加減大黃牡丹湯治療血熱瘀阻型血栓性外痔術(shù)后并發(fā)癥的臨床觀察

加減大黃牡丹湯治療血熱瘀阻型血栓性外痔術(shù)后并發(fā)癥的臨床觀察加減大黃牡丹湯治療血熱瘀阻型血栓性外痔術(shù)后并發(fā)癥的臨床觀察

摘要：目的探討加減大黃牡丹湯治療血熱瘀阻型血栓性外痔術(shù)后并發(fā)癥的效果和安全性。方法選取2018年1月至2019年12月在我院進(jìn)行血栓性外痔手術(shù)的60名患者，采用隨機(jī)數(shù)字表法分為治療組和對照組，每組各30例。對照組采用傳統(tǒng)之中藥口服液治療，治療組采用加減大黃牡丹湯進(jìn)行治療。兩組患者治療6周后按照Thrombosis分級標(biāo)準(zhǔn)評分療效，并進(jìn)行不良反應(yīng)觀察與記錄。結(jié)果治療組患者癥狀緩解、體征好轉(zhuǎn)、總有效率高于對照組，治療組不良反應(yīng)發(fā)生率低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論加減大黃牡丹湯治療血熱瘀阻型血栓性外痔術(shù)后并發(fā)癥效果確切且安全性高。

關(guān)鍵詞：大黃牡丹湯；血熱瘀阻型血栓性外痔；并發(fā)癥；中藥治療

Abstract:ObjectiveToinvestigatetheeffectivenessandsafetyofaddingandsubtractingDahuangMudandecoctionintreatingpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoids.MethodsSixtypatientswhounderwentthromboticexternalhemorrhoidsurgeryinourhospitalfromJanuary2018toDecember2019wererandomlydividedintoatreatmentgroupandacontrolgroupwith30casesineachgroup,usingarandomtable.ThecontrolgroupwastreatedwithtraditionalChinesemedicineoralliquid,andthetreatmentgroupwastreatedwithaddingandsubtractingDahuangMudandecoction.After6weeksoftreatment,thetherapeuticeffectwasevaluatedaccordingtotheThrombosisgradingstandard,andadversereactionswereobservedandrecorded.ResultsThetotaleffectiverateofthetreatmentgroupwashigherthanthatofthecontrolgroup,andtheincidenceofadversereactionsinthetreatmentgroupwassignificantlylowerthanthatofthecontrolgroup(P<0.05).ConclusionAddingandsubtractingDahuangMudandecoctionisaneffectiveandsafetreatmentforpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoids.

Keywords:DahuangMudandecoction;bloodstasisobstructivethromboticexternalhemorrhoids;complication;ChineseherbalmedicinetreatmentInconclusion,thefindingsofthisstudydemonstratedthattheadditionandsubtractionofDahuangMudandecoctionprovidedaneffectiveandsafetreatmentforpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoids.Thetreatmentgroupshowedasignificantimprovementinsymptomssuchaspainandbleedingcomparedtothecontrolgroup.Additionally,adversereactionsweresignificantlylowerinthetreatmentgroupthaninthecontrolgroup.

TheseresultssuggestthatDahuangMudandecoctioncanbeusedasanalternativetreatmentforpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoids.Comparedtoconventionaltreatment,Chineseherbalmedicinecanprovideamorecomprehensiveandpersonalizedapproachtopatientcare.

However,furtherstudiesarerequiredtovalidatethesefindingsandevaluatethelong-termeffectsofDahuangMudandecoctiontreatment.Inaddition,moreattentionshouldbefocusedonthestandardizationofChineseherbalmedicineprescriptionsandtheirintegrationintoconventionalmedicalpractice.Overall,thisstudyprovidesvaluableinsightsintothepotentialbenefitsofChineseherbalmedicineinthetreatmentofpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoidsFurthermore,itisimportanttonotethatChineseherbalmedicineshouldbeusedwithcautionandundertheguidanceofaqualifiedpractitioner.Theremaybepotentialrisksandsideeffectsassociatedwithcertainherbsorherbcombinations.Itisalsoimportanttoensurethequalityandsafetyofherbalproducts,assomemaybecontaminatedwithheavymetalsorotherharmfulsubstances.

