1 Materials and methods
1.1 General information
1.2 Inclusion and exclusion criteria
1.3 Treatment methods
During dressing change after surgery, compound berberine bisulfate ointment (Nanjing Baijingyu Pharmaceutical Co., Ltd., H32025526) and Mayinglong Musk Hemorrhoid Ointment (Ma Yinglong Pharmaceutical Group Co., Ltd., Z42021920) were intubated and applied in the rectum. Specific method: squeeze the medicine into the anus, after each bowel movement, take a bath with potassium permanganate 1:5000 warm water for 10min to 15min, when changing the dressing. Choose physiological saline to clean the wound well, and then apply the medicine in groups , once a day. After the wound is healed, the patient stops applying the medicine. During the treatment, fresh vegetables and fruits are the main food to avoid constipation, and to do a good job of local hygiene . During the medication, antibiotics are used prophylactically for 3 days.
1.4 Observation indicators and methods
Complete remission (CR): the patient has no pain after treatment; partial remission (PR): the patient has a significant improvement in pain after treatment than before administration; mild relief (MR): the patient has less pain after treatment It was relieved before administration; Ineffective (NC): After treatment, the patient had no improvement in pain compared with before treatment. The effective rate is the sum of CR and PR.
1.5 Statistical methods
The results were calculated using SPSS 19.0 statistical software. Measurement data were expressed in the form of (±s), using t test, counting data were expressed as relative numbers, using x2 test. The test standard was set to 0.05, and the difference was statistically significant when P<0.05.
2.1 Comparison of adverse reactions between the two groups of patients after medication
The complication rate in the observation group was 3.33% and that in the control group was 6.67%. There was no significant difference between the groups (x2=1.356, P=0.508).
2.2 Comparison of liver and kidney function in compound berberine bisulfate ointment group
There was no significant difference in liver function indexes of patients in the observation group 1 day before treatment and 1 week after treatment (P>0.05), indicating that there was no significant liver and kidney damage after treatment with compound berberine bisulfate ointment.
2.3 Comparison of analgesic effects
The analgesic effect of compound berberine bisulfate ointment group at 4 observation points within 48 hours after operation was significantly better than that of Mayinglong musk hemorrhoids ointment group, and there were statistical differences between the groups (P<0.05).
2.4 Comparison of analgesic effects at 0.5h after the first three dressing changes between the two groups
The analgesic effect of compound berberine bisulfate ointment group was significantly better than that of Mayinglong musk hemorrhoids ointment group at 0.5h after the first three dressing changes, and there was a statistical difference between the groups (P<0.05). See Table 5.
2.5 Comparison of the analgesic dose required by the two groups of patients within 48h after surgery
The demand for analgesics in the compound berberine bisulfate ointment group was significantly less than that of the Mayinglong musk hemorrhoids ointment group within 48 hours after surgery, and there was a statistical difference between the groups (P<0.05).
2.6 Comparison of wound healing time between the two groups
The compound berberine bisulfate ointment group shortened the wound healing time significantly better than the Mayinglong musk hemorrhoids ointment group, and there was a statistical difference between the groups (P<0.05).
In Chinese medicine, the anus is referred to as the "Paomen", which communicates with the meal and transmits the dross, also called the butt. "The Yellow Emperor's Internal Classic" believes that  the Pomen is also the five internal organs, and the water valley should not be hidden for long. The anus is where the human body eliminates turbidity and turbidity to regenerate. It controls the body's dirty air and also affects the body's dirty air. After the patient undergoes anal fissure surgery, due to the surgical incision, the tissue and nerve tissue are damaged, so that the anal sphincter is stimulated, and then contraction and spasm occur, causing pain to the body. After the body is injured, it will release various inflammatory mediators, mainly analgesic factors, causing pain in the body. These are the basis for the pathogenesis of anal pain. After anorectal surgery, the patient suffers pain from the wound, as well as pain from postoperative defecation and touch, which increases the pain of the patient.
The healing process of anal fissure wounds is complicated and takes a long time. During the perioperative period of anal fissure, patients should pay attention to a reasonable diet and adjust the diet appropriately, which can promote the smooth progress of the operation and the recovery of the postoperative wound. In addition, taking a reasonable diet can also reduce pain, reduce the suffering of patients, and at the same time, reduce the occurrence of complications. Under normal circumstances, you can add more nutrients, such as foods rich in protein and vitamins. Patients should also do a good job of personal hygiene to reduce the possibility of infection. Anal fissure surgery is affected by systemic factors. When patients have some conditions such as anemia, diabetes, etc., wound healing will slow down and wound healing time will be prolonged. When a local infection occurs in the patient's body, there will also be delayed wound healing. Infection of the body will cause granulation tissue necrosis, liquefaction of the wound surface, and delayed removal of inflammatory substances, making the wound surface difficult to heal.
It can be seen from this study that the postoperative analgesic effect and wound healing time of the observation group are significantly better than those of the control group. It can remove dampness and condense sores, cool blood to stop bleeding, clear heat and detoxify, reduce swelling and relieve pain.
At the same time, the results of this study found that the compound berberine bisulfate can protect the liver and kidney functions of patients well. The compound berberine bisulfate can prevent the decrease of renal blood flow, protect the renal tubules, stabilize the lysosomal membrane and antagonize granulocyte elastase, so it can significantly prevent renal damage and acute kidney after hepatectomy The role of decline.
In summary, the compound berberine bisulfate applied to analgesia and promote healing after anal fissure has a very good effect with few adverse reactions and is worthy of clinical promotion.
Published in "Chinese Medical Science" 2015, 5 (18): 30-33, 95