针刺对湿热壅滞型混合痔术后脱线期炎症因子、创缘水肿及膀胱尿动力学的影响

Effects of acupuncture on inflammatory factors，traumatic edge edema and cystourodynamics in the off-line period of postoperative hemorrhoids with damp-heat obstructing type

关键词:  针刺  混合痔  脱线期  炎症  膀胱尿动力学  镇痛药追加率

Key words:  acupuncture  mixed hemorrhoids  off-line stage  inflammation  cysturodynamics  analgesic supplemental rate

摘要:

[目的] 观察针刺对混合痔术后脱线期炎症因子、创缘水肿及膀胱尿动力学的影响。[方法] 选择于中国中医科学院广安门医院南区80例行外剥内扎术治疗的混合痔患者，按随机数字表法随机分为假针刺组和针刺组，每组40例。两组均行外剥内扎术治疗，术后给予常规对症治疗，假针刺组术后第4天进行假针治疗，针刺组术后第4天进行针刺治疗，治疗4 d后评价两组临床疗效。针刺前后给予中医证候评价，进行数字评估量表（NRS）评价，记录术后第4天起镇痛药追加率，进行创缘水肿评价，检测患者膀胱尿动力学指标逼尿肌压力、最大尿流量，检测两组血液指标降钙素原（PCT）、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）水平。[结果] 治疗后，针刺组总有效率高于假针刺组（P<0.05）；针刺组中医证候评分低于假针刺组（P<0.05），针刺组NRS、创缘水肿评分低于假针刺组（P<0.05），针刺组镇痛药追加率低于假针刺组（P<0.05）；针刺组逼尿肌压力、最大尿流量高于假针刺组（P<0.05）；针刺组血清IL-6、PCT、hs-CRP水平低于假针刺组（P<0.05）。[结论] 针刺治疗混合痔术后脱线期患者可提升临床疗效，降低中医证候评分，改善创缘水肿，缓解疼痛，降低镇痛药追加率，改善膀胱尿动力学，抑制炎症。

Abstract:

[Objective] To observe the effects of acupuncture on inflammatory factors，traumatic edge edema，and bladder urodynamics in the off-line period after mixed hemorrhoid surgery. [Methods] Eighty patients with mixed hemorrhoids treated with external stripping and internal ligation were selected from the southern district of Guang’anmen Hospital，China Academy of Chinese Medical Sciences. The random number table method was used to divide the patients into the sham acupuncture group and the acupuncture group，with 40 cases in each group. Both groups were treated with external stripping and internal ligation and received conventional symptomatic treatment after surgery. The sham acupuncture group received the sham acupuncture treatment on the 4th day after the operation，and the acupuncture group received the acupuncture treatment on the 4th day after the operation. The clinical efficacy of the two groups was evaluated after 4 d treatment，and traditional Chinese medicine（TCM） syndrome evaluation was given before and after acupuncture. The Digital Assessment Scale（NRS） was evaluated. The rate of analgesic addition from the 4th day after surgery was recorded. An assessment of traumatic edema was performed. Vesiculodynamic parameters，such as detrusor pressure and maximum urine flow，were detected. The levels of procalcitonin（PCT），interleukin-6（IL-6） and hypersensitive C-reactive protein（hs-CRP） were measured. [Results] The total effective rate of the acupuncture group was higher than that of the sham acupuncture group（P<0.05）. The TCM syndrome score of the acupuncture group was lower than that of the sham acupuncture group（P<0.05）. The scores of NRS and traumatic edge edema in the acupuncture group were lower than those in sham acupuncture group（P<0.05）. The addition rate of analgesic drugs in the acupuncture group was lower than that in the sham acupuncture group（P<0.05）. Detrusor pressure and maximum urine flow in the acupuncture group were higher than those in the sham acupuncture group（P<0.05）. The levels of IL-6，PCT and hs-CRP in the acupuncture group were lower than those in the sham acupuncture group（P<0.05）. [Conclusion] Acupuncture treatment of patients with mixed hemorrhoids at the off-line stage after surgery can improve clinical efficacy，reduce TCM syndrome score，improve traumatic edge edema，relieve pain，reduce the supplemental rate of analgesics，improve bladder urodynamics，and inhibit inflammation.