| Objective:Investigate the clinical therapeutic effect of The TST with Buzhong Yiqi Decoction in treating the mixedhemorrhoids,and find the relationship between hemorrhoids and VEGFR2 Methods:Hemorrhoid is one of the most common benign anorectal diseases.Tissue selection(tissue technique,TST)is a new method that has been performed in anorectal surgery in recent years.Because of its low postoperative pain and short recovery period,it gradually replaced traditional surgery.The prescription of Buzhong Yiqi Decoction often been used by Chinese medicine for the treatment of hemorrhoids.However,oral administration alone has certain limitations for III and IV mixed hemorrhoids.Currently,there are few reports about the TST operation combined with Buzhong Yiqi Decoction combined with Western medicine treatment.Vascular endothelial growth factor receptor 2(VEGFR2)is closely related to the occurrence and development of acne.The patients were treated with mixed grade III and IV hemorrhoids who were treated at the Chengdu Anorectal Hospital from February 2016 to July 2017.67 patients were treated by(tissue technique,TST),75 patients were treated by TST and Buzhong Yiqi Decoction.The intraoperative and postoperative bleeding,postoperative pain,postoperative complications,and anal function were observed in the 2 groups.Pain was scored using a visual analog scale(VAS).Anal incontinence was assessed using the"Incontinence Wexner Scoring System."qPCR and Western blot were used to determine gene and protein expression,respectively.Software SPSS19.0 was used for statistical analysis.D'Agootino-Pearson method was used to test the normality of the measurement data.The t-test was used for the normal distribution and the data was expressed as Mean±SD.The non-normal distribution uses the independent sample non-parametric test Mann-Whitney method and the data is Median±IQR.Rates or composition ratios are tested using chi-square test.P<0.05 indicates that the difference was statistically significant.Results:There was no significant difference in age(t=0.921,P=0.359),sex ratio(x~2=1.898,P=0.168),sputum grade(x~2=0.013,P=0.908),disease duration(t=0.815,P=0.417),VAS scores of daily anal pain(t=0.908,P=0.365)and Wexner score(t=1.291,P=0.199)between the two groups.The follow-up treatment indicators were comparable.Compared with TST group,intraoperative blood loss(z=-2.073,P=0.038)and postoperative 12h hemorrhage(z=-2.351,P=0.019)were significantly less in the combined group than in the TST group;The combined group had lower pain scores after 1 day(t=3.042,P=0.003)and 3d(t=2.184,P=0.031)than TST group.Compared with TST group,the Wexner score of anal incontinence was less than TST group in the combined group 3 months after operation(t=5.749,P<0.0001).The union wound healing time was less than TST group,the difference was statistically significant(t=2.423,P=0.017).The VEGFR2 expression were decreased in the combined group compared to the TST group.Conclusion:Compared with TST,combination therapy group has the advantages of less intraoperative and postoperative bleeding,less postoperative pain and better postoperative anal function.The mechanism may inhibit VEGFR2 expression by inhibiting Akt phosphorylation. |
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