便血方改善内痔患者临床症状的相关机制研究

王启; 王华; 童蕾; 钦梦婷

doi:10.16766/j.cnki.issn.1674-4152.003605

便血方改善内痔患者临床症状的相关机制研究

doi: 10.16766/j.cnki.issn.1674-4152.003605

王启^1, ,,
王华²,
童蕾¹,
钦梦婷¹

1.
嘉兴市中医医院肛肠科，浙江嘉兴 314001
2.
嘉兴市中医医院妇科

基金项目:

浙江省中医药科技计划项目 2022ZB349

详细信息

通讯作者:
王启，E-mail: qiqi4232010@163.com

中图分类号: R657.1 R243
计量
- 文章访问数: 140
- HTML全文浏览量: 72
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2024-03-11
- 网络出版日期: 2024-09-05

Study on the related mechanisms of Bianxue Formula in improving clinical symptoms of patients with internal hemorrhoids

1.
Department of Anorectal, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang 314001, China

摘要

摘要: 目的为提高内痔临床治疗水平，探索科学有效的中西医结合治疗途径，本研究探讨便血方用于改善内痔患者临床症状的疗效。方法选取2020年1月—2023年12月嘉兴市中医医院肛肠科收治的150例Ⅰ、Ⅱ度内痔患者为研究对象，采用随机数表法分为对照组(75例)和观察组(75例)。对照组予以复方角菜酸酯栓治疗，观察组在复方角菜酸酯栓基础上增加便血方治疗。比较患者治疗前后便血、坠痛及黏膜状态等临床症状改善情况，评价临床疗效水平，检测血清血管内皮因子和炎症因子含量变化，观察治疗期间药物不良反应。结果观察组治疗后便血评分、坠痛评分和痔核黏膜状态评分均低于对照组(P < 0.001)。观察组内痔治疗总有效率[93.33%(70/75)]显著高于对照组[74.67%(56/75), P＜0.05]。观察组治疗后血清内皮素-1(EF-1)、细胞间黏附因子-1(ICAM-1)、血管细胞黏附因子-1(VCAM-1)和内皮一氧化氮合酶(eNOS)等血管内皮因子水平均低于对照组(P < 0.001)。观察组治疗后血清IL-1β、IL-6、IL-8和TNF-α等炎症因子含量均低于对照组(P < 0.001)。结论便血方联合复方角菜酸酯栓治疗可有效缓解内痔患者临床症状，提高临床疗效，临床症状的改善可能与便血方抑制血管内皮损伤和炎症反应的相关性。
- 内痔 /
- 复方角菜酸酯栓 /
- 便血方 /
- 临床症状 /
- 血管内皮损伤 /
- 药理机制
Abstract: Objective In order to improve the clinical treatment level of internal hemorrhoids and explore a scientifically effective combination of traditional Chinese and Western medicine treatment approach, this study explores the clinical effect and pharmacological mechanism of Bianxue Formula to improve clinical symptoms in patients with internal hemorrhoids. Methods A total of 150 patients with grade Ⅰ and Ⅱ internal hemorrhoids admitted to the Department of Anorectal of Jiaxing Hospital of Traditional Chinese Medicine from January 2020 to December 2023 were selected as the research objects. According to the random number table method, they were divided into the control group (75 cases) and the observation group (75 cases). The control group was treated with compound cabbage ester suppository, while the observation group was treated with an additional formula for constipation and bleeding on the basis of compound carrageenan suppositories. The improvement of clinical symptoms such as rectal bleeding, pain, and hemorrhoid mucosal status before and after treatment were observed, the level of clinical efficacy was evaluated, the changes in serum vascular endothelial factor and inflammatory factor levels were detected, and the adverse drug reactions during treatment were followed up. Results After treatment, the observation group had lower scores for rectal bleeding, falling pain, and hemorrhoid mucosal status compared to the control group (P < 0.001). The overall effective rate of hemorrhoid treatment in the observation group [93.33% (70/75)] was higher than the control group [74.67% (56/75), P < 0.05]. The levels of vascular endothelial factors in serum such as endothelin 1 (EF-1), intercellular adhesion factor-1 (ICAM-1), vascular cell adhesion factor-1 (VCAM-1), and endothelial nitric oxide synthase (eNOS) in the observation group after treatment was lower than the control group (P < 0.001). The content of inflammatory factors in serum such as IL-1β, IL-6, IL-8, and TNF-α in the observation group after treatment were lower than the control group (P < 0.001). Conclusion The combination of Bianxue Formula and compound cabbage ester suppository can effectively alleviate clinical symptoms in patients with internal hemorrhoids, improve clinical efficacy, and the improvement of clinical symptoms is closely related to the pharmacological mechanism of Bianxue Formula in inhibiting vascular endothelial injury and inflammatory response.
- Internal hemorrhoids /
- Compound cabbage ester suppository /
- Bianxue Formula /
- Clinical symptoms /
- Vascular endothelial injury /
- Pharmacological mechanism

