University Aldo Moro of Bari, Department of Emergency and Organ transplantation , Policlinico, piazza G Cesare, 11, 70124 Bari , Italy +3397593066 ; +39 0805478735 ;
Expert Opin Pharmacother. 2013 Dec;14(17):2343-9. doi: 10.1517/14656566.2013.836181. Epub 2013 Sep 12.
Hemorrhoid disease is the cause of most proctologic complaints and hundreds of medical and surgical therapies have been proposed to relieve symptoms. However, the role and the correct indication of medical treatments are still controversial. Further, the utility of conservative measures are rarely scientifically supported by adequate trials.
This narrative review is based on the search and analysis of full papers in English language selected from PubMed in the past 30 years using the following MeSH Editing: hemorrhoids, conservative treatment, medical treatment and hemorrhoids, pregnancy and hemorrhoids, thrombosed hemorrhoids, randomized trials and hemorrhoids, postoperative pain and hemorrhoids.
Early stages (I/II degrees) of this disease could be effectively managed conservatively with several approaches as lifestyle changes, fiber supplement, topical ointments and phlebotonic drugs. The more advanced hemorrhoid stages (III/IV degrees) need some type of surgery, but medical therapy is still useful to minimize anal symptoms as a bridge-to-surgery treatment. Further, post-hemorrhoidectomy pain, hemorrhoidal crisis even in pregnancy could benefit from the adjunct of local and systemic medical treatment. This expert opinion, based also on long-lasting clinical practice, also supports the use of medical treatment in symptoms relief in patients with hemorrhoid disease.
痔病是大多数肛肠疾病的主要病因，目前已有数百种医学和外科疗法被提出用于缓解症状。然而，医学治疗的作用和正确适应证仍存在争议。此外，保守治疗的效果很少有充分的试验能科学证实。
这篇综述性文章基于对过去 30 年来在 PubMed 中以以下 MeSH 编辑检索和分析英文全文的结果：痔、保守治疗、痔的医学治疗、痔与妊娠、血栓性痔、痔的随机试验、痔与术后疼痛。
对于该疾病的早期（I/II 度），可以通过改变生活方式、纤维补充、局部软膏和静脉活性药物等多种方法进行有效的保守治疗。更严重的痔（III/IV 度）需要某种类型的手术，但在手术治疗前，医学治疗仍然有助于减轻肛门症状（作为桥接手术治疗）。此外，痔切除术后疼痛、痔的急性发作（即使在妊娠期间）也可以从局部和全身医学治疗的辅助中获益。这一专家意见也基于长期的临床实践，支持在痔病患者中使用医学治疗来缓解症状。
