七叶硝矾洗剂促进混合痔术后创面愈合的临床研究及对相关细胞因子的影响

发布时间：2018-05-03 08:02

本文选题：七叶硝矾洗剂 + 混合痔　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:观察七叶硝矾洗剂对混合痔术后的创口疼痛、肛缘水肿、创面愈合情况等方面的临床疗效,通过对肉芽组织中的VEGF、CD68等细胞因子的粗测,探讨七叶硝矾洗剂促进创伤修复的作用机制。方法:按病例纳入标准选择92例混合痔术后的患者,随机分为七叶硝矾洗剂治疗组46例和金玄痔科熏洗散对照组46例。治疗组用七叶硝矾洗剂熏洗坐浴,对照组用金玄痔科熏洗散熏洗坐浴,分别观察术后其改善肛缘水肿、疼痛和创面愈合等症状的时效及疗效;术后治疗7天分别随机选取七叶硝矾洗剂治疗组及金玄痔科熏洗散对照组各20例,切取肛缘后部创面肉芽组织,进行常规病理学对比观察。治疗7天观察肉芽生长情况,分别随机选取七叶硝矾洗剂组及金玄痔科熏洗散组各20例切取肛缘后部创面肉芽组织,甲醛液固定后送病理室,进行免疫组织化学检测,测定VEGF、CD68等相关细胞因子的阳性率,进行免疫组化分析比较。治疗14天创口面积减少率及创面愈合天数进行两组比较。结果:术后7天七叶硝矾洗剂治疗组肛缘创口水肿消退、疼痛情况改善明显快于金玄痔科熏洗散对照组(P0.05)。术后7天肉芽组织生长治疗组明显快于金玄痔科熏洗散对照组(P0.05)。术后7天VEGF、CD68阳性率治疗组明显高于对照组(P0.05)。术后14天创口面积减少率,治疗组明显高于对照组,创口愈合时间,清热凉血、消肿止痛的七叶硝矾洗剂治疗组明显短于对照组。结论:七叶硝矾洗剂用于混合痔术后熏洗,能明显减轻术后肛缘水肿疼痛、促进创面伤口愈合,促进肉芽组织生长,促进混合痔术后创口愈合。其促进创伤修复的作用机制可能与血管内皮生长因子(VEGF)、巨噬细胞(CD68)有关。
[Abstract]:Objective: to observe the clinical effect of aescinate lotion on wound pain, anal edema and wound healing after operation of mixed hemorrhoids, and to measure the cytokines such as VEGF CD68 in granulation tissue. To explore the mechanism of aescinate lotion in promoting wound repair. Methods: 92 patients with mixed hemorrhoids after operation were randomly divided into two groups: the treated group (n = 46) and the control group (n = 46). In the treatment group, the sitting bath was fumigated with aescinate alum lotion, and in the control group, Jinxuan hemorrhoids was used to fumigate and wash the sitting bath. The time and efficacy of improving the symptoms of anal edema, pain and wound healing after operation were observed respectively. Seven days after operation, 20 cases in the control group and 20 cases in the control group were randomly selected. The granulation tissue of the posterior anal margin wound was removed, and the routine pathological observation was carried out. The granulation growth was observed on the 7th day of treatment. The granulation tissues of the posterior anal margin wounds were taken from 20 cases in each group and 20 cases in each group. Formaldehyde solution was fixed and sent to the pathological room for immunohistochemical examination. The positive rates of VEGF CD68 and other related cytokines were determined and compared with immunohistochemical analysis. The reduction rate of wound area and the days of wound healing were compared between the two groups. Results: on the 7th day after operation, the edema of the anal margin in the treatment group was relieved, and the pain was improved more quickly than that in the control group (P 0.05). 7 days after operation, granulation tissue growth in the treatment group was significantly faster than that in the Jinxuan hemorrhoids fumigation and washing powder control group (P 0.05). The positive rate of VEGF CD68 in the treatment group was significantly higher than that in the control group on 7 days after operation (P 0.05). The reduction rate of wound area in the treatment group was significantly higher than that in the control group on the 14th day after operation. The wound healing time, clearing heat and cooling blood, detumescence and pain relief were significantly shorter in the treatment group than in the control group. Conclusion: the application of aescinate alum lotion in postoperative fumigation and washing of mixed hemorrhoids can obviously reduce the pain of perianal edema, promote wound healing, promote granulation tissue growth, and promote wound healing after mixed hemorrhoids. The mechanism of promoting wound repair may be related to vascular endothelial growth factor (VEGF), macrophage CD68.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R266

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