Niwatananun Kanokporn, Niwatananun Wirat, Piyamongkol Sirivipa, Hongwiset Darunee, Ruengorn Chidchanok, Koyratkoson Kiatkriangkrai, Sirisa-Ard Panee, Chansakaow Sunee, Yotsawimonwat Songwut, Saenjum Chalermpong, Phrutivorapongkul Ampai, Charumanee Suporn
Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
Evid Based Complement Alternat Med. 2021 Nov 2;2021:5605323. doi: 10.1155/2021/5605323. eCollection 2021.
Linn. (CQ) is a medicinal plant with good evidence for the treatment of hemorrhoids, listed in the Thai National List of Herbal Products in the oral dosage form. (Wall ex. DC.) R. K. Jansen. (AP) is a medicinal plant with a local anesthetic effect.
To investigate the potential of rectal suppositories containing CQ and AP extracts to alleviate symptoms of hemorrhoids compared with the commercialized rectal suppository containing hydrocortisone and cinchocaine.
Hemorrhoid outpatients ( = 105) with different severity grades (I, II, or III) from eight hospitals in northern Thailand were included in this study. Hemorrhoid severity was graded by proctoscopy associated with either anal pain or bleeding related to hemorrhoids or both. The patients were randomly allocated to two groups: CQ-AP group ( = 52) or the commercialized rectal suppository group ( = 53). One suppository was rectally administered twice daily in the morning and at bedtime for seven days. Evaluations were performed by physicians on days 1, 4, and 8 of the study. The primary endpoints were bleeding and prolapse size, while the secondary endpoint was anal pain.
Baseline demographics, lifestyle, constipation, number of prolapses, grade of hemorrhoid severity, and duration of experiencing hemorrhoids were comparable in both groups of patients. The effects of CQ-AP and the commercialized rectal suppository on bleeding, prolapse size, and anal pain were comparable. The patients in both groups were satisfied with both products at comparable levels and stated a preference for further use in the case of hemorrhoids recurrence. In terms of safety, the patients in the commercialized rectal suppository group experienced a higher incidence of adverse events, including anal pain and bleeding.
Rectal suppositories containing a combined extract of CQ and AP show potential in alleviating hemorrhoidal symptoms with a good safety profile.
Linn.（CQ）是一种药用植物，有充分证据表明其可治疗痔疮，以口服剂型列入泰国国家草药产品清单。（Wall ex. DC.）R. K. Jansen.（AP）是一种具有局部麻醉作用的药用植物。
与含氢化可的松和辛可卡因的商业化直肠栓剂相比，研究含CQ和AP提取物的直肠栓剂缓解痔疮症状的潜力。
本研究纳入了泰国北部八家医院的105例不同严重程度等级（I、II或III级）的痔疮门诊患者。通过直肠镜检查结合与痔疮相关的肛门疼痛或出血或两者来对痔疮严重程度进行分级。患者被随机分为两组：CQ - AP组（n = 52）或商业化直肠栓剂组（n = 53）。每天早晚各直肠给药一次栓剂，共七天。在研究的第1天、第4天和第8天由医生进行评估。主要终点是出血和脱垂大小，次要终点是肛门疼痛。
两组患者的基线人口统计学、生活方式、便秘情况、脱垂次数、痔疮严重程度等级以及患痔疮的持续时间具有可比性。CQ - AP和商业化直肠栓剂对出血、脱垂大小和肛门疼痛的效果相当。两组患者对两种产品的满意度相当，并表示在痔疮复发时更倾向于进一步使用。在安全性方面，商业化直肠栓剂组患者不良事件的发生率较高，包括肛门疼痛和出血。
含CQ和AP联合提取物的直肠栓剂在缓解痔疮症状方面显示出潜力，且安全性良好。
