【目的】 观察针刺足三里联合三黄汤熏洗对痔疮术后创面愈合修复的影响。【方法】 将 2020年 1月至 2022年 1月廊坊 市中医医院就诊的 110例痔疮术后患者按随机数字表法随机分为观察组和对照组，每组各 55例，对照组给予高锰酸钾溶液 坐浴治疗，观察组在对照组治疗的基础上，给予针刺足三里联合三黄汤熏洗治疗。2组均治疗 14 d。治疗 2周后，评价 2组 临床疗效，观察2组患者治疗前后肛管静息压、肛管舒张压、肛管最大收缩压的变化情况，以及创面肉芽组织、创面范围、 创面渗液、创面水肿、创面疼痛评分的情况。比较 2组患者治疗前后肿瘤坏死因子 α（TNF-α）、白细胞介素 6（IL-6）含量的 变化情况。并比较 2 组并发症总发生率与创面愈合时间。【结果】（1）观察组总有效率为 96.36%（53 /55），对照组为 74.55% （41/55）。观察组疗效优于对照组，差异有统计学意义（P < 0.05）。（2）治疗后，2组患者肛管静息压、肛管舒张压、肛管最大 收缩压均明显改善（P < 0.05），且观察组在改善肛管静息压、肛管舒张压、肛管最大收缩压方面明显优于对照组，差异均有 统计学意义（P < 0.05）。（3）治疗后，2 组患者创面肉芽组织、创面范围、创面渗液、创面水肿、创面疼痛评分均明显改善 （P < 0.05），且观察组在改善创面肉芽组织、创面范围、创面渗液、创面水肿、创面疼痛评分方面均明显优于对照组，差异 均有统计学意义（P < 0.05）。（4）治疗后，2 组患者血清 TNF-α、IL-6 均明显改善（P < 0.05），且观察组在改善血清 TNF-α、 IL-6 方面明显优于对照组，差异均有统计学意义（P < 0.05）。（5）观察组并发症总发生率 7.27%（4/55），对照组为 27.27% （15/55），观察组并发症总发生率明显低于对照组，差异有统计学意义（P < 0.05）。（6）观察组创面愈合时间明显少于对照组， 差异有统计学意义（P < 0.05）。【结论】 针刺足三里联合三黄汤熏洗治疗痔疮术后患者，可有效缓解患者肛周疼痛、水肿等临 床症状，改善患者的肛门功能，减轻炎症反应，降低并发症发生率，促进创面修复，疗效显著。

Objective To observe the effect of acupuncture at Zusanli（ST36）points combined with Sanhuang Decoction fumigation for postoperative hemorrhoid wound healing and repair. Methods A total of 110 postoperative hemorrhoidal patients were randomly divided into observation group and control group，55 cases in each group. The control group was treated by Potassium Permanganate Solution for sitz bath，and the observation group was treated by acupuncture at Zusanli points combined with Sanhuang Decoction fumigation on the basis of the control group􀆳s treatment. The course of treatment for the two groups covered 14 days. After two weeks of treatment，the clinical efficacy of the two groups were evaluated， and changes in the anal canal resting pressure， anal canal systolic blood pressure，anal maximal squeeze pressure，as well as the wound granulation tissue，wound area， wound effusion， and wound edema， and wound pain scores of the patients were observed before and after the treatment. The changes of levels of tumor necrosis factor α（TNF-α）and interleukin 6（IL-6）in the two groups before and after treatment were compared. Moreover，the total complication rate and wound healing time of the two groups were compared. Results（1）The total effective rate was 96.36%（53/55）in the observation group and 74.55%（41/55）in the control group. The efficacy of the observation group was superior to that of the control group， the difference being statistically significant（P < 0.05）.（2）After treatment，the anal canal resting pressure，anal canal systolic blood pressure， anal maximal squeeze pressure of patients in the two groups were significantly improved（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（3）After treatment，the wound granulation tissue， wound area， wound effusion， and wound edema， and wound pain scores of patients in the two groups were significantly improved（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（4）After treatment，levels of serum TNF-α and IL-6 were significantly improved in both groups（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）. （5）The total complication rate of the observation group was 7.27%（4 / 55），and that of the control group was 27.27%（15/55），and the total complication rate of the observation group was significantly lower than that of the control group， the difference being statistically significant （P < 0.05）. （6） The wound healing time of the observation group was significantly shorter than that of the control group，the difference being statistically significant （P < 0.05）. Conclusion Acupuncture at Zusanli points combined with Sanhuang Decoction fumigation for postoperative hemorrhoidal patients can effectively relieve their symptoms such as perianal pain and edema， improve the anal function， reduce inflammatory responses and the incidence of complications， promote wound repair.

R246.9

河北省中医药管理局科研计划项目（编号：2021377）