本文選題：黃連紫草膏 + 混合痔術(shù)后�。� 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察混合痔患者術(shù)后創(chuàng)面愈合的全過程,評價黃連紫草膏在創(chuàng)面愈合時間、創(chuàng)面肉芽組織生長情況、成纖維細胞數(shù)及防治水腫等方面療效。初步探討換黃連紫草膏促進創(chuàng)面愈合的作用機理。方法:將符合診斷標準的60例混合痔的患者納入本課題中,按照隨機分組、平行對照的設(shè)計方法分為治療組(黃連紫草膏組)、對照組(龍珠軟膏組),均為30例。兩組患者均在腰硬聯(lián)合麻醉方式下行混合痔外剝內(nèi)扎術(shù)。兩組患者自術(shù)后第1天起,每日排便后均用溫開水熏洗坐浴,馬應(yīng)龍麝香痔瘡栓納肛,治療組換藥時給予黃連紫草膏(由河南中醫(yī)藥大學(xué)第一教學(xué)醫(yī)院藥劑科供應(yīng))紗條外敷,對照組換藥時給予龍珠軟膏(由馬應(yīng)龍藥業(yè)集團股份有限公司生產(chǎn)國家藥監(jiān)局藥批準字號為Z10950017)紗條外敷,1次/日,直至創(chuàng)面完全愈合。兩組患者在年齡、性別、創(chuàng)面面積等方面均無統(tǒng)計學(xué)差異,具有可比性(P0.05)。用藥前后觀察并記錄肝腎功能變化及有無藥物不良反應(yīng);在創(chuàng)面愈合的過程中,換藥者仔細觀察兩組患者用藥后(第2、6、13天)臨床癥狀體征如創(chuàng)面疼痛、水腫等情況,并對其進行量化評分。在用藥后第6、13天觀察創(chuàng)面生長情況,詳細記錄量化評分。并從兩組患者中分別抽取20名患者,在用藥后的第6、13天各取創(chuàng)面中央正常組織一枚,做病理切片,鏡下觀察兩組成纖維細胞個數(shù);并記錄每組患者創(chuàng)面的愈合時間。并對以上各指標進行統(tǒng)計學(xué)分析。結(jié)果:1.黃連紫草膏組無肝腎功能損害及不良反應(yīng),療效顯著;2.黃連紫草膏組在緩解疼痛方面與龍珠軟膏組無明顯統(tǒng)計學(xué)差異(P0.05);在治療水腫方面較龍珠軟膏組比,在用藥后第2天,P0.05,無統(tǒng)計學(xué)意義,在第6天、13天,有顯著差異(P0.05);在創(chuàng)面肉芽生長情況方面,黃連紫草膏組與龍珠軟膏相比,在第6、13天P0.05,差異有統(tǒng)計學(xué)意義。結(jié)果表明黃連紫草膏與龍珠軟膏相比,在用藥后第6天能明顯促進創(chuàng)面肉芽生長;黃連紫草膏組創(chuàng)面平均愈合時間為(19.63±1.30),龍珠軟膏組平均愈合時間為(22.53±2.40),比龍珠軟膏組提前2.9天,有顯著差異(P0.05);在用藥后第6天,黃連紫草膏組成纖維細胞數(shù)明顯高于龍珠軟膏組(P0.05),差異有顯著性意義;用藥后第13天,黃連紫草膏組組內(nèi)比較,提示成纖維數(shù)目增生程度較前降低,而龍珠軟膏組成纖維細胞數(shù)較前增多(P0.05),但低于治療組第7天的成纖維數(shù)目,差異有統(tǒng)計學(xué)意義。黃連紫草膏能使混合痔術(shù)后傷面成纖維細胞顯著增生,使其較早的分化成熟為纖維細胞,加快切口愈合。結(jié)論:1.黃連紫草膏在臨床用藥過程中,療效確切,無明顯不良反應(yīng)及副作用。2.黃連紫草膏在痔瘡術(shù)后創(chuàng)面愈合過程中,能明顯減輕創(chuàng)面水腫;3.黃連紫草膏能促進創(chuàng)面肉芽組織生長,促進成纖維細胞增殖,使其盡快分化成熟為纖維細胞,縮短了創(chuàng)面完全上皮化所用時間。
[Abstract]:Objective: to observe the whole process of wound healing in patients with mixed hemorrhoids, and to evaluate the effect of Coptis chinensis ointment on wound healing time, granulation tissue growth, fibroblast count and edema prevention and treatment.Objective: to explore the mechanism of promoting wound healing by Rhizoma Coptidis Lagerica ointment.Methods: sixty patients with mixed hemorrhoids who met the diagnostic criteria were included in this study. According to the design method of randomized and parallel control, they were divided into treatment group (Rhizoma Coptidis) and control group (Longzhu ointment group, 30 cases).Both groups were treated with combined spinal-epidural anesthesia and combined hemorrhoid exfoliation and internal ligation.From the first day after operation, the patients in both groups were treated with warm boiled water after daily defecation. Ma Yinglong's Shexiang hemorrhoids suppository accepted anus. The treatment group was treated with Coptis purpura ointment (supplied by the Pharmacy Department of the first Teaching Hospital of Henan University of traditional Chinese Medicine).The control group was treated with Longzhu ointment (Z10950017 by Ma Yinglong Pharmaceutical Group Co., Ltd.) gauze gauze was applied once a day until the wound healed completely.There was no significant difference in age, sex and wound area between the two groups.The changes of liver and kidney function and adverse drug reactions were observed and recorded before