Perrotti P, Antropoli C, Molino D, De Stefano G, Antropoli M
Emergency Surgery Department, A. Cardarelli Hospital, Naples, Italy.
Dis Colon Rectum. 2001 Mar;44(3):405-9. doi: 10.1007/BF02234741.
This study was performed according to a prospective, randomized, open design. The aim was to test the efficacy of local application of nifedipine ointment in healing acute thrombosed external hemorrhoids.
Ninety-eight patients who gave their informed consent were recruited; they received clinical examination and anoscopy. A questionnaire to evaluate symptoms, pain, and concurrent use of analgesics was administered. Patients treated with nifedipine (n = 50) used topical 0.3 percent nifedipine and 1.5 percent lidocaine ointment every 12 hours for two weeks. The control group, consisting of 48 patients, received topical 1.5 percent lidocaine ointment during therapy.
Results obtained were as follows: complete relief of pain in 43 patients (86 percent) of the nifedipine-treated group as opposed to 24 patients (50 percent) of the control group after 7 days of therapy (P < 0.01); oral analgesics were used by 4 patients (8 percent) in the nifedipine-treated group as opposed to 26 patients (54.1 percent) of the control group after 7 days of therapy (P < 0.01); and resolution of acute thrombosed external hemorrhoids was achieved after 14 days of therapy in 46 patients (92 percent) of the nifedipine-treated group, as opposed to 22 patients (45.8 percent) of the control group (P < 0.01). We did not observe any systemic side effect in patients treated with nifedipine.
Our study clearly demonstrates that the use of topical nifedipine, which at present is for treatment of cardiovascular disorders, is a reliable new option in the conservative treatment of thrombosed external hemorrhoids.
本研究按照前瞻性、随机、开放设计进行。目的是测试局部应用硝苯地平软膏治疗急性血栓性外痔的疗效。
招募了98名签署知情同意书的患者；他们接受了临床检查和肛门镜检查。发放了一份评估症状、疼痛和镇痛药同时使用情况的问卷。接受硝苯地平治疗的患者（n = 50）每12小时局部使用0.3%硝苯地平与1.5%利多卡因软膏，共两周。对照组由48名患者组成，在治疗期间局部使用1.5%利多卡因软膏。
获得的结果如下：治疗7天后，硝苯地平治疗组43名患者（86%）疼痛完全缓解，而对照组为24名患者（50%）（P < 0.01）；治疗7天后，硝苯地平治疗组4名患者（8%）使用口服镇痛药，而对照组为26名患者（54.1%）（P < 0.01）；治疗14天后，硝苯地平治疗组46名患者（92%）急性血栓性外痔消退，而对照组为22名患者（45.8%）（P < 0.01）。我们在接受硝苯地平治疗的患者中未观察到任何全身副作用。
我们的研究清楚地表明，目前用于治疗心血管疾病的局部应用硝苯地平，是血栓性外痔保守治疗中一种可靠的新选择。
