Clinical effect of modified Yizi Decoction enema combined with endoscopic sclerotherapy in the treatment of grade Ⅰ-Ⅲ internal hemorrhoids
YAO Jingjing1 WANG Zaijian2 WU Yong3 LI Huixia2
1.The Third Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, China;
2.Department of Spleen and Stomach, Beijing University of Chinese Medicine Third Hospital, Beijing 100029, China;
3.Department of Gastroenterology, Jingdong Yumei Integrated Traditional Chinese and Western Medicine Nephropathy Hospital, Hebei Province, Sanhe 065201, China
Abstract Objective To study the clinical effect of modified Yizi Decoction enema combined with endoscopic sclerotherapy in the treatment of internal hemorrhoids. Methods A total of 100 patients with grade Ⅰ-Ⅲ internal hemorrhoids with bleeding who were hospitalized in Jingdong Yumei Integrated Traditional Chinese and Western Medicine Nephropathy Hospital of Hebei Province from October 2018 to June 2021 were selected. They were divided into two groups, with 50 cases in each group. The control group underwent surgical resection and the experimental group underwent endoscopic sclerosis, and the second day after surgery, modified Yizi Decoction enema was implemented. The length of hospital stay and clinical efficacy were compared between the two groups; the symptom scores and the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-10 and IL-17 before and after treatment were compared between the two groups. Results The length of hospital stay in experimental group was shorter than that in control group (P ＜ 0.05). After treatment, the scores of bleeding, anal distension discomfort, and pain in two groups were lower than those before treatment, and experimental group was lower than control group (P ＜ 0.05). The total effective rate of experimental group was higher than that of control group (P ＜ 0.05). After treatment, the levels of IL-17 and TNF-α in two groups were lower than those before treatment, and those in experimental group were lower than those in control group (P ＜ 0.05); the level of IL-10 was higher than that before treatment, and that in experimental group was higher than that in control group (P ＜ 0.05). Conclusion Modified Yizi decoction enema combined with endoscopic sclerosis in the treatment of internal hemorrhoids can shorten the length of hospital stay, reduce the symptoms of hematochezia, anal distension discomfort, and pain. It plays an anti-inflammatory effect on inflammatory cytokines such as IL-17, IL-10, and TNF-α, which is worthy of clinical promotion.
YAO Jingjing1 WANG Zaijian2 WU Yong3 LI Huixia2. Clinical effect of modified Yizi Decoction enema combined with endoscopic sclerotherapy in the treatment of grade Ⅰ-Ⅲ internal hemorrhoids[J]. 中国医药导报, 2022, 19(31): 135-138.
[1] 谢就坤，徐一劲，姚艳芳.东莞市3000例健康体检者肛肠疾病筛查结果分析[J].结直肠肛门外科，2020，26（5）：575-579.
[2] 周雪涛，李建明，曾伟，等.电子直乙肠镜在高龄人群肛肠疾病筛查中的应用价值[J].中国普外基础与临床杂志，2021，28（5）：606-609.
[3] Sandler RS，Peery AF. Rethinking What We Know About Hemorrhoids [J]. Clin Gastroenterol Hepatol，2019，17（1）：8-15.
[4] Ma W，Guo J，Yang F，et al. Progress in Endoscopic Treatment of Hemorrhoids [J]. J Transl Int Med，2020，8（4）：237-244.
[5] Wu X，Wen Q，Cui B，et al. Cap-assisted endoscopic sclerotherapy for internal hemorrhoids：technique protocol and study design for a multi-center randomized controlled trial [J]. Ther Adv Gastrointest Endosc，2020，13：1049436732.
[6] 陈俊均.中药方结合中药外用法治疗内痔的临床疗效分析[J].中医临床研究，2019，11（22）：124-125.
[7] 王文刚，翟文炜，张溪.中药药线内痔结扎外痔切缝术治疗混合痔的临床观察[J].陕西中医药大学学报，2019，42（6）：142-145.
