加味芍药甘草汤联合生物反馈治疗在肛瘘术后疼痛的应用研究

摘要

目的 观察加味芍药甘草汤联合生物反馈治疗对肛瘘患者术后疼痛的影响及血清肿瘤坏死因子-α (TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)的影响并探讨其机制.方法 将患者120例按随机数字表法分为对照组与观察组各60例;对照组采用生物反馈治疗,观察组在对照组基础上采用加味芍药甘草汤治疗.比较两组治疗前后中医证候积分、疼痛程度、症状消失时间、生活质量以及血清TNF-α、IL-6、IL-10水平,并评价两组临床疗效.结果 与治疗前相比,治疗后两组中医证候积分、VAS评分以及血清TNF-α、IL-6、IL-10水平均下降,而SF-36评分升高,且观察组优于对照组(P<0.01);观察组创面水肿、出血消失时间及愈合时间均短于对照组(P<0.01);治疗后,观察组的临床总有效率为96.67%,显著高于对照组的83.33% (P<0.05).结论 加味芍药甘草汤联合生物反馈治疗肛瘘术后患者,能明显改善患者疼痛症状,同时降低血清TNF-α、IL-6、IL-10水平,临床疗效确切.%Objective:To explore the influence of Modified Peony and Licorice Decoction combined with biofeedback therapy on postoperative pain of patients with anal fistula and changes of serum tumor necrosis fac-tor-α(TNF-α),interleukin-6(IL-6) and interleukin-10(IL-10). Methods:120 cases of patients with anal fis-tula were selected as the study objects,and divided into two groups according to the random principle,namely the control group and the observation group,with 60 cases in each group. The control group were given biofeedback therapy,while the observation group were given Modified Peony and Licorice Decoction on the basis of the control group. TCM symptom scores,pain degree,symptom disappearance time,quality of life,serum TNF-α,IL-6 and IL-10 levels before and after treatment were compared in the two groups,and clinical effect of the two groups were evaluated. Results:Compared with those before treatment,TCM syndrome scores,VAS score and serum TNF-α,IL-6 and IL-10 levels decreased after treatment,but SF-36 scores significantly increased,and those in the observation group was better than those in the control group(P<0.01). The edema,bleeding time and healing time of the observation group were lower than those of the control group(P<0.01).After treatment,the total effec-tive rate of the observation group was 96.67%,significantly higher than that of the control group (83.33%)(P<0.05). Conclusion:Modified Peony and Licorice Decoction combined with biofeedback therapy can obviously improve patients′ pain symptoms,and decrease serum TNF-α,IL-6 and IL-10 levels,with good clinical effect, worthy of clinical promotion.