中药熏洗、扩肛与红光治疗肛窦炎的正交优选研究

The Research into Orthogonal Optimization of Fumigation and Anal Dilatation and Red Light in the Treatment of Anal Sinusitis

目的:确定中药熏洗、扩肛和红光治疗肛窦炎的优选方案。方法:选取2016年9月至2018年5月西安市中医医院肛肠科住院治疗的肛窦炎患者105例,设定3个因素(A因素为中药熏洗,B因素为扩肛治疗,C因素为红光治疗)进行水平正交设计法,另设定空白治疗为D,将105例肛窦炎患者随机分为7组,每组15例,分别给予A+B+C、A+B+D、A+C+D、B+C+D、A+D、B+D、C+D方案治疗,治疗2个月后观察各组临床症状的变化情况。结果:在肛门疼痛,异物感,肛门冰凉、灼热感,总体有效等方面,中药熏洗效果强于扩肛及红光治疗(P <0. 05);在肛门憋胀、肛门下坠、排便不尽感等方面,扩肛治疗在三者中更具有优势(P <0. 05);红光对于各个方面均无明显优势,但配合其他两项治疗可使治疗有效率显著提高。A+B+C为最佳方案。结论:中药熏洗、扩肛联合红光治疗是肛窦炎的优选方案,能有效改善肛窦炎症状,提高疗效。

Objective: To determine the optimal scheme of fumigation and washing with Chinese herbal medicine,anal dilatation and red light in the treatment of anal sinusitis. Methods: One hundred and five patients with anal sinusitis hospitalized in Anorectal Department of Xi’an Hospital of TCM from September 2016 to May 2018 were selected. Three factors( factor A was fumigation and washing with TCM,factor B was anal dilatation therapy,factor C was red light therapy) were designed for horizontal orthogonal design. Another blank treatment was set as D. 105 patients with anal sinusitis were randomly divided into seven groups,with 15 cases in each group. A + B + C,A + B + D,A + C + D,B + C + D,A + D,B + D and C + D regimens were given respectively. The changes of clinical symptoms in each group were observed after 2 months of treatment. Results: In anal pain,foreign body sensation,anal cold,burning sensation,overall effectiveness,the effect of fumigation and washing of TCM is stronger than that of anal dilatation and red light therapy( P < 0. 05). Anal dilatation has more advantages in anal constriction,anal drop and incomplete defecation( P < 0. 05). Red light has no obvious advantages in all aspects,but combined with the other two treatments,it can significantly improve the efficiency of treatment.( A + B + C) is the best scheme. Conclusion: Fumigation and washing of TCM,anus dilatation combined with red light therapy is the best choice for the treatment of anal sinusitis,which can effectively improve the symptoms of anal sinusitis and improve the curative effect.