改良消痔灵注射治疗直肠内脱垂的临床研究  

Clinical study of modified Xiaozhiling injection in the treatment of internal rectal prolapse

作　　者：柯敏辉[1] 黄鸿铃 李志鹏 李雪玉[1] 郑霞霞[1] 郑鸣霄[1] KE Minhui;HUANG Hongling;LI Zhipeng;LI Xueyu;ZHENG Xiaxia;ZHENG Mingxiao(The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou 350003, Fujian,China)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003

出　　处：《现代中西医结合杂志》2022年第1期34-39,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金面上项目(81774118);福建省科技厅引导性项目(2019Y0029);福建中医药大学校管课题(X2019063-学科)。

摘　　要：目的观察改良消痔灵注射治疗直肠内脱垂致排便困难的临床疗效。方法选取2019年4月—2021年4月福建中医药大学附属第二人民医院诊治的40例直肠内脱垂患者作为研究对象,将患者随机分为2组,对照组采用传统消痔灵均匀注射法治疗,治疗组采用改良消痔灵注射术治疗。记录2组治疗前及治疗后第2周、第4周、第8周的排便频率、排便时间、肛门坠胀感、直肠排空不尽感积分和肛门镜积分及排粪造影检查结果,评判疗效;比较2组治疗前与治疗后第8周排粪造影检查与3D肛门直肠测压情况。结果治疗后第2周、第4周2组排便频率、排便时间、肛门坠胀及直肠排不尽感积分比较差异均无统计学意义(P均>0.05)。治疗后第8周,2组排便频率、排便时间、肛门坠胀及直肠排不尽感积分均较治疗前明显降低(P均<0.05),其中治疗组治疗后第8周排便时间和直肠排空不尽感积分均明显低于对照组(P均<0.05)。2组总有效率比较差异无统计学意义(P>0.05),但治疗组痊愈率明显高于对照组(P<0.05)。治疗后第8周2组肛门镜积分明显降低,直肠脱垂程度明显改善,差异均有统计学意义(P均<0.05),但2组间比较差异均无统计学意义(P均>0.05);2组治疗前后肛门括约肌最大收缩压、肛管静息压未见显著变化,差异均无统计学意义(P均>0.05);2组治疗后第8周直肠顺应性较治疗前明显升高,且治疗组明显高于对照组,差异均有统计学意义(P均<0.05)。结论相比于传统均匀注射,改良消痔灵注射能更有针对性地解决脱垂的直肠黏膜,更好地恢复患者直肠力学形态,提高直肠顺应性,从而更有效地缓解患者的临床症状。Objective It is to observe the clinical effect of modified Xiaozhiling injection in the treatment of dysdefecation induced by internal rectal prolapse.Methods Forty patients with internal rectal prolapse who were diagnosed and treated in the Second People’s Hospital of Fujian University of Traditional Chinese Medicine from April 2019 to April 2021 were selected as the research objects.The patients were randomly divided into a control group and a treatment group.The control group was treated with Xiaozhiling by traditional uniform injection,and the treatment group was treated with Xiaozhiling by modified injection.The frequency of defecation,defecation time,the scores of anal discomfort and endless defecation,anoscopy scores,and the result of defecography were recorded before treatment and on the 2nd,4th,and 8th weeks of treatment,and the curative effects were evaluated in the two groups.The results of defecography examination and 3D anorectal pressure measurement were compared before operation and on the 8th week of treatment between the two groups.Results There was no significant difference in defecation frequency,defecation time,the scores of anal discomfort and endless defecation between the two groups on the 2nd and 4th weeks of treatment(all P>0.05).On the 8th week of treatment,the defecation frequency,defecation time,the scores of anal discomfort and endless defecation of the two groups were significantly lower than those before treatment(all P<0.05),the defecation time and the score of endless defecation in the treatment group on the 8th week of treatment were significantly lower than those of the control group(all P<0.05).The total effective rate of the two groups was not statistically different(P>0.05),but the cure rate of the treatment group was significantly higher than that of the control group(P<0.05).On the 8th week of treatment,the anoscopy scores of the two groups were significantly reduced,and the degree of rectal prolapse evaluated by defecography was significantly improved,the differences wer

关 键 词：直肠内脱垂 消痔灵注射液 直肠顺应性 

分 类 号：R657.1[医药卫生—外科学]