[8] 中国中西医结合学会大肠肛门病专业委员会.中国痔病诊疗指南（2020）[J].结直肠肛门外科，2020，26（5）：519- 533.
[9] 乔敬华，何佳伟，周军惠.基于流行病学调查的农村社区居民痔病中医药防治对策探讨[J].上海中医药杂志，2019， 53（6）：14-19.
[10] 郑筱萸.中药新药临床研究指导原则[S].北京：中国医药科技出版社，2002.
[11] van Tol RR，Kleijnen J，Watson AJM，et al. European Society of ColoProctology：guideline for haemorrhoidal disease [J]. Colorectal Dis，2020，22（6）：650-662.
[12] Zhang G，Liang R，Wang J，et al. Network meta-analysis of randomized controlled trials comparing the procedure for prolapse and hemorrhoids，Milligan-Morgan hemorrhoidectomy and tissue-selecting therapy stapler in the treatment of grade Ⅲand Ⅳ internal hemorrhoids（Meta-analysis）[J]. Int J Surg，2020，74：53-60.
[13] 陈颖，陈炜，方青青，等.内镜下硬化术治疗出血性内痔的临床指南与相关问题探讨[J].上海医药，2020，41（9）：11-16，22.
[14] Bracchitta S，Bracchitta L M，Pata F. Combined rubber band ligation with 3% polidocanol foam sclerotherapy （ScleroBanding） for the treatment of second-degree haemorrhoidal disease：a video vignette [J]. Colorectal Dis，2021， 23（6）：1585-1586.
[15] Skowronski A，Diaco E，Trompetto M，et al. Use of video- guided sclerotherapy with 3% polidocanol foam for symptomatic second-degree haemorrhoidal disease-a video vignette [J]. Colorectal Dis，2020，22（9）：1198-1199.
[16] 秦国涛，杨丽，戴春雷，等.透明帽辅助结肠镜下聚桂醇不同给药方式硬化疗法治疗Ⅰ、Ⅱ期出血性内痔的临床效果[J].中国当代医药，2021，28（14）：65-68.
[17] 孙亚峰，朱素华，常超.中医结扎法治疗痔疮的效果观察[J].中国实用医刊，2021，48（9）：111-114.
[18] 席作武，杨娅娟.内痔病理学本质与中医证型相关性研究[J].国医论坛，2021，36（5）：23-25.
[19] 洪中华，管志敏，陈宏美，等.痔点挑治联合乙字汤治疗湿热下注型痔病便血临床研究[J].新中医，2020，52（1）：101-103.
[20] Porwal A，Kundu GC，Gajanan B，et al. Herbal medicine AnoSpray suppresses proinflammatory cytokines COX-2 and RANTES in the management of hemorrhoids，acute anal fissures and perineal wounds [J]. Exp Ther Med，2022， 23（1）：86.
[21] Francesco P，Alessandro S，Francesco F，et al. Anatomy，Physiology and Pathophysiology of Haemorrhoids [J]. Rev Recent Clin Trials，2020，16（1）：75-80.
[22] Ono T，Nakagawa H，Fukunari A，et al. Hemostatic Action of OC-108，a Novel Agent for Hemorrhoids，Is Associated With Regional Blood Flow Arrest Induced by Acute Inflammation [J]. J Pharmacol Sci，2019，102（3）：314-320.
[23] Mansueto P，Di Liberto D，Fayer F，et al. TNF-α，IL-17，and IL-22 production in the rectal mucosa of nonceliac wheat sensitivity patients：role of adaptive immunity [J]. Am J Physiol Gastrointest Liver Physiol，2020，319（3）：G281- G288.
[24] 冯予希，李五生，蒋青峰，等.肿痛熏洗液对肛肠手术后疼痛模型大鼠血清一氧化氮、前列腺素E2及白细胞介素-10水平的影响[J].广西医学，2019，41（3）：344-346.
[25] 徐成木，杜美萱，朱维娜，等.基于网络药理学和分子对接法探讨乙字汤治疗痔病的作用机制[J].湖南中医杂志，2021，37（12）：152-157.