and after treatment. During the healing of the wound, the patients in the two groups were carefully observed the clinical symptoms and signs such as pain and edema of the wound.And the quantitative score.The wound growth was observed on the 6th day after treatment and the quantitative score was recorded in detail.20 patients were selected from the two groups, and one normal tissue was taken from the central tissue of the wound on the 13th day after treatment, and the number of the fibroblasts was observed under microscope, and the healing time of the wound in each group was recorded.The above indexes were analyzed statistically.The result is 1: 1.Rhizoma Coptidis ointment group had no damage of liver and kidney function and adverse reaction, and the curative effect was 2. 5%.There was no significant difference in pain relief between Rhizoma Coptidis and Longzhu ointment group (P 0.05), but there was no significant difference in treatment of edema between Rhizoma Coptidis and Longzhu ointment group (P 0.05) on the 2nd day after treatment.There was a significant difference in granulation growth of wound surface between Rhizoma Coptidis and Longzhu ointment on the 6th 13th day (P0.05), the difference was statistically significant in Rhizoma Coptidis Ointment group and Longzhu Ointment group.The results showed that the average healing time of Rhizoma Coptidis and Longzhu ointment was 19.63 鹵1.30 and 22.53 鹵2.40, 2.9 days earlier than that of Longzhu ointment, respectively, on the 6th day after treatment, the mean healing time of wound was 19.63 鹵1.30 in Rhizoma Coptidis ointment group and 2.40 in Longzhu ointment group, which was 2.9 days earlier than that in Longzhu ointment group.On the 6th day after treatment, the number of fibrous cells of Rhizoma Coptidis ointment was significantly higher than that of Longzhu ointment group (P 0.05), and the difference was significant on the 13th day after treatment, the number of fiber cells in Rhizoma Coptidis ointment group was higher than that in Rhizoma Coptidis ointment group.The results suggested that the number of fibroblasts in the treated group was significantly lower than that in the treatment group on the 7th day, but the number of fibroblasts in the treated group was significantly lower than that in the treatment group.Rhizoma Coptidis can significantly proliferate fibroblasts after mixed hemorrhoids operation, make them differentiate and mature into fibroblasts earlier, and accelerate wound healing.Conclusion 1.Rhizoma Coptidis ointment is effective in the course of clinical medication, no obvious adverse reactions and side effects. 2. 2.Rhizoma Coptidis ointment in hemorrhoids postoperative wound healing process, can significantly reduce wound edema.Coptis chinensis ointment can promote the growth of wound granulation tissue, promote the proliferation of fibroblasts, make it differentiate and mature into fibroblasts as soon as possible, and shorten the time of complete epithelization of wound surface.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R266

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