马应龙麝香痔疮膏联合地奥司明片对混合痔术后创面水肿的防治效果
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摘要
目的:探讨马应龙麝香痔疮膏联合地奥司明片对混合痔术后创面水肿的防治效果。方法:选取2015年10月至2017年10月德阳市人民医院收治的混合痔术后患者144例作为研究对象,随机分为对照组和观察组,每组72例。对照组患者给予迈之灵片口服治疗,观察组给予地奥司明片口服,马应龙麝香痔疮膏涂抹于肛门创面附近,2组均连续治疗7 d,随访6个月。比较2组患者临床疗效,评估2组患者术后创面疼痛、水肿恢复情况、肛门功能,检测并比较2组创面P物质(SP)含量。结果:治疗后观察组总有效率为95. 83%显著高于对照组的79. 17%(P <0. 01)。术后2～6 d,2组创面NRS评分和水肿评分逐渐降低(P <0. 01),且术后4 d、6 d观察组创面NRS评分和水肿评分低于对照组,疼痛和水肿缓解时间较对照组缩短(P <0. 01)。从出院至术后6个月,2组Wexner评分逐渐降低(P <0. 01),观察组出院时Wexner评分低于对照组(P <0. 01),术后3～6个月2组Wexner评分差异无统计学意义(P> 0. 05)。术后2～6 d,2组创面SP含量呈现逐渐升高趋势(P <0. 01),且观察组术后4 d、6 d创面SP含量明显高于对照组(P <0. 01)。结论:混合痔术后患者应用马应龙麝香痔疮膏联合地奥司明片治疗可加速创面疼痛及水肿的缓解,改善患者肛门功能,可能与增加创面组织中SP含量有关。
Objective: To explore the prevention and curative effect of Mayinglong Shexiang Haemorrhoids Creams joint diosmin tablets on wound edema of mixed hemorrhoids after operation. Methods: A total of 144 cases of mixed hemorrhoids patients after operation in Deyang People's Hospital from October 2015 to October 2017 were selected as the research objects and randomly divided into the observation group( 72 cases) and the control group( 72 cases). The patients in the control group were given oral administration of Maizhiling tablets,and the observation group was given diosmin tablets orally. Mayinglong Shexiang Haemorrhoids Creams was smeared near the anal wound. The 2 groups were treated for 7 d and followed-up for 6 months. The clinical efficacy of the 2 groups were statistically analyzed,and wound pain and edema recovery,anal function in the 2 groups were evaluated. The content of wounds substance P( SP) in the 2 groups were detected and compared. Results: The total effective rate was 95. 83% in the observation group after treatment,which was significantly higher than 79. 17% in the control group( P < 0. 01). At 2 d to 6 d after operation,the NRS score and edema score of the 2 groups decreased gradually( P < 0. 01). At 4 d and 6 d after operation,the NRS score and edema score in the observation group were lower than those in the control group,and the remission time of pain and edema were shorter than those in the control group( P < 0. 01). From discharge to 6 months after operation,the Wexner score in the 2 groups gradually reduced( P < 0. 01),and the Wexner score of the observation group at discharge was lower than that of the control group( P < 0. 01),and there was no significant difference in the Wexner score of 3-6 months after operation between the 2 groups( P > 0. 05). At 2 d to 6 d after operation,the wound SP content in the 2 groups increased gradually( P < 0. 01),and the SP content of 2 ～ 4 d after operation in the observation group were significantly higher than those in the control group( P < 0. 01). Conclusion: Mayinglong Shexiang Haemorrhoids Creams joint diosmin tablets in the treatment of postoperative mixed hemorrhoids patients can accelerate the relief of wound pain and edema,improve the anal function,which may be related to the promotion of SP expression in the wound tissue.
Objective: To explore the prevention and curative effect of Mayinglong Shexiang Haemorrhoids Creams joint diosmin tablets on wound edema of mixed hemorrhoids after operation. Methods: A total of 144 cases of mixed hemorrhoids patients after operation in Deyang People's Hospital from October 2015 to October 2017 were selected as the research objects and randomly divided into the observation group( 72 cases) and the control group( 72 cases). The patients in the control group were given oral administration of Maizhiling tablets,and the observation group was given diosmin tablets orally. Mayinglong Shexiang Haemorrhoids Creams was smeared near the anal wound. The 2 groups were treated for 7 d and followed-up for 6 months. The clinical efficacy of the 2 groups were statistically analyzed,and wound pain and edema recovery,anal function in the 2 groups were evaluated. The content of wounds substance P( SP) in the 2 groups were detected and compared. Results: The total effective rate was 95. 83% in the observation group after treatment,which was significantly higher than 79. 17% in the control group( P < 0. 01). At 2 d to 6 d after operation,the NRS score and edema score of the 2 groups decreased gradually( P < 0. 01). At 4 d and 6 d after operation,the NRS score and edema score in the observation group were lower than those in the control group,and the remission time of pain and edema were shorter than those in the control group( P < 0. 01). From discharge to 6 months after operation,the Wexner score in the 2 groups gradually reduced( P < 0. 01),and the Wexner score of the observation group at discharge was lower than that of the control group( P < 0. 01),and there was no significant difference in the Wexner score of 3-6 months after operation between the 2 groups( P > 0. 05). At 2 d to 6 d after operation,the wound SP content in the 2 groups increased gradually( P < 0. 01),and the SP content of 2 ～ 4 d after operation in the observation group were significantly higher than those in the control group( P < 0. 01). Conclusion: Mayinglong Shexiang Haemorrhoids Creams joint diosmin tablets in the treatment of postoperative mixed hemorrhoids patients can accelerate the relief of wound pain and edema,improve the anal function,which may be related to the promotion of SP expression in the wound tissue.
