消肿止痛洗剂熏洗对混合痔术后创面愈合的临床观察

发布时间：2019-01-10 18:23

【摘要】：痔是肛肠科常见病,其在临床上的主要表现有肛门处出现水肿、疼痛、瘙痒甚至肛门坠胀等症状,并伴随大便出血等现象。采用手术治疗快捷有效,但是术后创面的水肿,疼痛以及创面的延期愈合,严重影响手术的治疗效果。大量的临床试验及资料证明中药熏洗坐浴对混合痔术后创面具有良好的促愈作用。1目的:对混合痔术后患者采用消肿止痛洗剂进行熏洗坐浴,验证其对创面的促愈作用。2方法:本课题的病例均来源于滁州市中西医结合医院肛肠科,时间为2015年6月份到2015年12月,在此时间段的住院的混合痔患者60人。然后随机的把这病例分组,治疗组和对照组各30例,治疗组术后第1天排便后开始使用消肿止痛洗剂(药物组成:大黄、芒硝、苍术、黄柏、苦参、赤芍、白芷)熏洗坐浴,随后用马应龙痔疮膏换药。对照组给予1/5000高锰酸钾液熏洗坐浴,随后用马应龙痔疮膏外用。主要观察和记录患者的诸多症状,比如疼痛、水肿、有无渗液、肉芽形态,成纤维细胞的数量情况,创面愈合时间等作为主要指标进行观察,收集临床数据,进行统计学分析。3结果:经统计学处理,对患者的疼痛,水肿,创面渗液状况进行对比,以术后2天,术后7天,术后14天为时间节点观察比较。疼痛状况术后2天,7天的数值显示:均有显著性差异(P0.05),术后14天(P0.05)无显著差异。水肿情况:术后第2天(P0.05),无显著差异。术后7天,14天均有显著性差异(P0.05)。对患者创面渗液情况进行对比,术后第2天创面渗液较对照组多,但是术后第7天,第14天(P0.05),说明早期形成湿润的创面环境,中后期明显减少创面渗液。观察肉芽生长状况对比,术后第7天和第14天的肉芽生长情况比较,(P0.05)。治疗组明显优于对照组。创面愈合时间方面,(P0.05),治疗组明显优于对照组。观察成纤维细胞第3天(P0.05),两组数字无差异。第8天(P0.05),说明治疗组数量比对照组多。4结论:通过应用消肿止痛洗剂用于混合痔患者术后,能减轻术后疼痛,消除水肿,有利于成纤维细胞生长,缩短创面愈合时间,促进创面愈合。此外且在临床熏洗过程中及出院随访中均未出现任何毒副作用及皮肤过敏现象。中药熏洗应用实施简单方便,安全有效,患者依从性好。
[Abstract]:Hemorrhoids is a common disease in anorectal department. Its clinical manifestations include edema, pain, itching and even anal distention, accompanied by stool bleeding and so on. The surgical treatment is quick and effective, but the edema, pain and delayed healing of the wound after operation seriously affect the curative effect of the operation. A large number of clinical trials and data have proved that traditional Chinese medicine fumigation and sitting bath has a good effect on the healing of postoperative wounds of mixed hemorrhoids. 1 objective: to take fumigation and sit bath with anti-swelling and analgesic lotion for patients with mixed hemorrhoids after operation. Methods: all the patients in this study were from the anorectal department of Chuzhou integrated Chinese and western medicine hospital, from June 2015 to December 2015. 60 patients with mixed hemorrhoids were hospitalized in this period. Then the cases were randomly divided into treatment group (30 cases) and control group (30 cases). The treatment group began to use detumescence and analgesic lotion (drug composition: rhubarb, mirabilite, Atractylodes, Cortex Phellodendri, Sophora flavescens, Radix Paeoniae Alba, Radix angelicae dahurica) after the first day of defecation. Then with Ma Ying long hemorrhoids ointment change medicine. The control group was given 1 / 5 000 potassium permanganate solution to fumigation and wash sit bath, then used Ma Ying long hemorrhoids ointment for external use. We mainly observed and recorded many symptoms of the patients, such as pain, edema, exudation, granulation morphology, the number of fibroblasts, wound healing time and so on, and collected clinical data. Results: after statistical treatment, the pain, edema and exudation of the wound were compared, and the two days, seven days and fourteen days after the operation were observed and compared. Pain status 2 days, 7 days value showed: there were significant differences (P0.05), postoperative 14 days (P0.05) no significant difference. Edema: on the second day after operation (P0.05), there was no significant difference. There were significant differences on 7 days and 14 days after operation (P0.05). On the second day after operation, there was more exudate on the wound surface than in the control group, but on the 7th and 14th days after operation (P0.05), the wet wound environment was formed in the early stage and the wound effusion was significantly reduced in the middle and late stage. The granulation growth was compared on the 7th day and the 14th day after operation (P0.05). The treatment group was superior to the control group. Wound healing time, (P0.05), the treatment group was significantly better than the control group. The fibroblasts were observed on the 3rd day (P0.05), and there was no difference between the two groups. On the 8th day (P0.05), the number of the treatment group was more than that of the control group. Conclusion: the treatment group can reduce the postoperative pain, eliminate the edema and benefit the growth of fibroblasts by using detumescence and analgesic lotion for the patients with mixed hemorrhoids. Shorten wound healing time and promote wound healing. In addition, there were no toxic side effects and skin allergy in the course of clinical fumigation and discharge. The application of traditional Chinese medicine fumigation is simple and convenient, safe and effective, and patient compliance is good.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R266

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