本文選題：七葉硝礬洗劑 + 混合痔�。� 參考：《云南中醫(yī)學院》2017年碩士論文

【摘要】：目的:觀察七葉硝礬洗劑對混合痔術后的創(chuàng)口疼痛、肛緣水腫、創(chuàng)面愈合情況等方面的臨床療效,通過對肉芽組織中的VEGF、CD68等細胞因子的粗測,探討七葉硝礬洗劑促進創(chuàng)傷修復的作用機制。方法:按病例納入標準選擇92例混合痔術后的患者,隨機分為七葉硝礬洗劑治療組46例和金玄痔科熏洗散對照組46例。治療組用七葉硝礬洗劑熏洗坐浴,對照組用金玄痔科熏洗散熏洗坐浴,分別觀察術后其改善肛緣水腫、疼痛和創(chuàng)面愈合等癥狀的時效及療效;術后治療7天分別隨機選取七葉硝礬洗劑治療組及金玄痔科熏洗散對照組各20例,切取肛緣后部創(chuàng)面肉芽組織,進行常規(guī)病理學對比觀察。治療7天觀察肉芽生長情況,分別隨機選取七葉硝礬洗劑組及金玄痔科熏洗散組各20例切取肛緣后部創(chuàng)面肉芽組織,甲醛液固定后送病理室,進行免疫組織化學檢測,測定VEGF、CD68等相關細胞因子的陽性率,進行免疫組化分析比較。治療14天創(chuàng)口面積減少率及創(chuàng)面愈合天數(shù)進行兩組比較。結果:術后7天七葉硝礬洗劑治療組肛緣創(chuàng)口水腫消退、疼痛情況改善明顯快于金玄痔科熏洗散對照組(P0.05)。術后7天肉芽組織生長治療組明顯快于金玄痔科熏洗散對照組(P0.05)。術后7天VEGF、CD68陽性率治療組明顯高于對照組(P0.05)。術后14天創(chuàng)口面積減少率,治療組明顯高于對照組,創(chuàng)口愈合時間,清熱涼血、消腫止痛的七葉硝礬洗劑治療組明顯短于對照組。結論:七葉硝礬洗劑用于混合痔術后熏洗,能明顯減輕術后肛緣水腫疼痛、促進創(chuàng)面?zhèn)谟?促進肉芽組織生長,促進混合痔術后創(chuàng)口愈合。其促進創(chuàng)傷修復的作用機制可能與血管內(nèi)皮生長因子(VEGF)、巨噬細胞(CD68)有關。
[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.
【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R266

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