清润合剂在湿热下注型混合痔术后应用的临床研究
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摘要
目的:观察清润合剂在湿热下注型混合痔术后帮助排便,减少粪便对创口的刺激,进而缓解疼痛、减少便时出血及肛缘水肿,促进愈合,缩短疗程的临床疗效。
方法:采用数字随机表分组的方法,将60例符合纳入标准的患者随机分为治疗组和对照组各30例。两组在术前术后常规治疗的基础上,治疗组自术后第1天开始口服清润合剂,每日1剂,日2服,连服9天,对照组术后不服用中药。观察指标包括术后第3、6、9天排便情况、创口疼痛、便时出血和创缘水肿等症状体征的变化,将各积分按标准填入“混合痔术后反应观察表”中,评定各症状体征总积分的变化情况,比较两组创面愈合时间。
结果:两组术后3,6,9天各症状体征积分经秩和检验有显著差异,1个疗程后各症状体征总积分经t检验均有显著差异,治疗组愈合时间比对照组有明显缩短。两组均未发现明显不良反应,治疗前后血常规、肝肾功无明显变化。
结论:清润合剂适用于湿热下注型混合痔术后,有效帮助排便、缓解疼痛、减少便时出血、减轻创缘水肿等症状,促进愈合,缩短疗程,无明显不良反应,是一种安全有效的中药制剂。
Objective:To observe the effect of Qing-run mixture soup on discharging excrement, then reduction of pain,bleeding,edema secretion after operation of mixed hemorrhoids ofdamp-heat pouring downward syndrome
Methods:It is a randoinized control study according to the diagnosis standard with 30 patients in treatment group and 30 patients in control group.The treatment group started the treatment with Qing-run mixture soup one day after operation and 1 agent one day,twice a day,do this for 9 day.While the control group,without the soup during the treatment. Evaluation criteria include score of symptoms and dosage of pain,bleeding,edema secretion in 3 day,6 day,9 day after operation then Appraise the total score of all symptoms.and the time of healing.
Results:After treatment,all of the score of each symptom and total score of all symptoms are significantly lower than control group.The dosage of antalgica in treatment group also significantly lower than the control group.Qing-run mixture soup can significantly discharge excrement,alleviate postoperative pain and edema,and relieved wound blood exudation,in 3 day,6 day,9 day after operation.There is no obviously side effect and no marked change of blood routin and liver-kindey merit in treatment group and control group.
Conclusion:Qing-run mixture soup can effectively alleviate the symptoms such as discharging excrement,pain,bleeding of excrement and edema.It can decrease the administrative rate and dosage of antalgic.It is safe and effective Chinese drugs pharmaceutics.
方法:采用数字随机表分组的方法,将60例符合纳入标准的患者随机分为治疗组和对照组各30例。两组在术前术后常规治疗的基础上,治疗组自术后第1天开始口服清润合剂,每日1剂,日2服,连服9天,对照组术后不服用中药。观察指标包括术后第3、6、9天排便情况、创口疼痛、便时出血和创缘水肿等症状体征的变化,将各积分按标准填入“混合痔术后反应观察表”中,评定各症状体征总积分的变化情况,比较两组创面愈合时间。
结果:两组术后3,6,9天各症状体征积分经秩和检验有显著差异,1个疗程后各症状体征总积分经t检验均有显著差异,治疗组愈合时间比对照组有明显缩短。两组均未发现明显不良反应,治疗前后血常规、肝肾功无明显变化。
结论:清润合剂适用于湿热下注型混合痔术后,有效帮助排便、缓解疼痛、减少便时出血、减轻创缘水肿等症状,促进愈合,缩短疗程,无明显不良反应,是一种安全有效的中药制剂。
Objective:To observe the effect of Qing-run mixture soup on discharging excrement, then reduction of pain,bleeding,edema secretion after operation of mixed hemorrhoids ofdamp-heat pouring downward syndrome
Methods:It is a randoinized control study according to the diagnosis standard with 30 patients in treatment group and 30 patients in control group.The treatment group started the treatment with Qing-run mixture soup one day after operation and 1 agent one day,twice a day,do this for 9 day.While the control group,without the soup during the treatment. Evaluation criteria include score of symptoms and dosage of pain,bleeding,edema secretion in 3 day,6 day,9 day after operation then Appraise the total score of all symptoms.and the time of healing.
