Department of Surgery, Sapienza University of Rome, Rome, Italy.
Ph.D. School in Translational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Tech Coloproctol. 2024 Sep 17;28(1):126. doi: 10.1007/s10151-024-02998-0.
Hemorrhoidal disease (HD) significantly impacts patients' quality of life. This study aimed to evaluate the effectiveness of preoperative treatment with the micronized purified flavonoid fraction (MPFF) and a sucralfate-based rectal ointment in managing HD symptoms and reducing interventions.
A prospective quasi-experimental study including consecutive cases and controls matched on the basis of sex was performed in a tertiary referral center. Cases received systemic and local therapy for HD, consisting of a rectal ointment containing 3% sucralfate and herbal extracts plus MPFF, in addition to conservative therapy, while controls received conservative therapy alone. The hemorrhoidal disease symptom score (HDSS), the Short Health Scale for HD (SHS-HD) score, and the Vaizey Incontinence Score were used to evaluate symptoms severity and their impact on quality of life and continence. Intervention requirements were assessed at baseline (T0) and after 60 days of treatment (T1).
Between January and December 2023, a total of 98 patients were assessed for eligibility. After exclusions, 56 patients were enrolled, with 28 in each group. Significant improvements were observed in HD symptom scores from T0 to T1: the intervention group showed a mean change in HDSS of -9 [95% confidence interval (CI) -10 to -8], and the control group showed no significant change (mean change of 0; 95% CI -1.5 to 0). At T1, a higher proportion of patients in the intervention group underwent less invasive interventions compared with controls (18% versus 11%). Age, treatment group, and baseline symptom severity significantly predicted post-treatment symptom scores.
In our study the preoperative treatment with MPFF and a sucralfate-based rectal ointment demonstrated clinical benefits in managing HD symptoms and reducing interventions. Further prospective trials are warranted to confirm and explore additional therapeutic strategies.
痔病（HD）显著影响患者的生活质量。本研究旨在评估术前应用微粉化纯化黄酮（MPFF）和基于蔗糖酯的直肠软膏治疗 HD 症状和减少干预措施的有效性。
在一家三级转诊中心进行了一项前瞻性准实验研究，纳入了连续病例和对照组，并根据性别进行了匹配。病例组接受了包括含有 3%蔗糖酯和草药提取物的直肠软膏以及保守治疗在内的 HD 全身和局部治疗，而对照组仅接受保守治疗。采用痔病症状评分（HDSS）、痔病简明健康量表（SHS-HD）评分和 Vaizey 失禁评分来评估症状严重程度及其对生活质量和控便能力的影响。在基线（T0）和治疗 60 天后（T1）评估干预需求。
在 2023 年 1 月至 12 月期间，共评估了 98 名患者的入选资格。排除后，共有 56 名患者入组，每组 28 名。从 T0 到 T1，HD 症状评分均显著改善：干预组 HDSS 平均变化为-9[95%置信区间（CI）-10 至-8]，对照组无显著变化（平均变化 0；95%CI-1.5 至 0）。在 T1 时，与对照组相比，干预组更多的患者接受了侵入性较小的干预措施（18%比 11%）。年龄、治疗组和基线症状严重程度显著预测了治疗后的症状评分。
在本研究中，术前应用 MPFF 和基于蔗糖酯的直肠软膏治疗在管理 HD 症状和减少干预措施方面显示出了临床益处。需要进一步的前瞻性试验来证实并探索额外的治疗策略。
