止痛如神汤熏洗联合常规西医疗法治疗混合痔术后临床研究

Clinical Study on Fumigation and Washing with Zhitong Rushen Decoction and Conventional Western Medicine for Post-operative Mixed Hemorrhoids

目的:观察止痛如神汤熏洗对混合痔患者术后疼痛、创面愈合及炎症因子的影响。方法:选取混合痔患者124例为研究对象,按随机数字表法分为研究组和对照组各62例。2组均行外剥内扎术治疗,术后给予注射用头孢美唑钠静脉滴注。术后对照组使用复方黄柏液熏洗,研究组使用止痛如神汤熏洗。评价2组临床疗效,比较2组术后疼痛程度、创面愈合率及炎症因子水平。结果:研究组总有效率为98.39%,高于对照组87.10%,差异有统计学意义(P<0.05)。研究组治疗1、2、3周的创面愈合率均高于对照组,差异有统计学意义(P<0.05)。术后第1天,2组数字疼痛评分法(NRS)评分比较,差异无统计学意义(P>0.05)。治疗第3、5、7天,2组NRS评分逐渐降低(P<0.05),且研究组NRS评分均低于同时间点对照组(P<0.05)。治疗1、3周后,2组肿瘤坏死因子-α (TNF-α)、白细胞介素-1β (IL-1β)、白细胞介素-6 (IL-6)水平均有不同程度的降低,且研究组低于对照组(P<0.05)。研究组术后并发症总发生率为6.45%,对照组为17.74%,2组比较,差异无统计学意义(P>0.05)。结论:止痛如神汤熏洗可有效缓解术后疼痛,降低炎症因子水平,促进创面愈合。

Objective: To observe the effect of the fumigation and washing with Zhitong Rushen Decoction on postoperative pain, wound healing and inflammatory factors in patients with mixed hemorrhoids. Methods: A total of 124 patients with mixed hemorrhoids were selected as the study subjects,and were divided into the study group and the control group according to random number table method, with 62 patients in each group. Both groups were treated with external stripping and internal ligation,and were given intravenous infusion of Cefmetazole Sodium after operation. After operation,the control group was given fumigation and washing with Compound Huangbai Liquid, and the study group was given fumigation and washing with Zhitong Rushen Decoction. The clinical effects in the two groups were evaluated,and the degree of postoperative pain,wound healing rate and inflammatory factors levels were compared between the two groups. Results:The total effective rate was 98.39% in the study group,higher than that of 87.10% in the control group, the difference being significant(P<0.05). The wound healing rate in the study group was higher than that of the control group after 1, 2 and 3 weeks of treatment, the difference being significant(P<0.05). On the first day after operation, there was no significant difference in the score of Numerical Rating Scale(NRS) between the two groups(P>0.05). On the third,fifth and seventh day of treatment,the NRS scores in the two groups were gradually decreased(P<0.05),and the NRS score in the study group was lower than that in the control group at the same time point(P<0.05). After 1 week and 3 weeks of treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β) and interleukin-6(IL-6) in the two groups were decreased to different degrees,and the above levels in the study group were lower than those in the control group(P<0.05). The total incidence of postoperative complications was 6.45% in the study group and 17.74% in the control group,there being no significant difference between the two groups(P>0.05). Conclusion:The fumigation and washing with Zhitong Rushen Decoction can effectively relieve postoperative pain, reduce the levels of inflammatory factors and promote wound healing.