八正散加减对湿热下注型痔瘘术后尿潴留疗效及对恢复排尿时间的影响  

Effect of Modified Bazhengsan on Postoperative Retention of Urine with Symptom of Downward Flow of Damp-heat After Hemorrhoid Fistula and Urination Function Recovery Time

作　　者：陈爱霞[1] 王欣[2] 吴春晓[1] 江雪 王梅青[1] 周颖[1] 刘占伦[1] 

机构地区：[1]河北省中医院,石家庄056006 [2]沧州医学高等专科学校,河北沧州061001

出　　处：《中国实验方剂学杂志》2018年第2期170-174,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科研计划项目(2013057)

摘　　要：目的：探讨湿热下注型痔瘘术后尿潴留（UR）应用八正散加减治疗的临床效果及对患者排尿功能恢复时间的影响。方法：选取河北省中医院2015年3月-2017年3月收治的134例痔瘘术后UR患者，运用随机数字表法均分为两组。所有患者均予以相同的基础治疗，对照组在此基础上联合新斯的明治疗，观察组在对照组基础上加用八正散加减治疗。记录比较两组治疗前后视觉模拟评分法（visual analogue scale，VAS），焦虑自评量表（self-rating anxiety scale，SAS）评分，术后首次排尿情况、临床疗效及不良反应情况。结果：与治疗前比较，两组治疗后VAS，SAS评分较治疗前均显著降低（P〈0．01）；与对照组治疗后比较，观察组下降更显著（P〈0．01）。观察组术后首次排尿时间显著缩短、膀胱残余尿量（RUV）显著减少、最大尿流率（Q…）较对照组显著升高（P〈0.01）。治疗后，观察组总有效率为94．0％，对照组总有效率79．1％，观察组优于对照组（P〈0．05）。治疗后观察组患者尿路感染、出血、疼痛及再次发生尿潴留发生率明显低于对照组（P〈0．05）。两组不良反应比较差异无统计学意义。结论：湿热下注型痔瘘术后尿潴留应用八正散加减治疗更能迅速缓解患者的临床症状体征、恢复自主排尿功能临床疗效优于新斯的明。Objective： To explore the effect of modified Bazhengsan on postoperative retention of urine （UR） with symptom of downward flow of damp-heat after hemorrhoid fistula and urination function recovery time. Method ： A total of 134 cases with UR after hemorrhoid fistula in our hospital from March 2015 to March 2017 were selected as research objectives and divided into two groups randomly. The same basic therapies were provided to both groups. Besides, neostigmine （Neo） was additionally administered to control group, while modified Bazhengsan was additionally administered to observation group. The two groups＇ visual analogue scale （VAS） , self- rating anxiety scale （SAS） score before and after treatment, first postoperative urination, clinical efficacy and adverse reactions were recorded and compared. Result： The two groups＇ VAS and SAS scores after treatment were significant lower than those before treatment （P 〈 0.01 ）, particularly the observation group （P 〈 0.01 ）. Compared with control group, observation group had a significantly shorter first postoperative urination time, with a significant decrease in residual urine volume （RUV） and a significant increase in maximum urinary flow rate （Qm^x） （ P 〈 0.01 ）. After treatment, observation group＇s total effective rate was 94.0%, which was significantly higher than 79. 1% of control group （P 〈 0.05 ）. There was no obvious adverse reaction/event in two groups. After treatment, the differences in incidence of urinary tract infection, hemorrhage, pain and re-occurrence of urinary retention were statistically significant between two groups （ P 〈 0.05 ）. Conclusion： Modified Bazhengsan can relieve clinical symptoms and signs among patients with retention of urine with symptom of downward flow of damp- heat after hemorrhoid fistula, with a better clinical efficacy than neostigmine.

关 键 词：痔瘘 术后尿潴留 湿热下注型 八正散加减 恢复排尿时间 

分 类 号：R24[医药卫生—中医临床基础] R22[医药卫生—中医学]