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表 1 2组内痔患者治疗前后临床症状评分比较(x ±s，分)

Table 1. Comparison of clinical symptom scores between two groups before and after treatment in patients with internal hemorrhoids (x ±s, points)

组别	例数	便血评分		坠痛评分		痔核黏膜状态评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	3.57±0.61	2.07±0.50^b	1.52±0.49	0.93±0.21^b	2.36±0.52	1.46±0.39^b
观察组	75	3.64±0.65	1.26±0.46^b	1.49±0.51	0.62±0.17^b	2.41±0.54	0.98±0.23^b
统计量		0.656^a	16.583^c	0.367^a	15.291^c	0.578^a	13.674^c
P值		0.513	＜0.001	0.714	＜0.001	0.564	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 2 2组内痔患者内痔临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy between two groups in patients with internal hemorrhoids[cases (%)]

组别	例数	治愈	有效	无效	总有效
对照组	75	20(26.67)	36(48.00)	19(25.33)	56(74.67)
观察组	75	29(38.67)	41(54.67)	5(6.67)	70(93.33)
注：2组总有效率比较，χ²=9.722，P=0.002。

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表 3 2组内痔患者治疗前后血清血管内皮因子含量比较(x ±s)

Table 3. Comparison of serum vascular endothelial factors before and after treatment between two groups in patients with hemorrhoids (x ±s)

组别	例数	EF-1(ng/L)		ICAM-1(μg/L)		VCAM-1(μg/L)		eNOS(μmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	42.39±3.82	28.63±2.94^b	528.63±19.84	316.59±14.39^b	375.74±16.27	241.54±11.62^b	86.15±6.92	42.06±3.47^b
观察组	75	41.84±3.67	21.47±2.56^b	530.84±20.23	237.06±13.48^b	378.26±16.93	167.26±10.94^b	85.62±7.04	29.35±2.81^b
统计量		0.899^a	32.526^c	0.675^a	42.361^c	0.929^a	35.847^c	0.465^a	26.413^c
P值		0.370	＜0.001	0.501	＜0.001	0.354	＜0.001	0.643	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组内痔患者治疗前后血清炎症因子含量比较(x ±s)

Table 4. Comparison of serum inflammatory factors before and after treatment between two groups in hemorrhoids patients (x ±s)

组别	例数	IL-1β(ng/L)		IL-6(ng/L)		IL-8(ng/L)		TNF-α(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	73.65±6.27	39.48±3.16^b	136.79±11.64	63.41±6.57^b	182.56±14.81	85.49±7.26^b	29.26±2.83	17.35±1.69^b
观察组	75	73.82±6.41	18.32±2.04^b	135.42±11.93	31.82±3.41^b	185.17±15.29	42.07±4.13^b	28.74±2.69	8.41±1.12^b
统计量		0.164^a	34.062^c	0.712^a	37.564^c	1.062^a	30.471^c	1.153^a	28.453^c
P值		0.869	＜0.001	0.478	＜0.001	0.290	＜0.001	0.251	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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