中药内服外敷联合PPH术治疗直肠黏膜内脱垂型便秘临床研究  

Clinical Study on Oral Administration and External Application of Chinese Medicine Combined with PPH Surgery for Constipation of Internal Prolapse of Rectal Mucosa

作　　者：潘学东 傅林平 蔡敬泽 PAN Xuedong;FU Linping;CAI Jingze

机构地区：[1]浙江中医药大学附属温州中医院,浙江温州325000

出　　处：《新中医》2021年第19期110-113,共4页New Chinese Medicine

摘　　要：目的:观察中药内服外敷联合吻合器痔上黏膜环形切除术(PPH)治疗直肠黏膜内脱垂型便秘的疗效。方法:将136例直肠黏膜内脱垂型便秘患者按随机数字表法分为观察组和对照组各68例。对照组给予PPH治疗,观察组在对照组基础上给予中药内服外敷治疗。比较2组临床疗效、症状总积分变化、肛管直肠测压变化及术后复发情况。结果:观察组总有效率为97.06%,高于对照组88.24%,差异有统计学意义(P<0.05)。术前,2组症状总积分比较,差异无统计学意义(P>0.05)。术后2周,2组症状总积分均较术前下降,观察组症状总积分低于对照组,差异有统计学意义(P<0.05)。术前,2组肛管收缩压、肛管静息压、最大耐受容量比较,差异均无统计学意义(P>0.05)。术后2周,2组肛管收缩压、肛管静息压、最大耐受容量均较术前升高,观察组肛管收缩压、肛管静息压、最大耐受容量高于对照组,差异均有统计学意义(P<0.05)。术后6个月,观察组复发率为1.47%,低于对照组11.76%,差异有统计学意义(P<0.05)。术后12个月,观察组复发率为2.94%,低于对照组16.18%,差异有统计学意义(P<0.05)。结论:中药内服外敷联合PPH术治疗直肠黏膜内脱垂型便秘,可促进症状恢复,增强治疗效果,改善肛管直肠压力,降低复发风险。Objective:To observe the curative effect of oral administration and external application of Chinese medicine combined with procedure for prolapse and hemorrhoids(PPH) for constipation of internal prolapse of rectal mucosa. Methods:A total of 136 cases of patients with constipation of internal prolapse of rectal mucosa were divided into the observation group and the control group according to the random number table method,68 cases in each group. The control group was given PPH, and the observation group was additionally given oral administration and external application of Chinese medicine combined with PPH. The clinical effect,the changes in the total symptom scores and results from anorectal manometry,and postoperative recurrence were compared between the two groups. Results: The total effective rate was 97.06% in the observation group, higher than that of 88.24% in the control group, the difference being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of the total symptom score between the two groups(P>0.05). After two-week surgery, the total symptom scores in the two groups were decreased when compared with those before surgery,and the score in the observation group was lower than that in the control group,the difference being significant(P<0.05). Before surgery,when compared anal canal systolic pressure,anal canal resting pressure,and maximal tolerable volume between the two groups,there was no significance being found in differences(P>0.05). After twoweek surgery,anal canal systolic pressure,anal canal resting pressure,and maximal tolerable volume in the two groups were increased when compared with those before surgery, and the three indexes above in the observation group were higher than those in the control group,differences being significant(P<0.05). After six-month surgery,the recurrence rate was 1.47% in the observation group,lower than that of 11.76% in the control group,the difference being significant(P<0.05). After twelve-month surgery,the rec

关 键 词：直肠黏膜内脱垂 便秘 吻合器痔上黏膜环形切除术 乙字汤 提肛散 肛管直肠测压 复发率 

分 类 号：R657.19[医药卫生—外科学]