Results:After treatment,all of the score of each symptom and total score of all symptoms are significantly lower than control group.The dosage of antalgica in treatment group also significantly lower than the control group.Qing-run mixture soup can significantly discharge excrement,alleviate postoperative pain and edema,and relieved wound blood exudation,in 3 day,6 day,9 day after operation.There is no obviously side effect and no marked change of blood routin and liver-kindey merit in treatment group and control group.
Conclusion:Qing-run mixture soup can effectively alleviate the symptoms such as discharging excrement,pain,bleeding of excrement and edema.It can decrease the administrative rate and dosage of antalgic.It is safe and effective Chinese drugs pharmaceutics.
引文
[1]石焕芝,任宝印.肛门直肠疾病流行病学分析[J].中国肛肠病杂志,2000,20(3):10-12.
[2]Treitz F.uber einen neuen Muskel am Duodenum des Menschen,ubor elastiche sehen,und einige andere anatomische Verhatt-nisse.Viertel Jahrschrift Prag Heikunder(prager),1853,I:113-114.
[3]痔临床诊治指南(2006版)[J]中华胃肠外科杂志2006 9(5):461.
[4]国家中医药管理局.中华人民共和国中医药行业标准.中医肛肠病诊断疗效标准[M].第1版.南京:南京大学出版社,1995.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M]第1版.北京:中国医药科技出版社,2002:295-299.
[6]李国栋,寇玉明.中西医临床肛肠病学[M].第1版.秦皇岛:中国中医药出版社,1996:1-3
[7]黄乃健.中国肛肠病学[M].第1版.山东:山东科学技术出版社,1996:1-8
[8]陆德铭.中医外科学[M].第1版.上海:上海科学技术出版社,2002:175.
[9]Parks AG.Haemorrhoids Hosp[J].Rep,1995,104:135-156.
[10]Thomson WHF.The nature of hemorrhoids[J].Br J Surg,1975,62(5):542-552.
[11]Londer PB,Kamm MA,Nichds RJ,et al.hemmorrhoids:pathology pathophysiology and etiology[J].Br J Surg:1994,81(7):946-954.
[12]李雨农.中华肛肠病学[M].第1版.重庆:科学技术文献出版社重庆分社:1990:100.
[13]董礼.疼痛与针刺镇痛.辽宁中医杂志,2005,32(8):768.
[14]魏民.病理学.第1版,北京:中国中医药出版社,1999:99.
[15]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:111.
[16]宫锡坤,陈星灿,张蓬,等.5种中药抑菌效果的测定[J].中国消毒学杂志.1998 15(2):46
[17]王跃华,徐文俊,何俊蓉,等.川黄柏离体培养及药用成分的抑菌试验研究[J].中国中药杂志,2004,29(10):1002.
[18]王建平,张惠云,秦红岩等.鬼针草抗炎新成分的药理作用[J].中草药.1997,28(11):665.
[19]Dimo T,Rakotonirina S V,Tan P V,et al.Leaf methanol extract of Bidens pilosa prevents and attenuates the hyper tension inducedbyhigh-fructosediet inWistar rats[J].JEthnophat}nacol,2002,83(3):183-191.
[20]LechnerD,et al The antistaphylococcal activity of angelica dahupica(Bai Zhi)[J].Phvtuchanistrv 2004 65(3):331.
[21]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:580.
[22]王道芳.浅述桃仁与苦杏仁的药理及临床应用[J].基层中药杂志.2002 16(6):61.
[23]周现军.鬼针草抗炎镇痛作用[J].四川中医.2008 26(10):62.
[24]中国医学科学院药物研究所.中药志(第二册)[M].北京:人民卫生出版社,1984.89.
[25]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:243.
[26]王喜习,刘建利.柏子仁研究进展[J].中药材.2007 30(2):244.
[27]周亮,刘元法,金青析等.瓜萎籽油理化性质及瓜萎酸结构分析[J].食品科学.200728(11):116.
[28]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:602.
[29]魏龙骥.白术通便秘[J].新医药学杂志,1978,(4):9.
[30]马允慰,吴坤平,胡小鹰,等.白术对家兔离体肠管活动的影响[J].中成药研究,1982,(12):26.
[31]李树英,李绍洲,王晓萍.鬼针草注射液对中枢神经系统的作用.河南中医.1984.(3):44.