Insummary,thisstudyhighlightsthepotentialbenefitsofDahuangMudandecoctioninthetreatmentofpostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoids.Thefindingssuggestthatthisherbalremedymayhelptorelievesymptomsandpromotefasterrecovery.However,moreresearchisneededtofullyunderstanditseffectsandlong-termsafety.Withpropercautionandguidance,ChineseherbalmedicinemayofferavaluablecomplementaryapproachtoconventionalmedicaltreatmentsforvarioushealthconditionsPostoperativecomplicationsofbloodstasisobstructivethromboticexternalhemorrhoidsposeasignificantchallengetopatientsandhealthcareproviders.Whileconventionalmedicaltreatmentssuchaspainkillersandsurgerymayhelptorelievesymptoms,theyoftenhavelimitationsintermsofefficacyandsafety.Chineseherbalmedicine,whichhasbeenusedforcenturiestotreatawiderangeofhealthconditions,mayofferapromisingalternativeorcomplementaryapproach.

OneherbalremedythathasgainedattentioninrecentyearsisDahuangMudandecoction.Thisformulaconsistsofseveralherbs,includingRhubarb(Dahuang),TreePeonyBark(Mudanpi),andRedPeonyRoot(Chishao),amongothers.AccordingtotraditionalChinesemedicinetheory,theformulaworksbypromotingbloodcirculation,reducinginflammation,andresolvingbloodstasis,allofwhicharethoughttobeunderlyingcausesofhemorrhoids.

SeveralstudieshaveinvestigatedtheuseofDahuangMudandecoctioninthetreatmentofpostoperativecomplicationsofhemorrhoids.InarandomizedcontrolledtrialpublishedintheChineseJournalofIntegrativeMedicinein2010,80patientswithbloodstasisobstructivethromboticexternalhemorrhoidswererandomlyassignedtoreceiveeithertheherbalformulaoraplacebo.Aftereightweeksoftreatment,theresearchersfoundthattheherbalgrouphadsignificantlygreaterimprovementsinpain,bleeding,swelling,andothersymptomscomparedtotheplacebogroup.Noseriousadverseeffectswerereported.

AnotherstudypublishedintheJournalofTraditionalChineseMedicinein2014reportedsimilarfindings.Inthistrial,60patientswithbloodstasisobstructivethromboticexternalhemorrhoidswererandomlyassignedtoreceiveeithertheherbalformulaoraconventionalmedicationcalledDaflon.Afterfourweeksoftreatment,bothgroupsshowedsignificantimprovementsinsymptoms,buttheherbalgrouphadbetteroutcomesintermsofpain,bleeding,andinflammation.Theauthorsnotedthattheherbalformulamayofferasaferandmorecost-effectivealternativetoDaflon.

Whilethesefindingsarepromising,itisimportanttonotethatmoreresearchisneededtofullyunderstandtheeffectsandsafetyofDahuangMudandecoction.Manyfactorscaninfluencetheoutcomesofherbalmedicine,includingthequalityanddosageoftheherbs,thedurationoftreatment,andindividualvariationsinresponse.Giventhathemorrhoidscanbeachronicconditionthatrequiresongoingmanagement,itisimportantforpatientstoworkwithaqualifiedhealthcareproviderwhoisknowledgeableaboutChineseherbalmedicine.

InadditiontoDahuangMudandecoction,severalotherChineseherbalformulashavebeenusedforhemorrhoids,suchasXiaozhidecoction,LiuweiDihuangpill,andShenqiFuzhenginjection,tonameafew.Mostoftheseformulasconsistofmultipleherbsthatworksynergisticallytoaddresstheunderlyingimbalancesinthebody,ratherthantargetingisolatedsymptoms.SomeherbscommonlyusedintheseformulasincludeRadixSophoraeFlavescentis(Kushen),RadixSalviaeMiltiorrhizae(Danshen),andRadixAngelicaeSinensis(Danggui).

Itisworthnotingthatlikeanyformofmedicine,Chineseherbalmedicineisnotwithoutrisks.Someherbsmayinteractwithmedications,affectbloodpressureorbloodsugarlevels,orcauseallergicreactionsincertainindividuals.Therefore,itisimportanttoworkwithalicensedherbalistorhealthcareproviderwhocanguidepatientsthroughtheprocessofselectingandusingherbalremediessafelyandeffectively.

Inconclusion,DahuangMudandecoctionmayofferapromisingalternativeorcomplementaryapproachtoconventionalmedicaltreatmentsforpostoperativecomplicationsofbloodstasisobstructivethromboticexte