缩泉润肠中药联合手术治疗中重度直肠前突型便秘的临床效果  

Study of Self-designed Empirical Formula of Suoquan Runchang combined with PPH-Block Surgery in Patients with Moderate to Severe Rectal Prolapse Constipation

作　　者：张肖楠 孙光军[2] ZHANG Xiao-nan;SUN Guang-jun(Department of Gastroenterology,Wuhan NO.1 Hospital,Wuhan,Hubei(430000),China)

机构地区：[1]武汉市第一医院胃肠外科,武汉430000 [2]湖北省中医院肛肠科,武汉430000

出　　处：《中国中西医结合外科杂志》2021年第4期586-591,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：中央级公益性科研院所基本科研业务费专项资金资助项目(YZ-1742)。

摘　　要：目的:探讨缩泉润肠中药口服联合经肛门直肠黏膜环切术(PPH术式)+经肛门直肠前突闭式修补术(Block术式)治疗中重度直肠前突型便秘的临床效果。方法:选取2017年3月—2019年12月湖北省中医院肛肠科收治的120例中重度RC型便秘且有孕育史的中老年女性患者,按照随机数表法将其随机分为观察组(60例)与对照组(60例),观察组患者采用PPH手术+Block手术治疗,对照组患者采用基于"缩泉润肠"自拟经验方联合PPH+Block手术治疗,比较两组患者的手术指标、临床疗效、Wexner便秘评分、生活质量及并发症情况。结果:观察组的平均住院时间短于对照组,差异有统计学意义(P<0.05),两组的手术平均时间、手术中平均出血量差异无统计学意义(P>0.05);两组患者术后便秘评分较术前明显改善(P<0.05),观察组术后3个月的Wexner便秘评分(6.83±1.93)和术后6个月的Wexner便秘评分(7.06±1.96)优于对照组(P<0.05);两组在临床疗效方面未见明显差异(P>0.05);两组患者术后3个月的生活质量方面,观察组在躯体功能(86.32±14.50)和整体生活质量(78.12±20.05)评分显著优于对照组(P<0.05),观察组在症状指标(疼痛、疲乏、食欲减退、便秘、气促、失眠)方面评分均高于对照组(P<0.05);对照组的非感染性并发症发生率(肛门坠胀不适、排气性肛门失禁、肛门狭窄)显著高于观察组(27%vs. 12%),差异有统计学意义(P<0.05)。结论:缩泉润肠中药口服联合PPH+Block手术多维度治疗中重度RC型便秘,住院时间短、临床疗效稳定、并发症少,可提高患者的生活质量。Objective To investigate the application of the combination of the Chinese herbal medicine and the PPH-Block in the treatment of moderate and severe rectocele constipation.Methods 120 middle-aged and elderly female patients with moderate and severe rectocele constipation were randomly divided into observation group(60 cases)and control group(60 cases)according to the table of random numbers.The patients in the observation group were treated by PPH+Block operation and the patients in the control group were treated with the self-made empirical formula based on“Suoquan Runchang”combined with PPH+Block operation.The changes of operation index,clinical effect,Wexner constipation score,quality of life and complication were observed.Results The average hospitalization time of the observation group was shorter than that of the control group(P<0.05).There was no significant difference between the two groups(P>0.05).The postoperative constipation of the two groups was better than that of the control group(P<0.05).The Wexner constipation score in the observation group was significantly better than that in the control group at the 1st month and the 3rd month after operation(P<0.05).The improvement of constipation index is obvious by the combination of oral administration of Traditional Chinese medicine and Suoquan Runchang.There was no significant difference in clinical effect between the two groups(P>0.05).The qualities of life of the two groups was significantly better than those of the control group(P<0.05).The symptom indexes(pain,fatigue,loss of appetite,constipation,shortness of breath,insomnia)of the control group were higher than those of the observation group(P<0.05).The treatment of Suoquan Runchang combined with operation can improve the quality of life of patients.The incidence of non-infectious complications in the control group was significantly higher than that in the observation group(P<0.05).The combination of Suoquan Runchang and operation can reduce the incidence of non-infectious complications.Conclus

关 键 词：缩泉润肠方 PPH术 Block术 直肠前突型便秘 中老年女性 

分 类 号：R256.35[医药卫生—中医内科学]