腕踝针联合中药熏蒸对混合痔患者术后肛周水肿及肛门功能的影响

Effects of wrist-ankle acupuncture combined with traditional Chinese medicine fumigation on perianal edema and anal function in patients with mixed hemorrhoids after operation

目的 观察腕踝针联合中药熏蒸对混合痔术患者术后肛周水肿及肛门功能的影响。方法 将83例行混合痔手术的患者随机分为熏蒸组(28例)、腕踝针组(25例)和联合组(30例)。3组均采用常规治疗,熏蒸组采用四妙散熏蒸治疗,腕踝针组进行腕踝针治疗,联合组采用腕踝针联合四妙散熏蒸治疗。观察3组治疗前后便秘症状评分(粪便性状、排便困难和排便时间评分)、肛肠动力学指标[直肠静息压(rectal resting pressure,RRP)、肛管静息压(anal resting pressure, ARP)和肛管最大收缩压(anal maximal contraction pressure,AMCP)]、肛周水肿评分、视觉模拟量表(visual analog scale, VAS)评分和肛门功能评分(排气、稀便、黏液和干便评分),并比较3组临床疗效。结果 与治疗前比较,3组治疗后便秘症状评分、肛周水肿评分、VAS评分和肛门功能评分降低,肛肠动力学指标升高(P<0.05);联合组上述指标优于熏蒸组和腕踝针组(P<0.05)。联合组总有效率为93.3%,高于熏蒸组的78.6%和腕踝针组的72.0%(P<0.05);熏蒸组和腕踝针组总有效率比较,差异无统计学意义(P>0.05)。结论 在常规治疗的基础上,腕踝针联合四妙散熏蒸治疗,可降低混合痔患者术后肛周水肿程度,并改善患者肛门功能,减轻患者疼痛程度。

Objective To observe the effect of wrist-ankle acupuncture combined with traditional Chinese medicine fumigation on perianal edema and anal function in patients with mixed hemorrhoids after operation.Method A total of 83 patients with mixed hemorrhoids were randomly divided into a fumigation group(28 cases),a wrist-ankle acupuncture group(25 cases)and a combination group(30 cases).In addition to routine treatment,the fumigation group was treated with Simiao Powder fumigation,the wrist-ankle acupuncture group was treated with wrist-ankle acupuncture,and the combination group was treated with wrist-ankle acupuncture combined with Simiao powder fumigation.Before and after treatment,the scores of constipation symptoms(scores of fecal characters,defecation difficulty and defecation time),anorectal dynamic indexes[rectal resting pressure(RRP),anal resting pressure(ARP)and anal maximal contraction pressure(AMCP)],perianal edema score,and visual analog scale(VAS)score and anal function score(exhaust,loose stool,mucus and dry stool score)were observed in the three groups,and the clinical efficacy of the three groups were compared.Result Compared before treatment,the constipation symptom score,perianal edema score,VAS score and anal function score were decreased,and the anorectal dynamic index was increased after treatment in the three groups(P<0.05).The above indexes in the combination group were better than those in the fumigation group and the wrist-ankle acupuncture group(P<0.05).The total effective rate was 93.3%in the combination group,which was higher than 78.6%in the fumigation group and 72.0%in the wrist-ankle acupuncture group(P<0.05).There was no significant difference in the total effective rate between the fumigation group and the wrist-ankle acupuncture group(P>0.05).Conclusion Based on routine treatment,wrist-ankle acupuncture combined with fumigation of Simiao powder can reduce the degree of perianal edema,improve anal function and relieve pain in patients with mixed hemorrhoids after operation.