凉血地黄汤加减对混合痔患者术后疼痛水肿及创面愈合的影响

Effect of modified Liangxue Dihuang decoction on postoperative pain and edema and wound healing in patients with mixed hemorrhoids

目的探讨凉血地黄汤加减对混合痔患者术后疼痛水肿及创面愈合的影响。方法选取2020年1月至2022年12月于景德镇市中医医院肛肠科行手术治疗的96例混合痔患者作为研究对象,按照随机数字表法分为对照组与研究组,每组48例。对照组给予常规西医治疗,研究组在对照组基础上给予凉血地黄汤加减治疗。比较两组治疗前后血清CXC趋化因子受体4(CXCR4)、淀粉样蛋白A(SAA)、白细胞介素-8(IL-8)、前列腺素E2(PGE2)、β内啡肽(β-EP)、血管内皮生长因子(VEGF)、Ⅰ型胶原蛋白(COL-Ⅰ)水平及创面水肿程度、疼痛程度[疼痛数字分级量表(NRS)评分]、创面愈合时间。结果治疗后,研究组血清CXCR4、IL-8、SAA、PGE2水平均低于对照组,血清β-EP、VEGF、COL-Ⅰ水平均高于对照组,差异有统计学意义(P<0.05)。治疗后,研究组水肿评分、NRS评分均低于对照组,差异有统计学意义(P<0.05);研究组创面愈合时间短于对照组,差异有统计学意义(P<0.05)。结论凉血地黄汤加减治疗混合痔术后患者,可抑制机体炎症反应,改善疼痛介质及VEGF、COL-Ⅰ水平,缓解患者疼痛及创面水肿程度,促进创面愈合。

Objective To investigate the effects of modified Liangxue Dihuang decoction on postoperative pain,edema and wound healing in patients with mixed hemorrhoids.Methods 96 patients with mixed hemorrhoids who underwent surgical treatment in the Proctology department of Jingdezhen Hospital of Traditional Chinese Medicine were selected as the study subjects,and they were divided into the control group and the study group according to the random number table method,with 48 cases in each group.The control group was given conventional Western medicine,while the study group was given modified Liangxue Dihuang decoction on the basis of the control group,the levels of serum CXC chemokine receptor 4(CXCR4),amyloid A(SAA),interleukin-8(IL-8),prostaglandin E2(PGE2),β-endorphin(β-EP),vascular endothelial growth factor(VEGF)and collagen typeⅠ(COL-Ⅰ)before and after treatment,the degree of wound edema and degree of pain(numerical rating scale[NRS]score)and wound healing time were compared between the two groups.Results After treatment,the levels of serum CXCR4,IL-8,SAA and PGE2 in the study group were lower than those in the control group,while the levels of serumβ-EP,VEGF and COL-Ⅰin the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the edema score and NRS score in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05);the wound healing time in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The modified Liangxue Dihuang decoction in the treatment of patients with mixed hemorrhoids after operation can inhibit the inflammatory response of the body,improve the levels of pain mediators,VEGF and COL-Ⅰ,relieve the pain and the degree of wound edema of patients,and promote wound healing.