2、一氧化氮、β-内啡肽)水平显著低于对照组(P<0.01)。治疗1个月、3个月两组混合痔复发率比较差异无统计学意义(P>0.05)。结论 复方黄柏液在混合痔术后康复中疗效确切,可调节血清碱性成纤维细胞生长因子、分化群68及痔组织微血管数量,降低中医证候积分,减轻疼痛程度,加速创面愈合。

Objective To investigate the effect of compound Huangbai liquid on TCM syndrome, basic fibroblast growth factor(bFGF), cluster of differentiation 68(CD68) and microvessel count(MVC) in patients with mixed hemorrhoids after operation. Methods A total of 102 patients with mixed hemorrhoids after surgery were selected and grouped according to simple randomization, with 51 cases in each group. Both groups were treated with conventional treatment, the control group was treated with TDP irradiation, and the study group was treated with compound Huangbai liquid based on the control group. Both groups were treated for 1 week. The clinical efficacy, clinical symptom relief time, wound healing time, and TCM syndromes(hematochezia, pain, swelling), bFGF, CD68, MVC, pain mediators [prostaglandin E2(PEG2), nitric oxide(NO), β-endorphin(β-EP)] before and after treatment of the two groups were observed, and the recurrence of mixed hemorrhoids was followed up 3 months after treatment. Results The total effective rate of the study group was significantly higher than that of the control group(P<0.05). The pain, bleeding, edema, exudate relief time and wound healing time were significantly shorter than those of the control group(P<0.01). After treatment, the scores of hematochezia, pain and swelling in the study group were significantly lower than those in the control group(P<0.01).After treatment,the level of serum bFGF in the study group was significantly higher than that in the control group(P<0.01),and the level of CD68was significantly lower than that in the control group(P<0.01).There was no significant difference in MVC between the two groups(P>0.05).After treatment,the levels of pain mediators(PEG2,NO,β-EP)in study group were significantly lower than those in control group(P<0.01).There was no significant difference in the recurrence rate of mixed hemorrhoids between the two groups at 1 month and 3 months after treatment(P>0.05).Conclusions Compound Huangbai liquid has a definite effect in treating postoperative patients with mixed hemorrhoids.It can adjust bFGF,CD68,MVC,reduce TCM syndrome scores,reduce pain,and accelerate wound healing.