[32]孟祥颖,李晶,李向高.鬼针草的研究概况[J].中药材,2001,24(6):453.
[33]邓士贤.滇自芷的药理研究[J].中草药,1988 19(10):22.
[34]王梦月,贾敏如,马逾英等.白芷镇痛有效部位的化学成分研究[J].中国药学杂志,2005,40(8):584.
[35]王访,苏耀海.甘草的药理作用及临床应用[J].时珍国医国药,2002,13(5):304.
[36]张明发,沈雅琴,朱白平,等.薏苡仁镇痛抗炎抗血栓形成作用的研究[J].基层中药杂志.1998.12(2):34.
[37]田代.实用中医对药方[M].第1版.北京:人民卫生出版社,2000.687,697.
[38]王建.中医药学概论[M].第5版.北京:人民卫生出版社,2003.145.
[39]冉先穗.中华药海哈尔滨:哈尔滨出版社,1998:1588-1589.
(1)张东铭.痔病人民卫生出版社2004,6:76
(2)Thomson WH.The nature of haemorrhoids.BrJSurg,1975,62:542 552.
(3)Sun W M,Read NW,Shorthouse AJ.Hypertensive anal cushions as a cause of the high anal canal pressure in patiens with hemorrhoids.Br J Surg,1990,77:458-462.
(4)RomeⅡ.The functional gastrointestinal disorders.Diagnosis,pathophysi ology and treatment:a multinational consensus.Gut,1999,45(SupplⅡ):Ⅱ608.
(5)张东铭.痔源性便秘.中国实用外科杂志,2002,22:711 714.
(6)李文燕,柯美云,刘新光等.痔、便秘及腹泻的相关性调查.临床内科杂志,2006,23(4):256-258.
(7)李富增,弋巧玲.加味麻仁润肠丸治疗痔源性便秘46例临床观察.四川中医2004,22(9):74-76.
(8)2008.3.3内外科联合研讨对痔病与便秘的治疗--三亚双峰会会议纪要
(9)耿学斯,赵斌,藤赞庆.环状混和痔术后应用复方角菜酸脂栓的临床观察[J].中国肛肠病杂志,2005,25(3):39-40
(10)徐永强,吴庆平,孟惠芬.苁蓉通便口服液在混合痔术后疗效观察 中医药学刊2006,24(8):1576-1577.
(11)蔡而玮,游志华.增液汤加味治疗Ⅲ期混合痔术后便秘56例福建中医药2007(7):46-47.
[2]Treitz F.uber einen neuen Muskel am Duodenum des Menschen,ubor elastiche sehen,und einige andere anatomische Verhatt-nisse.Viertel Jahrschrift Prag Heikunder(prager),1853,I:113-114.
[3]痔临床诊治指南(2006版)[J]中华胃肠外科杂志2006 9(5):461.
[4]国家中医药管理局.中华人民共和国中医药行业标准.中医肛肠病诊断疗效标准[M].第1版.南京:南京大学出版社,1995.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M]第1版.北京:中国医药科技出版社,2002:295-299.
[6]李国栋,寇玉明.中西医临床肛肠病学[M].第1版.秦皇岛:中国中医药出版社,1996:1-3
[7]黄乃健.中国肛肠病学[M].第1版.山东:山东科学技术出版社,1996:1-8
[8]陆德铭.中医外科学[M].第1版.上海:上海科学技术出版社,2002:175.
[9]Parks AG.Haemorrhoids Hosp[J].Rep,1995,104:135-156.
[10]Thomson WHF.The nature of hemorrhoids[J].Br J Surg,1975,62(5):542-552.
[11]Londer PB,Kamm MA,Nichds RJ,et al.hemmorrhoids:pathology pathophysiology and etiology[J].Br J Surg:1994,81(7):946-954.
[12]李雨农.中华肛肠病学[M].第1版.重庆:科学技术文献出版社重庆分社:1990:100.
[13]董礼.疼痛与针刺镇痛.辽宁中医杂志,2005,32(8):768.
[14]魏民.病理学.第1版,北京:中国中医药出版社,1999:99.
[15]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:111.
