黄连紫草膏促进混合痔术后创面愈合的临床观察

发布时间：2018-04-15 06:31

本文选题：黄连紫草膏 + 混合痔术后　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:观察混合痔患者术后创面愈合的全过程,评价黄连紫草膏在创面愈合时间、创面肉芽组织生长情况、成纤维细胞数及防治水肿等方面疗效。初步探讨换黄连紫草膏促进创面愈合的作用机理。方法:将符合诊断标准的60例混合痔的患者纳入本课题中,按照随机分组、平行对照的设计方法分为治疗组(黄连紫草膏组)、对照组(龙珠软膏组),均为30例。两组患者均在腰硬联合麻醉方式下行混合痔外剥内扎术。两组患者自术后第1天起,每日排便后均用温开水熏洗坐浴,马应龙麝香痔疮栓纳肛,治疗组换药时给予黄连紫草膏(由河南中医药大学第一教学医院药剂科供应)纱条外敷,对照组换药时给予龙珠软膏(由马应龙药业集团股份有限公司生产国家药监局药批准字号为Z10950017)纱条外敷,1次/日,直至创面完全愈合。两组患者在年龄、性别、创面面积等方面均无统计学差异,具有可比性(P0.05)。用药前后观察并记录肝肾功能变化及有无药物不良反应;在创面愈合的过程中,换药者仔细观察两组患者用药后(第2、6、13天)临床症状体征如创面疼痛、水肿等情况,并对其进行量化评分。在用药后第6、13天观察创面生长情况,详细记录量化评分。并从两组患者中分别抽取20名患者,在用药后的第6、13天各取创面中央正常组织一枚,做病理切片,镜下观察两组成纤维细胞个数;并记录每组患者创面的愈合时间。并对以上各指标进行统计学分析。结果:1.黄连紫草膏组无肝肾功能损害及不良反应,疗效显著;2.黄连紫草膏组在缓解疼痛方面与龙珠软膏组无明显统计学差异(P0.05);在治疗水肿方面较龙珠软膏组比,在用药后第2天,P0.05,无统计学意义,在第6天、13天,有显著差异(P0.05);在创面肉芽生长情况方面,黄连紫草膏组与龙珠软膏相比,在第6、13天P0.05,差异有统计学意义。结果表明黄连紫草膏与龙珠软膏相比,在用药后第6天能明显促进创面肉芽生长;黄连紫草膏组创面平均愈合时间为(19.63±1.30),龙珠软膏组平均愈合时间为(22.53±2.40),比龙珠软膏组提前2.9天,有显著差异(P0.05);在用药后第6天,黄连紫草膏组成纤维细胞数明显高于龙珠软膏组(P0.05),差异有显著性意义;用药后第13天,黄连紫草膏组组内比较,提示成纤维数目增生程度较前降低,而龙珠软膏组成纤维细胞数较前增多(P0.05),但低于治疗组第7天的成纤维数目,差异有统计学意义。黄连紫草膏能使混合痔术后伤面成纤维细胞显著增生,使其较早的分化成熟为纤维细胞,加快切口愈合。结论:1.黄连紫草膏在临床用药过程中,疗效确切,无明显不良反应及副作用。2.黄连紫草膏在痔疮术后创面愈合过程中,能明显减轻创面水肿;3.黄连紫草膏能促进创面肉芽组织生长,促进成纤维细胞增殖,使其尽快分化成熟为纤维细胞,缩短了创面完全上皮化所用时间。
[Abstract]:Objective: to observe the whole process of wound healing in patients with mixed hemorrhoids, and to evaluate the effect of Coptis chinensis ointment on wound healing time, granulation tissue growth, fibroblast count and edema prevention and treatment.Objective: to explore the mechanism of promoting wound healing by Rhizoma Coptidis Lagerica ointment.Methods: sixty patients with mixed hemorrhoids who met the diagnostic criteria were included in this study. According to the design method of randomized and parallel control, they were divided into treatment group (Rhizoma Coptidis) and control group (Longzhu ointment group, 30 cases).Both groups were treated with combined spinal-epidural anesthesia and combined hemorrhoid exfoliation and internal ligation.From the first day after operation, the patients in both groups were treated with warm boiled water after daily defecation. Ma Yinglong's Shexiang hemorrhoids suppository accepted anus. The treatment group was treated with Coptis purpura ointment (supplied by the Pharmacy Department of the first Teaching Hospital of Henan University of traditional Chinese Medicine).The control group was treated with Longzhu ointment (Z10950017 by Ma Yinglong Pharmaceutical Group Co., Ltd.) gauze gauze was applied once a day until the wound healed completely.There was no significant difference in age, sex and wound area between the two groups.The changes of liver and kidney function and adverse drug reactions were observed and recorded before and after treatment. During the healing of the wound, the patients in the two groups were carefully observed the clinical symptoms and signs such as pain and edema of the wound.And the quantitative score.The wound growth was observed on the 6th day after treatment and the quantitative score was recorded in detail.20 patients were selected from the two groups, and one normal tissue was taken from the central tissue of the wound on the 13th day after treatment, and the number of the fibroblasts was observed under microscope, and the healing time of the wound in each group was recorded.The above indexes were analyzed statistically.The result is 1: 1.Rhizoma Coptidis ointment group had no damage of liver and kidney function and adverse reaction, and the curative effect was 2. 5%.There was no significant difference in pain relief between Rhizoma Coptidis and Longzhu ointment group (P 0.05), but there was no significant difference in treatment of edema between Rhizoma Coptidis and Longzhu ointment group (P 0.05) on the 2nd day after treatment.There was a significant difference in granulation growth of wound surface between Rhizoma Coptidis and Longzhu ointment on the 6th 13th day (P0.05), the difference was statistically significant in Rhizoma Coptidis Ointment group and Longzhu Ointment group.The results showed that the average healing time of Rhizoma Coptidis and Longzhu ointment was 19.63 卤1.30 and 22.53 卤2.40, 2.9 days earlier than that of Longzhu ointment, respectively, on the 6th day after treatment, the mean healing time of wound was 19.63 卤1.30 in Rhizoma Coptidis ointment group and 2.40 in Longzhu ointment group, which was 2.9 days earlier than that in Longzhu ointment group.On the 6th day after treatment, the number of fibrous cells of Rhizoma Coptidis ointment was significantly higher than that of Longzhu ointment group (P 0.05), and the difference was significant on the 13th day after treatment, the number of fiber cells in Rhizoma Coptidis ointment group was higher than that in Rhizoma Coptidis ointment group.The results suggested that the number of fibroblasts in the treated group was significantly lower than that in the treatment group on the 7th day, but the number of fibroblasts in the treated group was significantly lower than that in the treatment group.Rhizoma Coptidis can significantly proliferate fibroblasts after mixed hemorrhoids operation, make them differentiate and mature into fibroblasts earlier, and accelerate wound healing.Conclusion 1.Rhizoma Coptidis ointment is effective in the course of clinical medication, no obvious adverse reactions and side effects. 2. 2.Rhizoma Coptidis ointment in hemorrhoids postoperative wound healing process, can significantly reduce wound edema.Coptis chinensis ointment can promote the growth of wound granulation tissue, promote the proliferation of fibroblasts, make it differentiate and mature into fibroblasts as soon as possible, and shorten the time of complete epithelization of wound surface.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R266

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