直肠前壁全层切闭术结合中医辨证治疗直肠前突型便秘的研究  

A study on treating rectal prolapse by full-thickness rectal anterior wall plus TCM

作　　者：廖颖婴[1] 魏志军[1] 陈浩洋[1] 李伟林[1] 张朝斌[1] 张悦[1] 杜明国 吴喜华[1] 张婧茹 黄志芳[2] Liao Yingying

机构地区：[1]深圳市中医院,广东深圳518000 [2]广州中医药大学第四临床医学院,广东深圳518000

出　　处：《中医临床研究》2019年第13期44-48,共5页Clinical Journal Of Chinese Medicine

基　　金：直肠前壁全层切闭术结合中医治疗直肠前突型便秘的研究(2016深圳市科技开发基金),项目编号:JCYJ20160428175517213

摘　　要：目的:对直肠前壁全层切闭术结合中医治疗直肠前突型(Rectocele,RC)便秘的临床疗效进行探讨。方法:将78例直肠前突型便秘患者随机分成两组,治疗组40例,行直肠前壁全层切闭术结合中医辨证治疗,对照组38例,行经肛吻合器直肠切除术(Stapled Transanal Rectal Resection,STARR)结合中医辨证治疗。术后3、6、12个月进行随访,两组评价指标进行对比,评价指标包括疗效评价、影像学检查、便秘症状严重程度评分(SS)、生活质量量表评分(PAC-QOL)、远期疗效评定。结果:两组患者术后排便困难症状及生活质量均有明显改善。治疗组和对照组每组患者术后3、6、12个月较术前SS评分及PAC-QOL评分差异均有统计学意义(P<0.05);术前、术后3、6、12个月治疗组与对照组两组间SS评分及PAC-QOL评分差异无统计学意义(P>0.05);术后12个月治疗组和对照组影像学结果差异有统计学意义,P<0.05;术后12个月治疗组疗效优于对照组(χ^2=6.701,P=0.01);两组手术时间、术中出血量、术后住院时间比较,差异均无统计学意义(P>0.05);对照组的并发症发生率高于治疗组(P<0.05);住院费用对照组也明显高于治疗组(P<0.05)。结论:直肠前壁全层切闭术结合中医治疗直肠前突型便秘疗效满意,且操作简单,并发症发生率低,费用低。Objective:To explore the clinical efficacy of total anterior rectal claudication with TCM on rectal prolapse.Methods:78 patients with rectal prolapse constipation were randomly divided into two groups.The treatment group consisted of 40 patients,who were treated by the anterior rectal wall and TCM syndrome differentiation.38 patients in the control group were treated by STARR plus TCM syndrome differentiation.Results:Both groups had significant improvement in postoperative defecation symptoms and quality of life.There were significant differences in the preoperative SS score and the PAC-QOL score between the treatment group and the control group in the 3,6 and 12 months after operation (P<0.05).There was no significant difference in SS score and PAC-QOL score between the treatment group and the control group (P>0.05).There was significant differences in the imaging results between the treatment group and the control group at 12 months after operation (P<0.05).After 12 months,the efficacy in the treatment group was better (χ^2=6.701,P=0.01).There was no significant difference in the operation time,intraoperative blood loss,and postoperative hospital stay between two groups (P>0.05).The complication rate in the control group was higher (P<0.05).The cost in the control group was also significantly higher than the treatment group (P<0.05).Conclusion:The anterior rectal wall and TCM syndrome differentiation on rectal prolapse show a satisfactory effect;and the operation is simple,with lower complication rate and cost.

关 键 词：直肠前突 便秘 直肠前壁全层切闭术 中医治疗 

分 类 号：R256.35[医药卫生—中医内科学]