| 聂桂宽,王 锐,孙 蕾,王 丽,李京向.凉血地黄汤对湿热下注证混合痔外剥内扎术后患者创面愈合、肛门功能和新生血管形成的影响[J].,2022,(17):3270-3274 |
| 凉血地黄汤对湿热下注证混合痔外剥内扎术后患者创面愈合、肛门功能和新生血管形成的影响 |
| Effects of Liangxue Dihuang Decoction on Wound Healing, Anal Function and Neovascularization after External Stripping and Internal Ligation of Mixed Hemorrhoids with Damp Heat Injection Syndrome |
| 投稿时间：2022-02-24 修订日期：2022-03-20 |
| DOI：10.13241/j.cnki.pmb.2022.17.013 |
| 中文关键词: 凉血地黄汤 湿热下注证 混合痔外剥内扎术 创面愈合 肛门功能 新生血管形成 |
| 英文关键词: Liangxue Dihuang decoction Damp heat injection syndrome External stripping and internal ligation of mixed hemorrhoids Wound healing Anal function Neovascularization |
| 基金项目:西藏自治区自然科学基金项目（2016ZR-15-73） |
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| 中文摘要: |
| 摘要 目的：观察凉血地黄汤对湿热下注证混合痔外剥内扎术后患者创面愈合、肛门功能和新生血管形成的影响。方法：采用随机数字表法，将北京中医药大学东直门医院2019年10月~2021年9月间接收的150例混合痔外剥内扎术后患者分为对照组（n=75）和研究组（n=75）。对照组患者接受常规处理，研究组患者在对照组基础上接受凉血地黄汤治疗。对比两组疗效、创面愈合、肛门功能、新生血管形成情况和并发症。结果：研究组的临床总有效率为94.67%（71/75），高于对照组的74.67%（56/75），差异有统计学意义（P<0.05）。研究组的创面缩小率大于对照组，创面愈合时间短于对照组（P<0.05）。研究组视觉疼痛模拟评分（VAS）评分低于对照组，瘙痒症状消失时间、出血消失时间、排便疼痛消失时间、肛门分泌物消失时间短于对照组（P<0.05）。两组治疗7 d后血小板源性生长因子（PDFG）、血管内皮生长因子（VEGF）及碱性成纤维生长因子（bFGF）水平均升高，且研究组高于对照组（P<0.05）。两组治疗7 d后wexner便秘评分、肛管收缩压、肛管静息压下降，且研究组低于对照组（P<0.05），两组治疗7 d后直肠最大容量阀值、直肠感觉阀值下降，但研究组高于对照组（P<0.05）。研究组的并发症发生率低于对照组（P<0.05）。结论：凉血地黄汤用于湿热下注证混合痔外剥内扎术后患者，可减轻患者术后疼痛，促进患者创面愈合，改善机体肛门功能，降低并发症发生率，可能与调节机体新生血管形成有关。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of Liangxue Dihuang decoction on wound healing, anal function and neovascularization after external stripping and internal ligation of mixed hemorrhoids with damp heat injection syndrome. Methods: Using random number table method, 150 patients with mixed hemorrhoids after external stripping and internal ligation in Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from October 2019 to September 2021 were divided into control group (n=75) and study group (n=75). According to the random number table method, they were divided into control group and study group, with 75 cases in each group. The patients in the control group received routine treatment, and the patients in the study group received Liangxue Dihuang decoction on the basis of the control group. The curative effect, wound healing, anal function, neovascularization and complications were compared between the two groups. Results: The total clinical effective rate in the study group was 94.67% (71/75), which was higher than 74.67% (56/75) in the control group, the difference was statistically significant (P<0.05). The wound reduction rate in the study group was greater than that in the control group, and the wound healing time was shorter than that in the control group (P<0.05). The visual pain analog scale (VAS) score in the study group was lower than that in the control group, the disappearance time of pruritus, bleeding, defecation pain and anal secretion in the control group were shorter than those in the control group (P<0.05). 7 d after treatment, the platelet-derived growth factor (PDFG), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) increased in the two groups, and the study group was higher than the control group (P<0.05). Wexner constipation score, anal systolic pressure and anal resting pressure decreased in the two groups at 7 d after treatment, and the study group was lower than the control group (P<0.05). The maximum rectal volume threshold and rectal sensory threshold decreased in the two groups at 7 d after treatment, but the study group was higher than the control group (P<0.05). The incidence rate of complications in the study group was lower than that in the control group (P<0.05). Conclusion: Liangxue Dihuang decoction used in patients with external stripping and internal ligation of mixed hemorrhoids with damp heat injection syndrome can reduce postoperative pain, promote wound healing, improve anal function, and reduce the incidence rate of complications, which may be related to regulating the formation of neovascularization. |
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