槐花四物汤治疗混合痔继发贫血术后的临床疗效

姜燕诗 罗敏

[摘要] 目的 評价槐花四物汤口服对混合痔继发贫血术后的临床效果及安全性。 方法 选取2019年3月至2020年3月在湖南中医药大学第二附属医院接受治疗的混合痔继发贫血术后患者120例为研究对象，随机分为空白组（40例）、对照组（40例）和试验组（40例），空白组予常规处理，对照组在常规处理基础上予琥珀酸亚铁片联合裸花紫珠片口服，试验组在常规处理基础上予槐花四物汤口服，三组均治疗1个月。比较三组患者入组时、术后4、7、10 d创面渗血、便血情况及出血停止时间;比较治疗前及治疗后15 d、1个月三组患者的RBC、Hb、HCT变化情况、总有效率及药物不良反应发生情况。 结果 术后10 d试验组患者创面渗血及便血评分低于空白组和对照组，差异有统计学意义（P<0.05）;试验组患者术后出血停止时间为（6.74±3.69）d，短于对照组和空白组，差异有统计学意义（P<0.05）;治疗后1个月，对照组、试验组患者的RBC、Hb、HCT较治疗前均有升高，且试验组各项指标上升更明显，差异有统计学意义（P<0.05）;试验组总有效率为87.50%，高于对照组的80.00%，差异有统计学意义（P<0.05）;对照组腹胀3例、恶心呕吐2例、便秘2例，治疗后症状均缓解，无严重不良反应，未中断治疗，试验组未出现不良反应。 结论 槐花四物汤对于改善混合痔继发贫血患者术后贫血症状更有优势，且安全性好，同时有利于减少术后出血的发生。

[关键词] 混合痔术后;贫血;槐花四物汤;临床疗效

[中图分类号] R574.63          [文献标识码] B          [文章编号] 1673-9701（2021）07-0143-04

Cinical efficacy of Huaihua Siwu Decoction in treating postoperative anemia secondary to mixed hemorrhoids

JIANG Yanshi1   LUO Min2

1.Hu′nan University of Chinese Medicine， Changsha   410000， China; 2.Department of Anorectal， the Second Affiliated Hospital of Hunan University of Chinese Medicine， Changsha   410000， China

[Abstract] Objective To evaluate the clinical effect and safety of oral administration of Huaihua Siwu Decoction on postoperative of anemia secondary to mixed hemorrhoids. Methods A total of 120 postoperative patients with anemia secondary to mixed hemorrhoids treated in the Second Affiliated Hospital of Hunan University of Chinese Medicine from March 2019 to March 2020 were selected as the research subjects. The subjects were randomly divided into the blank group （40 cases）， the control group（40 cases） and the experimental group（40 cases）. The blank group was treated with routine treatment. The control group was treated with ferrous succinate tablets combined with Callicarpa nudiflora Hook. et Arn. tablets on the basis of routine treatment. The experimental group was treated with Huaihua Siwu Decoction on the basis of routine treatment. The three groups were all treated for 1 month. The wound bleeding， blood in the stool when the patients were enrolled， 4， 7 and 10 days after the operation and the bleeding stop time of each group were compared. The changes of RBC， Hb， HCT before treatment， at 15 days and 1 month after treatment， the total effective rate and adverse drug reactions of the three groups were compared. Results 10 days after the operation， the scores of wound bleeding and blood in the stool of the experimental group were statistically significant lower than those of the blank group and the control group （P<0.05）. The time of bleeding stop after the surgery of the experimental group was （6.74±3.69） days， which was statistically significant shorter than that of the control group and the blank group（P<0.05）. After 1 month of treatment， RBC， Hb and HCT of the control group and the experimental group were all statistically significant improved compared with those before treatment， while the indicators of the experimental group rose more significantly （P<0.05）. The total effective rate of the experimental group was 87.50%， statistically significant higher than 80.00% of the control group（P<0.05）. In the control group， 3 cases had abdominal distension， 2 cases had nausea and vomiting， and 2 cases had constipation. After treatment， the symptoms were all relieved， with no severe adverse reactions. No treatment was interrupted. The experimental group had no adverse reactions. Conclusion Huaihua Siwu Decoction has more advantages in improving postoperative anemia symptoms in patients with mixed hemorrhoids secondary anemia， with good safety， and reduces the occurrence of postoperative bleeding.

[Key words] Postoperative mixed hemorrhoid surgery; Anemia; Huaihua Siwu Decoction; Clinical efficacy

随着人们生活习惯的改变及工作压力的增大，肛肠疾病患病率日趋上升，高达50.1%，且肛肠疾病患者中98.08%有痔疮症状[1]，然而因患者重视程度不高，导致其未能及时治疗。随着病情的加重，患者出现持续便血或喷射状出血的情况增多，混合痔继发贫血的情况屡见不鲜，即使进行手术治疗，贫血亦可致患者术后恢复缓慢;且术后出血，特别是痔核结扎脱落期出血，是混合痔术后最常见的并发症，其发生率为0.5%～2.0%[2-3]，术后出血可加重贫血，严重影响混合痔继发贫血患者术后的预后和生活质量，故如何能在纠正患者贫血的同时减少术后出血已成为医患共同关注的焦点之一。……