灌肠膏联合中药熏洗剂在溃疡性结肠炎患者保留灌肠时对肛门及肛管的保护作用

Protective Effects of Enema Cream Combined With Retention Enema With TCM Fumigants and Lotion on Anus and Anal Canal in Patients With Ulcerative Colitis

目的探讨灌肠膏联合中药熏洗剂在溃疡性结肠炎(UC)患者保留灌肠过程中对肛门及肛管的保护作用。方法将120例应用保留灌肠治疗的UC患者随机分为4组,每组30例。治疗组在灌肠前采用中药熏洗剂熏洗,再使用灌肠膏润滑灌肠管及肛门;对照Ⅰ组用温水熏洗和灌肠膏润滑;对照Ⅱ组仅用灌肠膏润滑;对照Ⅲ组仅用液体石蜡油润滑。各组均每日进行保留灌肠两次,21天为1个疗程。观察各组的研究者客观评价、患者主观评价及患者总体评价。结果研究者客观评价比较:治疗组出现肛门水肿、发红、破溃例数均少于对照Ⅰ、Ⅱ、Ⅲ组(P<0.05或P<0.01);治疗组药液保留时间>4h例数多于对照Ⅰ、Ⅱ、Ⅲ组(P<0.05);患者主观评价比较:治疗组出现插管不适、注药不适、肛门坠迫感、灌肠后腹部不适、瘙痒例数及疼痛评分均少于或低于对照Ⅰ、Ⅱ、Ⅲ组(P<0.05);患者总体评价满意度优于各对照组(P<0.05)。结论灌肠膏联合中药熏洗剂可减轻UC患者保留灌肠过程中对肛门黏膜的刺激程度,减少患者痛苦,增加患者的舒适度。

Objective To study the protective effects of enema cream combined with retention enema with TCM fumigants and lotion on anus and anal canal in patients with ulcerative colitis （UC）. Methods Totally 120 UC patients who received retention enema were randomized into 4 groups, with 30 in each. The treatment group was given TCM fumigants and lotion before enema, and enema cream was used for lubrication. The No. 1 control group was fumigated and washed with warm water and lubricated with enema cream. The No. 2 control group was lubricated with enema cream. The No. 3 control group was lubricated with liquid paraffin oil. Each group was received retention enema twice daily. One treatment course lasted for 21 days. The objective evaluation by researchers, subjective evaluation by patients and overall assessment by patients were observed. Results The objective evaluation by researchers showed that the case numbers of anal edema, redness and ulceration in the treatment group were fewer than those in three control groups （P 〈 0. 05 or P 〈 0. 01 ）, and the numbers of patients who received over 4-hour retention enema in the treatment group were more than those in three control groups （ P 〈 0.05 ）. The subjective evaluation by patients showed that the case numbers of intubation discomfort, injection discomfort, fall feeling of anus, abdominal discomfort after enema, and itching in the treatment group were fewer than those in three control groups, and the pain score in the treatment group was significantly lower than that in three control groups （ P 〈 0. 05 ）. The satisfaction of overall as- sessment in the treatment group was superior to that in three control groups （P 〈 0. 05 ）. Conclusion The combo therapy of enema cream and TCM fumigants and lotion can lessen the irritation to anal mucosa, reduce pain and increase comfort.