温阳生气汤联合痔上黏膜环切钉合术治疗直肠黏膜内脱垂40例  

Clinical effect of Wenyang Shengqi decoction combined with procedure for prolapse and hemorrhoids in treatment of internal rectal mucosal prolapse:An analysis of 40 cases

作　　者：曾祥强 陆文洪[2] 罗雯鹏 李鑫磊 李帅军[2] ZENG Xiangqiang;LU Wenhong;LUO Wenpeng;LI Xinlei;LI Shuaijun(Hunan University of Chinese Medicine,Changsha 410208,Hunan,China;The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,Hunan,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第二附属医院,湖南长沙410005

出　　处：《湖南中医杂志》2023年第5期13-16,38,共5页Hunan Journal of Traditional Chinese Medicine

基　　金：湖南省卫生健康委员会科研计划项目(20201829)。

摘　　要：目的:观察温阳生气汤联合痔上黏膜环切钉合术(PPH)治疗直肠黏膜内脱垂的临床疗效。方法:选择120例直肠黏膜内脱垂患者,按随机数字表法分为治疗组和对照1组、对照2组,每组各40例。对照1组单纯行PPH手术以及术后西医常规治疗,对照2组在对照1组的基础上联合补中益气汤口服治疗,治疗组在对照1组的基础上联合温阳生气汤口服治疗。比较3组术后1、3个月的临床疗效、Longo-排便梗阻综合征(ODS)评分、肛门坠胀评分。结果:术后1个月,总有效率治疗组为97.5%(39/40),高于对照1组的90.0%(36/40)、对照2组的95.0%(38/40),但3组差异无统计学意义(P>0.05)。术后3个月,总有效率治疗组为92.5%(37/40),对照1组为72.5%(29/40),对照2组为75.0%(30/40),治疗组高于对照1、2组,差异均有统计学意义(P<0.05)。术后1、3个月,3组Longo-ODS评分及肛门坠胀评分均降低,且治疗组下降幅度较对照1、2组明显,差异均有统计学意义(P<0.05)。结论:温阳生气汤联合PPH治疗直肠黏膜内脱垂能有效缓解临床症状,远期疗效佳,值得临床推广应用。Objective:To investigate the clinical effect of Wenyang Shengqi decoction combined with procedure for prolapse and hemorrhoids(PPH)in the treatment of internal rectal mucosal prolapse.Methods:A total of 120 patients with internal rectal mucosal prolapse were divided into treatment group,control group 1,and control group 2 using a random number table,with 40 patients in each group.The patients in the control group 1 were given PPH and postoperative con-ventional Western medicine treatment,those in the control group 2 were given oral administration of Buzhong Yiqi decoc-tion in addition to the treatment in the control group 1,and those in the treatment group were given oral administration of Wenyang Shengqi decoction in addition to the treatment in the control group 1.The three groups were compared in terms of clinical response rate,Longo-obstructed defecation syndrome(ODS)score,and anal pendant expansion score at 1 and 3 months after surgery.Results:At 1 month after surgery,the treatment group had a significantly higher overall response rate than the control group 1[97.5%(39/40)vs 90.0%(36/40)]and the control group 2[97.5%(39/40)vs 95.0%(38/40)],and there was no significant different between the three groups(P>0.05).At 3 months after surgery,the treat-ment group had a significantly higher overall response rate than the control group 1[92.5%(37/40)vs 72.5%(29/40)]and the control group 2[92.5%(37/40)vs 75.0%(30/40)],and there was a significant different between the three groups(P<0.05).At 1 and 3 months after surgery,all three groups had significant reductions in Longo-ODS and anal pendant expansion score,and the treatment group had significantly greater reductions than the control groups 1 and 2(P<0.05).Conclusion:In the treatment of internal rectal mucosal prolapse,Wenyang Shengqi decoction combined with PPH can effectively alleviate clinical symptoms with a good long-term clinical effect,and therefore,it holds promise for clinical application.

关 键 词：直肠黏膜内脱垂 温阳生气汤 痔上黏膜环切钉合术 

分 类 号：R269.571.9[医药卫生—中西医结合]