复方亚甲蓝混合液皮内注射辅助治疗肛周瘙痒的临床观察

Clinical Observation on the Therapeutic Efficacy of Intracutaneous Injection of Methylene Blue Compound in the Adjuvant Treatment of Perianal Pruritus

为评价复方亚甲蓝混合液局部皮内注射辅助治疗以肛周瘙痒为主要症状的肛周疾患的临床疗效，将248例以肛周瘙痒为主要症状的患者随机分为治疗组（132例）和对照组（116例），治疗组采用皮损局部皮内注射亚甲蓝混合液（1％亚甲蓝1．5ml、0．75％布比卡因5ml、2％利多卡因5ml和10％碳酸氢钠10ml）加常规药物治疗，对照组只采用常规药物治疗，伴有痔、肛周尖锐湿疣或病变皮肤等均行手术切除。结果显示，治疗组痊愈96例，显效36例，无无效病例，有效率为100％；对照组痊愈51例，显效50例，无效15例，有效率为87．1％。治疗组有效率明显高于对照组，P〈0．01。随访3个月，治疗组复发率（3．8％）明显低于对照组（28．4％），P〈0．01。结果表明，复方亚甲蓝混合液局部皮内注射辅助治疗以肛周瘙痒为主要症状的肛周疾患临床疗效满意、安全、复发率低。

Two hundreds and forty eight patients with perianal pruritus as their main symptom were recruited in the study and randomized into two groups so as to evaluate the curative effect of intracutaneous in- jection of Methylene blue compound for these patients. Patients in the study group（ n = 132） underwent lo- cal intracutaneous injection of Methylene blue compound（1% Methylene blue, 1.5ml;0.75 % Bupivacaine, 5ml ;20% Lidocaine, 5ml ; 10 % Sodium bicarbonate, 10ml） together with routine treatment. Patients in the control group（ n = 116） received routine treatment only. The concomitant hemorrhoids, perianal condyloma acuminatum or other lesions were all resected. As results, the cured, improved, ineffective number of patients in the study and control groups was 96 vs 51,36 vs 50,0 vs 15 respectively,while the total improve- ment rate in the two groups was 100% vs 87.1%（ P d0.01）. Follow up of 3 months showed a recurrence rate of 3.8% in the study group and 28.4% in the control group（ P 〈0.01）. It is concluded that this adju- vant treatment can ensure a better therapeutic efficacy and is safe and lower in recurrence.