目的 探讨首荟通便胶囊联合聚乙二醇4000散治疗气阴两虚型混合痔术后便秘的临床疗效。方法 研究对象选取2023年9月—2025年10月湖北省中医院肛肠科收治的66例混合痔术后便秘气阴两虚型患者进行回顾性分析，根据治疗方式不同将患者分为对照组和治疗组，每组33例。对照组口服聚乙二醇4000散，20 g/次，1次/d。治疗组在对照组的治疗基础上口服首荟通便胶囊，2粒/次，3次/d。两组持续用药14 d。观察两组患者疗效情况，比较两组中医症状评分、Wexner便秘评分、肛周水肿评分量表评分、便秘患者生活质量量表（PAC-QOL）评分、血清血管活性肠肽（VIP）、白细胞介素-6（IL-6）、神经肽Y（NPY）、D-乳酸（D-LA）水平。结果 治疗后，治疗组患者总有效率93.94%显著高于对照组的75.76%（P＜0.05）。治疗后，两组大便干结评分、欲便不出评分、神疲乏力评分、食少纳呆评分均显著降低（P＜0.05）；治疗后，与对照组相比，治疗组大便干结评分、欲便不出评分、神疲乏力评分、食少纳呆评分均较低（P＜0.05）。治疗后，两组Wexner便秘评分、肛周水肿评分、PAC-QOL评分降低明显（P＜0.05）；与对照组对比，治疗组Wexner便秘评分、肛周水肿评分、PAC-QOL评分均较低（P＜0.05）。治疗后，两组VIP、IL-6、NPY、D-LA水平均显著降低（P＜0.05）；与对照组对比，治疗后治疗组VIP、IL-6、NPY、D-LA水平均较低（P＜0.05）。结论 首荟通便胶囊与聚乙二醇4000协同治疗混合痔术后便秘（气阴两虚型）效果显著，能改善患者便秘严重程度，降低肠道炎性反应，明显提升患者生活质量，值得借鉴与应用。

Objective To explore the clinical study of Shouhui Tongbian Capsules combined with Macrogol 4000 Powder in treatment of constipation after surgery for mixed hemorrhoids with Qiyin deficiency type. Methods The research subjects were selected from 66 patients of constipation after surgery for mixed hemorrhoids with Qiyin deficiency type who were admitted to Proctology Department of Hubei Provincial Hospital of TCM from September 2023 to October 2025. According to different treatment methods, the patients were divided into control group and treatment group, with 33 cases in each group. Patients in control group were given oral administration of Macrogol 4000 Powder, 20 g per time, once daily. Patients in treatment group were given Shouhui Tongbian Capsules orally in addition to treatment of control group, 2 capsules per time, 3 times daily. Both groups continued the medication for 14 d. The therapeutic effects of two groups were observed, and traditional Chinese medicine symptoms scores, Wexner constipation score, perianal edema score scale score, constipation patient quality of life scale (PAC-QOL) score, serum vasoactive intestinal peptide (VIP), interleukin-6 (IL-6), neuropeptide Y (NPY), and D-lactic acid (D-LA) levels were compared between two groups. Results After treatment, the total effective rate of treatment group was 93.94%, significantly higher than that of control group (75.76%) (P < 0.05). After treatment, the scores for constipation due to dry stool, inability to defecate, fatigue and weakness, and poor appetite in both groups significantly decreased (P< 0.05). After treatment, compared with control group, the scores for constipation due to dry stool, inability to defecate, fatigue and weakness, and poor appetite in the treatment group were all lower (P < 0.05). After treatment, the Wexner constipation score, perianal edema score, and PAC-QOL score in both groups decreased significantly (P < 0.05). Compared with control group, Wexner constipation score, perianal edema score, and PAC-QOL score in treatment group were all lower (P < 0.05). After treatment, the levels of VIP, IL-6, NPY, and D-LA in both groups significantly decreased (P < 0.05). Compared with control group, the levels of VIP, IL-6, NPY, and D-LA in treatment group were all lower (P< 0.05). Conclusion Shouhui Tongbian Capsules combined with Macrogol 4000 Powder has achieved remarkable effect in treatment of constipation after surgery for mixed hemorrhoids with Qiyin deficiency type, can alleviate the severity of constipation in patients, reduce intestinal inflammatory responses, significantly improve life quality of patients, which is worthy of reference and application.

R975

湖北省科技创新计划项目重点研发专项（2023BCB031）