目的:观察加减凉血地黄汤联合揿针治疗湿热下注型混合痔术后的临床疗效。方法:将2022年10月至2023年10月云南省中医院肛肠科病区住院并符合纳入标准的混合痔患者72例随机分为治疗组及对照组各36例,对照组予凉血地黄汤口服治疗,治疗组予凉血地黄汤配合揿针治疗;比较两组术后疼痛、创面水肿程度。结果:治疗组总有效率相较于对照组更高,差异有统计学意义(P Objective: This paper aims to observe the clinical efficacy of Modified Liangxue Dihuang Decoction combined with snap needles in the treatment of mixed hemorrhoids (Damp Heat Injection Syndrome) after surgery. Method: 72 cases of mixed hemorrhoid patients who were hospitalized in the anorectal ward of Yunnan Provincial Hospital of Traditional Chinese Medicine from October 2022 to October 2023 and qualified for inclusion were randomly divided into treatment group and control group of 36 cases each. The control group was given Modified Liangxue Dihuang Decoction, and the treatment group was given Modified Liangxue Dihuang Decoction with snap needles;the two groups of postoperative pain and the degree of traumatic edema were compared. Results: The total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant (P < 0.05), and the degree of traumatic pain and edema of the treatment group was lighter. Conclusion: Modified Liangxue Dihuang Decoction combined with snap needles can effectively improve patients’ postoperative pain and traumatic edema.
目的观察凉血地黄汤联合雷火灸对混合痔外剥内扎术后创面愈合及炎性因子的影响。方法选取2021年1月—2022年12月长沙市中医医院/长沙市第八医院收治的混合痔外剥内扎术后患者98例,按照随机数字表法分为观察组(49例)和对照组(49例)。对照组给予注射用头孢呋辛钠+金玄痔科熏洗散治疗,观察组在对照组基础上加用凉血地黄汤联合雷火灸治疗,2组均治疗14 d。比较2组临床疗效,术后2 d、14 d视觉模拟评分法(VAS)评分、水肿评分,创面愈合时间,治疗前后血清学指标[转化生长因子-β(TGF-β)、Ⅰ型胶原蛋白(COL-Ⅰ)、表皮生长因子(EGF)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)],不良反应。结果观察组治疗总有效率高于对照组(97.96%vs.79.59%,χ^(2)=8.295,P=0.004)。2组术后2 d VAS评分与水肿评分比较差异无统计学意义(P>0.05);2组术后14 d VAS评分与水肿评分低于术后2 d,且观察组术后14 d VAS评分低于对照组(P<0.01);观察组创面愈合时间为(20.26±3.03)d,短于对照组的(32.26±4.13)d(t=16.399,P<0.001)。治疗14 d后,2组血清TGF-β、COL-Ⅰ、EGF水平高于治疗前,血清IL-6、IL-8、TNF-α水平低于治疗前,且观察组升高/降低幅度大于对照组(P<0.01)。观察组不良反应总发生率低于对照组(4.08%vs.16.33%,χ^(2)=4.009,P=0.045)。结论凉血地黄汤联合雷火灸对混合痔外剥内扎术后患者有积极影响,可有效促进局部血液循环,缓解疼痛程度,加速创面愈合,减轻炎性反应,且安全性较高。
