挂线疗法联合五倍子汤加减坐浴治疗复杂高位性肛瘘临床研究  

Clinical Study on Treatment of Complex High Anal Fistula by Thread Hanging Therapy Combined with Hip Bath with Modified Wubeizi Decoction(五倍子汤)

作　　者：陈瑜[1] 袁志强[1] 王冬琴 杨英楠 张卫刚[2] CHEN Yu;YUAN Zhiqiang;WANG Dongqin;YANG Yingnan;ZHANG Weigang(Department of Traditional Chinese Medicine Hemorrhoids,Luodian Hospital,Shanghai 201908,China;Berger’s Anorectal Department,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市宝山区罗店医院中痔科,上海201908 [2]上海中医药大学附属曙光医院柏氏肛肠科,上海201203

出　　处：《山东中医杂志》2021年第8期822-827,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：上海市宝山区卫生和计划生育委员会科研课题(编号:BSZK-2018-A10-01);上海市宝山区医学卫生项目(编号:18-E-43)。

摘　　要：目的:探究挂线疗法联合五倍子汤加减坐浴治疗复杂高位性肛瘘的临床疗效。方法:选取60例复杂高位性肛瘘患者作为研究对象,根据患者就诊时间分为观察组32例与对照组28例。两组患者均采用挂线疗法进行治疗,术后对照组患者给予高锰酸钾溶液外洗,观察组采用五倍子汤加减坐浴外洗,对比两组总体疗效以及视觉模拟评分法(VAS)评分、水肿评分、创面渗液评分、创面愈合时间、肛门括约肌功能与肛门功能。结果:术后1 d,两组患者VAS评分、水肿评分、创面渗液评分比较,差异均无统计学意义(P>0.05)。术后7 d、14 d,两组患者VAS评分、水肿评分、创面渗液评分均逐渐降低(P<0.05),且观察组评分均低于对照组(P<0.01);观察组创面愈合时间、平均住院时间均少于对照组(P<0.001);治疗后观察组肛门括约肌功能与肛门功能均明显优于对照组(P<0.05);观察组治疗总有效率为93.75%,对照组为82.14%,两组疗效比较差异无统计学意义(P=0.117)。结论:挂线疗法联合五倍子汤加减坐浴治疗复杂高位性肛瘘的疗效显著,可以有效缩短患者创面愈合时间,减轻患者疼痛,促进疾病康复。Objective:To explore the clinical effect of thread hanging therapy combined with hip bath with modified Wubeizi Decoction(五倍子汤)in the treatment of complex high anal fistula.Methods:Sixty patients with complex high anal fistula were selected as the study objects.The patients were divided into the observation group(32 cases)and the control group(28 cases)according to the treatment time.Patients in both groups were treated with thread hanging therapy,and after the surgery,the control group was given potassium permanganate solution for external washing while the observation group was given hip bath with modified Wubeizi Decoction.The total effectiveness rate,visual analogy scale(VAS)score,edema score,wound exudate score,wound healing time,anal sphincter function and anal function of the two groups were compared.Results:One day after the surgery,there was no statistically significant difference in VAS score,edema score and wound exudate score between the two groups(P>0.05).Seven and 14 days after the surgery,these scores in both groups were gradually reduced(P<0.05),and in the observation group,these scores were significantly lower than those in the control group(P<0.01);the wound healing time and average hospitalization time in the observation group were shorter than those in the control group(P<0.001);after the treatment,anal sphincter function and anal function in the observation group were significantly better than those in the control group(P<0.05);the effectiveness rate in the observation group was 93.75%,and in the control group was 82.14%,without statistically significant difference between 2 groups(P=0.117).Conclusion:Thread hanging therapy combined with hip bath with modified Wubeizi Decoction is effective in the treatment of complex high anal fistula,and could effectively reduce the healing time of the wound,relieve the pain of the patients,and promote the early recovery.

关 键 词：挂线疗法 五倍子汤加减 中药坐浴 复杂高位性肛瘘 创面愈合 肛门括约肌 

分 类 号：R266[医药卫生—中医外科学]