龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响

陈莹璐; 钟传篪; 徐月; 陈霞

doi:10.13422/j.cnki.syfjx.2017080178

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龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响

临床 | 更新时间：2024-01-04

- 龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响
- Healing Effect of Longxuejie Capsule and Jiuhua Ointment Treatment on Wound After Mixed Hemorrhoid Surgery and Its Effect on Neovascularization
- 中国实验方剂学杂志 2017年23卷第8期页码：178-183
- 作者机构：
- 作者简介：
- 基金信息：
  
  重庆市卫生和计计划生育委员会医学科研计划项目（20142069）
- DOI：10.13422/j.cnki.syfjx.2017080178
  中图分类号： R266
- 纸质出版日期：2017
- 稿件说明：
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陈莹璐, 钟传篪, 徐月, 等. 龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响[J]. 中国实验方剂学杂志, 2017,23(8):178-183.

CHEN Ying-lu, ZHONG Chuan-chi, XU Yue, et al. Healing Effect of Longxuejie Capsule and Jiuhua Ointment Treatment on Wound After Mixed Hemorrhoid Surgery and Its Effect on Neovascularization[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(8): 178-183.
陈莹璐, 钟传篪, 徐月, 等. 龙血竭胶囊合九华膏对环状混合痔术后创面促愈作用及对新生血管形成的影响[J]. 中国实验方剂学杂志, 2017,23(8):178-183. DOI： 10.13422/j.cnki.syfjx.2017080178.

CHEN Ying-lu, ZHONG Chuan-chi, XU Yue, et al. Healing Effect of Longxuejie Capsule and Jiuhua Ointment Treatment on Wound After Mixed Hemorrhoid Surgery and Its Effect on Neovascularization[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(8): 178-183. DOI： 10.13422/j.cnki.syfjx.2017080178.

摘要

目的：观察龙血竭胶囊合九华膏对环状混合痔术后恢复的疗效，及其对创面和血清血管内皮生长因子的影响。方法：将190例患者根据入院先后顺序，随机按数字表法分为对照组和观察组各95例。两组患者均行分段多层次弧切缝合加注射术，术后常规进行抗生素静脉滴注预防感染；并内服芪蓉润肠口服液，20 mL/次，3次/d，便后采用苦参汤伤口清洗。对照组采用马应龙麝香痔疮膏涂抹肛门，以无菌纱布覆盖创面，1 g/次，1～2次/d。观察组以龙血竭胶囊合九华膏涂抹肛门，以无菌纱布覆盖创面，1 g/次，1～2次/d。两组疗程均为10 d。记录术后第3，10天创面的疼痛、水肿、创面渗液、创面面积和创面肉芽组织情况，记录创面愈合时间；评价术后10 d创面毛细血管含量，采用免疫组化评价创面血管内皮生长因子（VEGF），碱性成纤维生长因子（bFGF）表达情况；检测治疗前后血清血小板源性生长因子（PDFG），血管内皮生长因子（VEGF），碱性成纤维生长因子（bFGF）。结果：术后10 d，观察组临床疗效总有效率为91.58%，优于对照组的77.89%（χ2=6.877，P<0.01）；观察组在术后3 d和10 d疼痛、水肿、创面渗液、创面面积和创面肉芽组织评分均低于同期对照组（P<0.01）；观察组创面平均愈合时间为（11.5±2.1）d，低于对照组的（13.7±2.5）d，比较差异有统计学意义（P<0.01）；观察组创面毛细血管数目多于对照组（P<0.01），观察组创面VEGF和bFGF表达的MOD值高于对照组（P<0.01）；治疗后观察组患者血清PDFG，VEGF和bFGF水平均高于对照组，差异有统计学意义（P<0.01）。治疗过程中未发现与龙血竭联合九华膏相关不良反应。结论：采用龙血竭胶囊合九华膏治疗环状混合痔术后创面的治疗，能促进创面的修复，缩短愈合时间，其作用机制可能与调节血清和创面VEGF，PDFG，bFGF等因子表达，促进创面毛细管血管形成，促使肉芽组织生长与修复有关。

Abstract

Objective: To observe the effect of Longxuejie capsule and Jiuhua ointment on the recovery after mixed hemorrhoid surgery

and the wound and serum vascular endothelial growth factor. Method: One hundred and ninety patients were randomly divided into control group (95 cases) and observation group (95 cases) by random number table. Both groups' patients got segmented multi-layer arc-cut suture surgery. After the surgery

intravenous dripping of antibiotics was provided for prevention of infection. The patients took Qirong Runchang oral solution

20 mL/time

3 times/day. After defecation

Kushen soup was used for cleaning the wound. Patients in control group used Mayinglong hemorrhoids ointment at anus

1 g/time

1-2 time/day

the wound was covered with sterile gauze. Patients in observation group got Longxuejie capsule and Jiuhua ointment 1 g/time

1-2 time/day

the wound was covered with sterile gauze. The course of treatment was 10 days. At the 3th and 10th after surgery

pain

edema

wound exudates

wound area and wound granulation tissue were recorded. At the 10th after surgery

wound capillary content was evaluated

and expression of wound's vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were evaluated by immunohistochemistry. And levels of serum platelet-derived growth factor (PDFG)

VEGF and bFGF before and after treatment were detected. Result: At the 10th day after surgery

the total effective rate in observation was 91.58%

which was superior to 77.89% in control group (χ2=6.877

P<0.01). At the 3th and 10th day after the surgery

scores of pain

edema

wound exudates

wound area and wound granulation tissue were all lower than those in control group (P<0.01). Mean healing time of wound was (11.5±2.1) days

which was less than (13.7±2.5) days in control group

with statistically significant difference (P<0.01). At the 10th day after treatment

expression of wound's vascular endothelial growth factor

VEGF

bFGF and MOD in observation group were more than that in control group (P<0.01). After treatment

PDFG

VEGF and bFGF in serum of observation group were higher than those in control group

with statistically significant difference (P<0.01). There was no adverse reaction caused by Longxuejie capsule and Jiuhua ointment. Conclusion: Longxuejie capsule and Jiuhua ointment can promote the recovery of wound

and shorten healing time. Its mechanism may be correlated with regulation of the expressions of VEGF

PDFG and bFGF

and promotion of formation of wound capillary blood vessels

granulation tissue growth and repair.

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