Clinical And Experimental Study Of Shaobi Injection In The Treatment Of Internal Hemorrhoids In Stage Ⅱ ～ Ⅲ

Part one: clinical study on the efficacy of Shaobi injection in the treatment of internal hemorrhoids in stage Ⅱ ～ Ⅲ.Objective: To observe the clinical efficacy and complications of Shaobi injection,Xiaozhiling injection and ligation of internal hemorrhoids in the treatment of stage Ⅱ ～ Ⅲ internal hemorrhoids,so as to provide clinical basis and ideas for the treatment of internal hemorrhoidsMethods: Ninety patients with stage Ⅱ ～ Ⅲ internal hemorrhoids who met the inclusion criteria were randomly divided into Shaobi group,Xiaozhiling group and operation group.The curative effect,incidence of postoperative hematochezia,postoperative pain,postoperative complications(induration,anal distension,anal margin edema,urine retention),intraoperative blood loss,operation time and hospital stay were observed in the three groups.Results:(1)there was no significant difference in age,sex,clinical symptoms,signs and stages of internal hemorrhoids among the three groups,(2)there was no significant difference in the short-term effective rate among the three groups(P > 0.05);(3)the incidence of hematochezia in the three groups decreased significantly after treatment,but there was no significant difference among the three groups after treatment.(4)postoperative pain: there was no significant difference between Shaobi group and Xiaozhiling group,but there was significant difference between Shaobi group and simple operation group(P < 0.05and);(5).The occurrence of induration after Shaobi injection was significantly less than that after Xiaozhiling injection,and no induration was found in internal hemorrhoid ligation group.(6)urine retention after operation: there was significant difference between Shaobi group and operation group,but there was no significant difference between Shaobi group and Xiaozhiling group(P >);(7).There was no significant difference in anal distension between Shaobi group and operation group,but there was no significant difference between Shaobi group and Xiaozhiling group.(8)the incidence of postoperative anal edema: there was significant difference between Shaobi group and operation group on the third and seventh day after operation(P < 0.05).There was no significant difference in the incidence of anal edema among the three groups on the first day after operation(P > 0.05).(9)in terms of blood loss,operation time and hospital stay: P < 0.05,there was significant difference.The blood loss,operation time and hospital stay in Shaobi group were better than those in operation group.However,there was no significant difference between Shaobi group and Xiaozhiling group(P > 0.05).Conclusion(s):1.Shaobi injection,Xiaozhiling injection and ligation of internal hemorrhoids have the same short-term clinical effect in the treatment of Ⅱ ～ Ⅲ degree internal hemorrhoids,and can significantly improve the symptoms of hematochezia and prolapse in patients with internal hemorrhoids.Shaobi injection has shorter operation time and hospitalization time than internal hemorrhoid ligation in the treatment of internal hemorrhoids,and the postoperative complications are less and lighter,and it is less easy to produce induration than Xiaozhiling injection.The second part:Experimental study on the difference of rectoanal tissue changes between Shaobi injection and Xiaozhiling injection in ratsObjective: To observe the histological changes of rectoanal canal in rats treated with Shaobi injection and Xiaozhiling injection from histopathology,and to explore the difference between them in the treatment of hemorrhoidsMethods: 45 qualified SD rats were randomly divided into Shaobi group(n = 15),Xiaozhiling group(n = 15)and blank control group(n= 15).After anesthesia,Shaobi injection,Xiaozhiling injection and normal saline were injected respectively(the amount of injection was converted into 5.25ml/1000 g according to the dosage of experimental animals and adults).The general activity,poor defecation,hematochezia and signs of discomfort were observed every day after injection.on the 1st,3rd and 7th day,5 rats in each group were randomly selected from the anorectal segment of each group,and then palpated with the index finger of the right hand,mainly to observe the difference between the injection site and the surrounding tissue,whether there was induration or not,and made HE staining section specimens.Histopathological observation and analysis,such as vascular changes,tissue arrangement(proliferation,fiber changes)inflammatory cell infiltration,phagocytes,tissue necrosis and so on.Results:The main results were as follows:(1)comparison of general conditions and gross morphological observation of anorectal tissue:there was no death in the other two groups except 1 case died in the normal saline control group on the first day.Every day,the discomfort manifestations of rats in each group were observed,such as defecation obstruction,hematochezia,pain and so on.On the first day,the injection site was dark red in Shaobi group and Xiaozhiling group,and became lighter with time.Xiaozhiling saw 1 case of tissue swelling with mild tissue necrosis,and no obvious physiological abnormality was found.On the third day,the tissue color of the injection site in the Shaobi group was lighter than that in the previous two days,and the finger examination was gentle;the color in the Xiaozhiling group was still dark red,and 2 cases had local induration on palpation;the normal saline group was the same as before.On the seventh day,the tissue of the injection site in the Shaobi group showed atrophy and became smaller than the surrounding tissue,the color was slightly white,and the palpation was gentle;in the Xiaozhiling group,the color was still dark red,there were 2 cases of swelling,mild erosive changes,and 3 cases of palpation,and the normal saline group was the same as before.(2)histopathological observation of anorectal tissue of rats in each group: after injection,the tissue was arranged relatively neatly and intact,the vasoconstriction was obvious,and it was atrophic and compact with the increase of time,accompanied by thrombosis and connective tissue production.Hyperplastic fibroblasts were seen,but no edema,inflammatory cell infiltration and tissue necrosis were found.Xiaozhiling group: after injection,the arrangement of mucosal tissue was disordered,vasoconstriction was obvious,partial occlusion,a few inflammatory cell infiltration,edema appeared,with the increase of time,the arrangement of each muscle layer was close,and local edema was formed.there was no inflammatory cell infiltration and tissue necrosis.Normal saline group: the tissues were arranged neatly after injection,and there was no vascular occlusion,edema,inflammatory cell infiltration and tissue necrosis.Conclusion(s): Both Shaobi injection and Xiaozhiling injection have vasoconstriction and occlusion on rat anorectal tissue,but Shaobi injection is less likely to produce induration and scar tissue in rat anorectal tissue than Xiaozhiling injection.its specific mechanism remains to be further studied.