[16]宫锡坤,陈星灿,张蓬,等.5种中药抑菌效果的测定[J].中国消毒学杂志.1998 15(2):46
[17]王跃华,徐文俊,何俊蓉,等.川黄柏离体培养及药用成分的抑菌试验研究[J].中国中药杂志,2004,29(10):1002.
[18]王建平,张惠云,秦红岩等.鬼针草抗炎新成分的药理作用[J].中草药.1997,28(11):665.
[19]Dimo T,Rakotonirina S V,Tan P V,et al.Leaf methanol extract of Bidens pilosa prevents and attenuates the hyper tension inducedbyhigh-fructosediet inWistar rats[J].JEthnophat}nacol,2002,83(3):183-191.
[20]LechnerD,et al The antistaphylococcal activity of angelica dahupica(Bai Zhi)[J].Phvtuchanistrv 2004 65(3):331.
[21]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:580.
[22]王道芳.浅述桃仁与苦杏仁的药理及临床应用[J].基层中药杂志.2002 16(6):61.
[23]周现军.鬼针草抗炎镇痛作用[J].四川中医.2008 26(10):62.
[24]中国医学科学院药物研究所.中药志(第二册)[M].北京:人民卫生出版社,1984.89.
[25]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:243.
[26]王喜习,刘建利.柏子仁研究进展[J].中药材.2007 30(2):244.
[27]周亮,刘元法,金青析等.瓜萎籽油理化性质及瓜萎酸结构分析[J].食品科学.200728(11):116.
[28]马清钧.临床实用中药学[M].第1版.南昌.江西科学技术出版社:2002:602.
[29]魏龙骥.白术通便秘[J].新医药学杂志,1978,(4):9.
[30]马允慰,吴坤平,胡小鹰,等.白术对家兔离体肠管活动的影响[J].中成药研究,1982,(12):26.
[31]李树英,李绍洲,王晓萍.鬼针草注射液对中枢神经系统的作用.河南中医.1984.(3):44.
[32]孟祥颖,李晶,李向高.鬼针草的研究概况[J].中药材,2001,24(6):453.
[33]邓士贤.滇自芷的药理研究[J].中草药,1988 19(10):22.
[34]王梦月,贾敏如,马逾英等.白芷镇痛有效部位的化学成分研究[J].中国药学杂志,2005,40(8):584.
[35]王访,苏耀海.甘草的药理作用及临床应用[J].时珍国医国药,2002,13(5):304.
[36]张明发,沈雅琴,朱白平,等.薏苡仁镇痛抗炎抗血栓形成作用的研究[J].基层中药杂志.1998.12(2):34.
[37]田代.实用中医对药方[M].第1版.北京:人民卫生出版社,2000.687,697.
[38]王建.中医药学概论[M].第5版.北京:人民卫生出版社,2003.145.
[39]冉先穗.中华药海哈尔滨:哈尔滨出版社,1998:1588-1589.
(1)张东铭.痔病人民卫生出版社2004,6:76
(2)Thomson WH.The nature of haemorrhoids.BrJSurg,1975,62:542 552.
(3)Sun W M,Read NW,Shorthouse AJ.Hypertensive anal cushions as a cause of the high anal canal pressure in patiens with hemorrhoids.Br J Surg,1990,77:458-462.
(4)RomeⅡ.The functional gastrointestinal disorders.Diagnosis,pathophysi ology and treatment:a multinational consensus.Gut,1999,45(SupplⅡ):Ⅱ608.
(5)张东铭.痔源性便秘.中国实用外科杂志,2002,22:711 714.
(6)李文燕,柯美云,刘新光等.痔、便秘及腹泻的相关性调查.临床内科杂志,2006,23(4):256-258.
(7)李富增,弋巧玲.加味麻仁润肠丸治疗痔源性便秘46例临床观察.四川中医2004,22(9):74-76.
(8)2008.3.3内外科联合研讨对痔病与便秘的治疗--三亚双峰会会议纪要
(9)耿学斯,赵斌,藤赞庆.环状混和痔术后应用复方角菜酸脂栓的临床观察[J].中国肛肠病杂志,2005,25(3):39-40
(10)徐永强,吴庆平,孟惠芬.苁蓉通便口服液在混合痔术后疗效观察 中医药学刊2006,24(8):1576-1577.
(11)蔡而玮,游志华.增液汤加味治疗Ⅲ期混合痔术后便秘56例福建中医药2007(7):46-47.