引文
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[10]戴淑琴,李彩云,张龙,等.迈之灵片联合微波治疗混合痔术后并发症的效果[J].宁夏医学杂志,2016,38(4):354-356.
[11]姬清华,程海玉,张汝一,等.吻合器痔上黏膜环切术治疗重度痔和嵌顿性痔临床观察[J].贵阳医学院学报,2010,35(2):190-191.
[12]黄斌,张玉茹,刘连成,等.超声刀痔切除术后帕瑞昔布钠的镇痛效果及安全性[J].山东医药,2016,56(11):61-62.
[13]龙庆,李艳,李俊,等.针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀临床观察[J].中国针灸,2016,36(6):603-606.
[14]高宗跃,周晓丽.消痔灵联合肾上腺素治疗内痔出血患者的临床疗效[J].中成药,2016,38(7):1468-1472.
[15]陈莹璐,钟传篪,徐月,等.龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响[J].中国实验方剂学杂志,2017,23(8):178-183.
[16]林晓智,翁治委,陆泽楷,等.中药联合地奥司明治疗轻中度精索静脉曲张合并精子质量异常的临床观察[J].中国男科学杂志,2017,31(3):57-59.
[17]姜义武,李杰,唐海云,等.马应龙麝香痔疮膏对直肠黏膜急性损伤的修复作用及机制研究[J].中国医院用药评价与分析,2017,17(2):176-178.
[18]Chen YW,Tzeng JI,Lin MF,et al.Forced treadmill running suppresses postincisional pain and inhibits upregulation of substance Pand cytokines in rat dorsal root ganglion[J].J Pain,2014,15(8):827-834.
[19]Tian Y,Yang G,Zhang X,et al.Effects of substance P on growth of fibroblast-like cells derived from bile duct:an in vitro cell culture study[J].Chin Med J(Engl),2014,127(17):3121-3126.
[2]袁和学,曾宪东,殷志韬.超声多普勒引导下痔动脉结扎联合自动痔疮套扎术治疗痔病[J].中国现代医学杂志,2015,25(28):102-105.
[3]闻亚平,蒋干超,杨青云,等.自拟中药熏洗组方在混合痔外剥内扎术后应用的临床研究[J].世界中医药,2017,12(10):2379-2381,2385.
[4]宋立峰,赵占强,孙海芳,等.术芍除湿活血方治疗混合痔术后疼痛与水肿100例[J].环球中医药,2015,8(12):1504-1506.
[5]唐海明,陆彩忠,王明华,等.消肿化痔汤治疗混合痔术后肛缘水肿的临床观察[J].中医药信息,2014,31(1):87-89.
[6]中华医学会外科学分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(5):461-463.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[8]Powers J G,Higham C,Broussard K,et al.Wound healing and treating wounds:Chronic wound care and management[J].Journal of the American Academy of Dermatology,2016,74(4):607-625.
[9]Mangoni ML,Mc Dermott AM,Zasloff M.Antimicrobial peptides and wound healing:biological and therapeutic considerations[J].Exp Dermatol,2016,25(3):167-173.
[10]戴淑琴,李彩云,张龙,等.迈之灵片联合微波治疗混合痔术后并发症的效果[J].宁夏医学杂志,2016,38(4):354-356.
[11]姬清华,程海玉,张汝一,等.吻合器痔上黏膜环切术治疗重度痔和嵌顿性痔临床观察[J].贵阳医学院学报,2010,35(2):190-191.
[12]黄斌,张玉茹,刘连成,等.超声刀痔切除术后帕瑞昔布钠的镇痛效果及安全性[J].山东医药,2016,56(11):61-62.
[13]龙庆,李艳,李俊,等.针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀临床观察[J].中国针灸,2016,36(6):603-606.
[14]高宗跃,周晓丽.消痔灵联合肾上腺素治疗内痔出血患者的临床疗效[J].中成药,2016,38(7):1468-1472.
[15]陈莹璐,钟传篪,徐月,等.龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响[J].中国实验方剂学杂志,2017,23(8):178-183.
[16]林晓智,翁治委,陆泽楷,等.中药联合地奥司明治疗轻中度精索静脉曲张合并精子质量异常的临床观察[J].中国男科学杂志,2017,31(3):57-59.
[17]姜义武,李杰,唐海云,等.马应龙麝香痔疮膏对直肠黏膜急性损伤的修复作用及机制研究[J].中国医院用药评价与分析,2017,17(2):176-178.
[18]Chen YW,Tzeng JI,Lin MF,et al.Forced treadmill running suppresses postincisional pain and inhibits upregulation of substance Pand cytokines in rat dorsal root ganglion[J].J Pain,2014,15(8):827-834.
[19]Tian Y,Yang G,Zhang X,et al.Effects of substance P on growth of fibroblast-like cells derived from bile duct:an in vitro cell culture study[J].Chin Med J(Engl),2014,127(17):3121-3126.