针刺联合中药熏洗对混合痔外切内扎术后创面及疼痛的影响

Effect of acupuncture combined with traditional Chinese medicine fumigation on trauma and pain after mixed hemorrhoids external excision and internal ligation surgery

目的观察针刺承山穴联合三黄汤熏洗治疗混合痔外切内扎术后恢复的临床疗效及对患者创面渗液、创面愈合及疼痛程度的影响。方法对92例接受外切内扎术的混合痔患者进行回顾性研究,根据不同治疗方法分为观察组和对照组,每组46例。对照组术后予高锰酸钾坐浴及常规治疗,观察组在对照组治疗基础上予针刺承山穴联合三黄汤熏洗治疗。比较两组水肿和渗出物消失时间、创面愈合时间、临床疗效以及并发症发生率。观察两组治疗前后肛门水肿积分、疼痛视觉模拟量表(visual analog score,VAS)评分、血清炎性因子水平、血清碱性成纤维生长因子(basic fibroblast growth factor,bFGF)水平和血小板源性生长因子(platelet-derived growth factor,PDGF)水平的变化。结果观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。观察组治疗后肛门水肿积分和VAS评分均低于对照组(P<0.05),血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)低于对照组(P<0.05),血清bFGF和PDGF水平高于对照组(P<0.05)。观察组水肿和渗出物消失时间、创面愈合时间均短于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论在常规治疗和高锰酸钾坐浴治疗基础上,针刺承山穴联合三黄汤熏洗治疗外切内扎术后混合痔患者可有效缓解创面渗液、水肿和疼痛,减轻炎症反应,加快创面愈合,降低并发症发生率,提高临床疗效。

Objective To observe the clinical efficacy of acupuncture at Chengshan(BL57)combined with San Huang Tang fumigation in the treatment of mixed hemorrhoids after external excision and internal ligation for recovery and its effect on wound exudation,wound healing and pain level of patients.Method A retrospective study was conducted on 92 patients with mixed hemorrhoids who underwent external excision and internal ligation,and they were divided into an observation group and a control group according to the different treatment methods,with 46 cases in each group.The control group was treated with Potassium permanganate sitz bath and routine treatment,while the observation group was treated with acupuncture at Chengshan and fumigation with San Huang Tang on the basis of the treatment of the control group.The two groups were compared in terms of the disappearance of edema and exudate,wound healing time,clinical efficacy and complication rate.The anal edema score,visual analog score(VAS),serum inflammatory factor level,serum basic fibroblast growth factor(bFGF)level and platelet-derived growth factor(PDGF)level were observed before and after treatment in both groups.Result The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The anal edema points and VAS scores of the observation group were lower than those of the control group(P<0.05),and the serum hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were lower than those of the control group(P<0.05),and the serum levels of PDGF were lower than those of the control group(P<0.05).The disappearance time of edema and exudate and the wound healing time of the observation group were shorter than those of the control group(P<0.05).The complication rate of the observation group was lower than that of the control group(P<0.05).Conclusion On the basis of conventional treatment and Potassium permanganate sitz bath treatment,acupuncture at Chengshan acupoint combined with San Huang Tang fumigation treatment for mixed hemorrhoids after external cutting and internal ligation can effectively alleviate traumatic exudate,edema and pain,reduce inflammatory reaction,accelerate traumatic healing,reduce the incidence of complications,and improve the clinical efficacy.