Pitesa Renato, Yuen Wai Yan Rachel, Hill Andrew G
Department of General Surgery, Middlemore Hospital, Auckland, New Zealand.
Department of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
ANZ J Surg. 2024 Sep;94(9):1480-1490. doi: 10.1111/ans.19116. Epub 2024 Jun 7.
Haemorrhoidectomy is the gold standard for definitive treatment of high-grade symptomatic haemorrhoids but is often associated with substantial pain. This systematic review aims to explore the potential of flavonoids in alleviating the postoperative symptom burden following excisional haemorrhoidectomy.
A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42023472711). Randomized controlled trials (RCTs) published PubMed, MEDLINE, Embase, and Scopus from inception to 1st December 2023 were retrieved. The primary outcome investigated was post-operative pain. Meta-analysis was performed using Review Manager version 5.4.1.
Ten articles with 775 patients were included. The meta-analysis identified statistically significant decreases in post-operative pain in favour of the flavonoid groups (Standardized Mean Difference -0.66 [95% confidence intervals (CI) -0.82, -0.52]; P < 0.00001), and bleeding (Odds Ratio 0.13 [95% CI 0.09, 0.19]; P < 0.00001).
Flavonoids show promise as a means of reducing pain associated with excisional haemorrhoidectomy. Further research is required to investigate topical routes of administration and standardize regimes.
痔切除术是治疗重度症状性痔疮的金标准，但常伴有剧痛。本系统评价旨在探讨类黄酮在减轻痔切除术后症状负担方面的潜力。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南（PROSPERO CRD42023472711）对文献进行系统评价。检索了从创刊至2023年12月1日在PubMed、MEDLINE、Embase和Scopus上发表的随机对照试验（RCT）。研究的主要结局是术后疼痛。使用Review Manager 5.4.1版进行Meta分析。
纳入10篇文章，共775例患者。Meta分析发现，类黄酮组术后疼痛有统计学意义的显著减轻（标准化均数差-0.66 [95%置信区间（CI）-0.82，-0.52]；P < 0.00001），出血情况也有改善（比值比0.13 [95% CI 0.09，0.19]；P < 0.00001）。
类黄酮有望作为减轻痔切除术后疼痛的一种手段。需要进一步研究以探讨局部给药途径并规范用药方案。
Zotero 插件