温阳健脾汤辅助PPH术治疗直肠黏膜内脱垂疗效观察  

Curative Effect Observation of Wenyang Jianpi Tang Combined with PPH for IRP

作　　者：张栋梁[1] 巫秀义[1] 孙迎斌[1] 毛玉娥 

机构地区：[1]南京中医药大学附属镇江市中医院,江苏镇江212000

出　　处：《新中医》2017年第5期65-67,共3页New Chinese Medicine

基　　金：镇江市科技支撑计划镇江市卫生科技重点项目(SH2013093)

摘　　要：目的:观察温阳健脾汤辅助痔上黏膜环切吻合术(PPH)治疗直肠黏膜内脱垂(IRP)的近远期疗效,并评价其安全性。方法:将60例患者随机分为2组各30例。对照组予PPH术及术后常规治疗,治疗组在对照组治疗方案的基础上加用温阳健脾汤治疗,观察2组Cleveland便秘评分(CCS),术后恢复情况(肛门坠胀、疼痛指数、排尿困难、大便出血、住院时间),6月随访情况(肛门坠胀、肛门狭窄、肛门失禁、复发)、中医证候评分。结果:2组临床疗效总有效率比较,差异无统计学意义(P>0.05);2组Cleveland便秘评分比较,差异有统计学意义(P<0.05);2组中医证候评分,差异有统计学意义(P<0.05);治疗组肛门坠胀、疼痛指数、排尿困难、大便出血各项评分均低于对照组,差异均有统计学意义(P<0.05);治疗组住院时间短于对照组,差异有统计学意义(P<0.05);随访6月,肛门坠胀、肛门狭窄、肛门失禁、复发情况,2组比较,差异均有统计学意义(P<0.05)。结论:温阳健脾汤配合PPH术治疗直肠黏膜内脱垂能够增强患者体质,促进康复,改善症状,减缓复发,提高患者生活质量。Objective：To observe the long-dated curative effect of Wenyang Jianpi tang combined with PPH in treating internal rectal prolapse（IRP）,and evaluated its safety. Methods ：Selected 60 IRP patients and divided them into two groups of30 cases in each. The control group was given PPH,and the treatment group was given Wenyang Jianpi tang combined with PPH. Observed Cleveland Constipation Score（CCS）,postoperative recovery（anus bleated,pain index,dysuria,bloody stool and hospitalization）, six months follow up（anus bleated, anal stenosis, fecal incontinence and recurrence）, Chinese medicine syndrome score of the two groups. Results ：Compared clinical symptoms of the two groups, there was no significant difference（P〈0.05）;compared CCS and Chinese medicine syndrome score of the two groups,the difference being significant（P〈0.05）. Scores of anus bleated,pain index,dysuria,bloody stool in the treatment group were all lower than those of the control group,the difference being significant（P〈0.05）;hospitalization of the treatment group was shorter than that of the control group, the difference being significant（P〈0.05）; Compared anus bleated, anal stenosis, fecal incontinence and recurrence of the two groups of the six months follow up, the difference being significant（P〈0.05）.Conclusion：Wenyang Jianpi tang combined with PPH can build-up the constitutions of patients,promote recovery,improve clinical symptoms,retard recurrence and improve quality of life of patients in treating IRP.

关 键 词：痔上黏膜环切吻合术 直肠黏膜脱垂 温阳健脾汤 Cleveland便秘评分(CCS) 肛门坠胀 肛门失禁 

分 类 号：R657.18[医药卫生—外科学]