滋脾增液方治疗混合痔术后排便困难的随机对照临床研究  

A randomized controlled clinical study on Zipi Zengye Formula in treatment of postoperative difficult defecation of mixed hemorrhoids

作　　者：王奕韵 陆宏[1] 瞿胤 方臣阳 杨敏[1] 林晖[2] 孙健[2] 郑德[1] WANG Yiyun;LU Hong;QU Yin;FANG Chenyang;YANG Min;LIN Hui;SUN Jian;ZHENG De(Anorectal Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Anorectal Department,Tianshan Branch of Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200051,China)

机构地区：[1]上海中医药大学附属曙光医院肛肠科,上海200021 [2]上海中医药大学附属龙华医院天山分院肛肠科,上海200051

出　　处：《上海中医药大学学报》2024年第1期47-51,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科技计划项目(21Y11923200);上海市卫健委省级中医治未病中心能力建设治未病技术推广项目;上海市浦东新区卫健委卫生计生科研项目(PW2022D-14);上海市长宁区科委科研课题项目(CNKW2022Y27);上海市长宁区名中医工作室建设项目(CNMZY-2021006)。

摘　　要：目的:探讨滋脾增液方治疗混合痔术后排便困难的临床疗效。方法:纳入混合痔术后脾虚气弱证排便困难患者72例,随机分为治疗组和对照组,每组各36例。治疗组患者给予滋脾增液方口服,对照组患者给予乳果糖溶液口服,治疗周期为3周。于用药前及用药14、21 d后,比较两组患者的排便情况总积分;用药21 d后评价两组的临床疗效;于术后当天及第3、7、14天,采用计分法评价患者的术后肛门疼痛、创面水肿、出血、尿潴留等并发症发生情况;采用便秘患者生活质量自评量表(PAC-QOL)评价患者的生活质量;比较两组患者的创面愈合时间。结果:(1)用药14、21 d后,两组患者的排便情况总积分均显著降低(P<0.05),且治疗组患者的总积分低于对照组(P<0.05)。(2)用药后,治疗组的临床总有效率为88.9%,对照组为66.7%,治疗组的疗效优于对照组(P<0.05)。(3)术后第3、7、14天,治疗组患者的疼痛评分均低于对照组(P<0.05,P<0.01);术后第7天,治疗组患者的创面水肿、出血评分亦低于对照组(P<0.05)。(4)两组患者的创面愈合时间比较,差异无统计学意义(P>0.05)。(5)用药7、28 d后,两组患者的PAC-QOL评分均显著降低(P<0.05),且治疗组患者的评分均低于对照组(P<0.05)。结论:滋脾增液方可明显改善混合痔术后脾虚气弱证排便困难患者的排便情况,减轻术后并发症,提高患者的生活质量。Objective:To investigate the clinical efficacy of Zipi Zengye Formula in the treatment of postoperative difficult defecation of mixed hemorrhoids.Methods:A total of 72 patients with difficult defecation of spleen deficiency and qi weakness syndrome after operation of mixed hemorrhoids were included and randomly divided into the treatment group and the control group,36 cases in each group.The patients in the treatment group were orally treated with Zipi Zengye Formula and the patients in the control group were orally treated with lacrosugar solution,with a course of 3 weeks.Before medication,14 and 21 days after medication,the total scores of defecation were compared between the two groups.Twenty-one days after medication,the clinical efficacy of the two groups was evaluated.On the day of surgery and the 3rd,7th and 14th days after surgery,the complications including anal pain,wound edema,bleeding and uroschesis were evaluated by scoring method.The quality of life was evaluated by Patient-Assessment of Constipation-Quality of Life(PAC-QOL).The wound healing time was compared between the two groups.Results:(1)Fourteen and twenty-one days after medication,the total scores of defecation in the two groups were significantly decreased(P<0.05),and the total score of the treatment group was lower than that of the control group(P<0.05).(2)After medication,the total clinical effective rate was 88.9% in the treatment group and 66.7% in the control group,and the effect of the treatment group was better than that of the control group(P<0.05).(3)On the 3rd,7th and 14th days after surgery,the pain score of the treatment group was lower than that of the control group(P<0.05,P<0.01).On the 7th day after surgery,the wound edema and bleeding scores of the treatment group were also lower than those of the control group(P<0.05).(4) There was no statistically significant difference on the wound healing time between the two groups(P>0.05).(5) Seven and twenty-eight days after medication,the scores of PAC-QOL in the two groups were sign

关 键 词：混合痔 围手术期 脾虚气弱证 滋脾增液方 术后 排便困难 

分 类 号：R266[医药卫生—中医外科学]