RESUMO
BACKGROUND@#Hemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.@*OBJECTIVE@#This study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#This was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min.@*MAIN OUTCOME MEASURES@#The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients' first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.@*RESULTS@#The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092).@*CONCLUSION@#The pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.
RESUMO
Objective: In order to explore the anti-oxidant capacity of wild and cultivated ginseng, the anti-oxidase activities and antioxidants contents on ascorbic acid-glutathione (AsA-GSH) cycle were compared. Methods: The activity of superoxide dismutase (SOD) was detected by NBT method and the activity of catalase (CAT) was detected by potassium permanganate titration. The anti-oxidase activities and anti-oxidants contents on AsA-GSH cycle were tested using spectrophotometric determination. The contents of glutamate (Glu), cysteine (Gly), and glycine (Cys) were tested by automatic amino acid analysis. Results: The activities of SOD and CAT in wild ginseng were higher than that of cultivated ginseng. In AsA-GSH cycle, the activities of anti-oxidase such as ascorbate peroxidase (APX), monodehydroascorbate reductase (MDHAR), and glutathione reductase (GR). And the contents of antioxidants such as glutathione (GSH), ascorbic acid (AsA), and dehydroascorbic acid (DHA) were also more in wild ginseng. And then the contents of amino acids (Glu, Gly, and Cys), the precursor of GSH synthesis were high expression in wild ginseng to keep the balance of AsA and GSH recirculation. Conclusion: The anti-oxidase activities and antioxidants content on AsA-GSH cycle in wild ginseng are higher than those in cultivated ginseng, which may be leaded to the antioxidant capacity of wild ginseng is stronger. It will provide a theoretical basis for efficacy differences research on wild and cultivated ginseng.