中药坐浴熏洗联合复方亚甲蓝对肛肠术后疼痛的影响

Analgesia efficacy observation of methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation

目的探讨复方亚甲蓝联合中药坐浴熏洗缓解肛肠手术患者术后疼痛的临床疗效。方法收集2009年3月至2011年10月河南省商丘市第一人民医院肛肠科患者，按住院顺序将168例肛肠手术患者随机分为两组各84例，对照组患者术后常规创口换药，并同时给予头孢替安、甲硝唑治疗。治疗组在对照组治疗基础上给予复方亚甲蓝并联合中药坐浴熏洗治疗。结果①术后疼痛发生率比较：治疗组术后疼痛发生率为58．3％（49／84），对照组为100．0％（84／84），两组比较差异有统计学意义（X2=44．21，P〈0．01）。②疼痛数字分级法（NRS）疼痛评分比较：治疗后治疗组NRS疼痛评分[（4．1±1．2）分]明显低于对照组[（7．2±2．0）分]，P〈0．05。③尿潴留情况比较：治疗组未见尿潴留情况发生，对照组尿潴留发生率为14．3％（12／84），两组比较差异有统计学意义（t=12．92，P〈0．01）。④疼痛消失时间与创面愈合时间比较：治疗组术后疼痛消失时间为（5．9±2．1）d，创面愈合时间为（19．2±4．8）d，均较对照组[分别为（9．1±3．2）d、（23．1±6．3）d]明显缩短（，值分别为6．25、5．22，P均〈0．05）。结论复方亚甲蓝注射及中药坐浴熏洗联用可明显缓解肛肠手术患者术后疼痛。

Objective To explore the efficacy of Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation. Methods 168 cases with postoperation pain after anorectal operation were randomly divided into an observation group and a control group （both n=84）. All patients were treated by Cefpiramide and Tinidazole after operation. On this basis, the patients in the observation group were treated additionally by Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath. Results The postoperation pain rate of the observation group was lower than that of the control group （X^2=44.21, P〈0.01）, and the NRS score of pain in the observation group was lower than that in the control group （t= 12.2, P〈0.05）. There was significant difference between two groups in the urinary retention rate （X2=12.92, P〈0.01） .The disappeared time of pain, the healing time of the wound in the observation group were （5.9±2.1） d and （19.2 ±4.8） d, both lower than those in the control group （t=6.25, 5.22, P〈0.05）. Conclusion Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation would relieve the pain.