中医扩肛加激素注射术联合中药口服治疗耻骨直肠肌综合征的效果  

Effect of traditional Chinese medicine anal dilation and hormone injection combined with oral administration of traditional Chinese medicine in the treatment of puborectal muscle syndrome

作　　者：贾菲[1] 智建文[1] 杨祎 陈鑫宇 王松 洪子夫[1] JIA Fei;ZHI Jianwen;YANG Yi;CHEN Xinyu;WANG Song;HONG Zifu(Department of Anorectal,Guanganmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Anorectal,Sanming Integrated Traditional Chinese and Western Medicine Hospital,Fujian Province,Sanming 365001,China)

机构地区：[1]中国中医科学院广安门医院肛肠科,北京100053 [2]福建省三明市中西医结合医院肛肠科,福建三明365001

出　　处：《中国医药导报》2023年第26期152-156,共5页China Medical Herald

基　　金：福建省中医药科研项目(2021zyyj74);中国中医科学院科技创新工程课题(C12021A02105);中国中医科学院广安门医院国家中医临床研究示范基地科研专项项目(2018S431)。

摘　　要：目的探讨中医扩肛加激素注射术联合中药口服治疗耻骨直肠肌综合征的临床效果。方法选择2020年3月至2022年6月于中国中医科学院广安门医院肛肠科收治的耻骨直肠肌综合征患者60例,将其按照随机数字表法分为观察组与对照组,各30例。两组均采用微创手术,观察组为中医扩肛加激素注射术式,对照组为耻骨直肠肌部分切断术式,两组术后均给予养血润肠颗粒剂口服3个月。比较两组疗效、术中指标、住院天数、Wexner便秘量化评分主要症状积分、视觉模拟评分、排粪造影肛直角度数和术后并发症情况。结果两组总体疗效比较,差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,手术时长和住院天数均短于对照组,差异有统计学意义(P<0.05)。整体分析发现:不完全排空感、每次排便时间积分的组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组术后、随访时的不完全排空感、每次排便时间积分均低于术前,差异有统计学意义(P<0.05);组间比较:观察组随访时的不完全排空感、每次排便时间积分均低于对照组,差异有统计学意义(P<0.05)。整体分析发现:视觉模拟评分组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组术后第3、7天视觉模拟评分均低于术后第1天,两组术后第7天视觉模拟评分均低于术后第3天,差异有统计学意义(P<0.05);组间比较:观察组术后第3、7天视觉模拟评分均低于对照组,差异有统计学意义(P<0.05)。术前两组静息时、力排时肛直角度数比较,差异无统计学意义(P>0.05);随访时两组静息时、力排时肛直角度数比较,差异无统计学意义(P>0.05);随访时两组力排时肛直角度数均大于术前,差异有统计学意义(P<0.05);两组术前、随访时的静息时肛直角度数比较,差异无统计学Objective To investigate clinical effect of traditional Chinese medicine anal dilation and hormone injection combined with oral administration of traditional Chinese medicine in the treatment of puborectal muscle syndrome.Methods Sixty patients with puborectal muscle syndrome admitted to Department of Anorectal,Guanganmen Hospital,China Academy of Chinese Medical Sciences from March 2020 to June 2022 were selected and they were divided into observation group and control group according to the random number table method,with 30 patients in each group.Minimally invasive surgery was adopted in both groups.The observation group was treated with traditional Chinese medicine anal dilation and hormone injec tion,while control group was treated with partial resection of the puborectal muscle.Both groups were given Yangxue Runchang Granules orally for three months after surgery.Efficacy,intraoperative indicators,hospitalization day,Wexner constipation quantification score main symptom score,visual analogue scale score,defecography anorectal angulation degree,and postoperative complications of two groups were compared.Results There was no statistically significant difference in overall efficacy between two groups(P>0.05).The intraoperative bleeding in observation group was less than that in control group,and the surgical duration and hospitalization day in observation group were shorter than those in control group,the differences were statistically significant(P<0.05).Overall analysis found that there were statistically significant differences in the intergroup comparison,time point comparison,interaction differences of incomplete emptying sensation score and each defecation time score(P<0.05).Further pairwise comparison,intra group comparison:the scores of incomplete emptying sensation and defecation time in both groups during postoperative and follow-up were lower than before surgery,the differences were statistically significant(P<0.05).Comparison between groups:the scores of incomplete emptying sensation and defecation

关 键 词：耻骨直肠肌综合征 便秘 中医扩肛加激素注射术 耻骨直肠肌部分切断术 养血润肠颗粒剂 

分 类 号：R256.35[医药卫生—中医内科学]