【作者】 李京向；

【导师】 丁克；

【作者基本信息】 山东中医药大学 ， 中医外科学， 2004， 硕士

【摘要】 混合痔术后疼痛是肛肠科常见症状，而术后镇痛一直是临床上的一个难点，故越发被临床医师所重视。中医认为混合痔术后疼痛主要是手术或结扎损伤筋脉、络脉，局部经气阻隔，气机不畅，气血瘀阻，经络不通而产生疼痛。治疗若仅局限于清热解毒、祛风利湿、消肿止痛则收效甚微，当逐淤行气治其本，瘀血去而气血通，经络通而疼痛消。临床观察63例，随机分成治疗组32例与对照组31例。治疗组给予肛痛宁软膏，对照组应用九华痔疮栓，结果：治疗组显效19例，好转10例，无效3例，有效率为90． 63%；而对照组相应分别为5、 14、 12例，有效率为61． 29%；经统计分析，两组疗效之间有显著性差异(P<0． 05) 。治疗前后积分差异亦明显(P<0． 05) 。药理实验研究肛痛宁软膏对小白鼠尾根部加压镇痛、对腹腔注射醋酸所致小白鼠扭体反应、大鼠足跖肿胀实验、对小鼠耳廓微循环的影响，并设九华痔疮栓为对照组。结果表明：肛痛宁软膏对腹腔注射醋酸所致小白鼠扭体反应抑制率达47． 32%，使小白鼠尾根部加压镇痛的痛阈明显提高，明显抑制对鸡蛋清所致大鼠足跖肿胀的炎性反应，对小白鼠微循环有明显改善作用。说明肛痛宁软膏有较强的镇痛、抗炎、改善微循环作用。通过实验与临床观察，混合痔术后镇痛从瘀阻论治，应用逐瘀行气、通络止痛法治疗，效果较为满意。更多还原

【Abstract】 As a kind of familiar symptoms in clinic,mixed haemorrhoids post-operational pain is always difficult to be treated.Therefore,clinical doctors pay more and more attention to it.Thinking in traditional Chinese medicine(TCM),such kind of pain was mainly caused by operation or ligation, which damage physique-vessels, channels and collaterals in that qi was blocked in the part of channels and could not become unimpeded,so the qi-blood became stagnation,meridians and collaterals impassable, the patient ached.There would be little effect if you treat the post-operational pain only throuth removing pathogenic heat and toxic materials,dispelling wind to promote diuresis,subduing swelling and alleviating pain except of removing blood stasis and promoting the circulation of qi.which is the key to the problem. 63cases was divided randomly into two group.The treatment group(including 32 cases) was treated with the ointment of Gang Tong Ning(GTN),and among the control group (including 31 cases) with Jiu Hua Suppository(JHS).The efficient rate of treatment group was 90.63%, as a contrast, the control group 61.29%.There existed marked difference between them(P<0.05). Meanwhile, the integral calculus also has obvious diffierence between pretreatment and post-treatment(P<0.05).For the objective of probing the pharmacology of GTN,authors investigated the influence of GTN on mouse torsion reaction caused by acetic acid injecting from abdominal carity,on mouse tail root where paining caused by stress, on the swell experiment to the big rat foot metatarsus, the influence on small rat ear outline tiny circulation, compared with JHS. Results showed that inhibition rate of mouse torsion reaction was 47.32% caused by GTN which prolonged latent period of pain threshold,obviously repressing swelling responds to big rat foot metatarsus caused by albumen, and had the obvious ameliorative function to the tiny circulation of small white rat.lt suggested that GTN had significant effect of analgesia and anti-inflammation,improving tiny circulation. From the clinic and experiment,it showed that GTN was effective on mixed haemorrhoids post-operational pain treated from stagnation, by removing blood stasis and promoting the circulation of qi,clearing out the obstruction in the channels to arrest pain.更多还原