中药洗浴联合扩肛治疗对高龄肛裂患者的临床效果分析

Anal fissure treated by anal canal dilataltion plus demibain using traditional Chinese medicine in senior patients

目的探究中药洗浴联合扩肛治疗对高龄肛裂患者的临床疗效以及预后。方法选取2015年3月—2017年3月在温州医科大学附属第二医院治疗的110例高龄肛裂患者,采用随机数字表法将患者分为观察组(55例)、对照组(55例),2组患者的性别、年龄、病程等基线资料差异均无统计学意义(均P> 0. 05)。对照组患者采用扩肛治疗,每日扩肛2次,扩肛治疗后予以长效止痛剂局部皮下注射,每日大便之后用1 500 m L 1∶5 000的高锰酸钾溶液冲洗,每次15～30 min,疗程1个月;观察组患者在对照组的基础上加用苦参汤坐浴治疗,每日大便后1次,每次15～30 min,疗程1个月。比较2组患者的治疗效果、NRS评分、创面愈合时间、并发症以及复发率。结果观察组和对照组患者的治疗总有效率分别为96. 36%、74. 55%,差异有统计学意义(P <0. 05);观察组患者治疗后NRS评分及创面愈合时间显著低于对照组,差异均有统计学意义(均P <0. 05);观察组和对照组患者的并发症发生率分别为3. 64%、20. 00%,差异有统计学意义(P <0. 05);随访1年,观察组和对照组患者复发率分别为3. 64%和27. 27%,差异有统计学意义(P <0. 05)。结论中药洗浴联合扩肛治疗可有效减轻高龄肛裂患者的疼痛症状,加快创面愈合,降低复发率,值得临床推广。

Objective To explore the effect of anal canal dilataltion plus demibain using traditional Chinese medicine in treatment of anal fissure. Methods A total of 110 patients diagnosed as anal fissure and met standard were collected in March 2015 to March 2017 in our hospital. They were randomly divided into two groups: the experimental group( n =55) and the control group( n = 55). General information such as gender,age and cause of disease of the two groups showed no significant differences( P > 0. 05). The patients of control group received anal canal dilataltion 2 times a day.Long-acting analgesic was injected subcutaneously after anal dilatation. After defecation,the patients were washed with 1500 m L 1∶ 5 000 potassium ferrate solution,15-30 minutes each time for 1 month. The patients of experimental group received demibain using TCM on the basis of the control group once a day after stool,15-30 minutes each time for1 month. The therapeutic effect,NRS score,wound healing time,complications and recurrence rate of two groups were compared. Results Total effective rate of experimental group and control group were 96. 36% and 74. 55%,and the difference was statistically significant( P < 0. 05). The NRS score and wound healing time in the experimental group were significantly lower than those in the control group after treatment( P < 0. 05). Complication rate of experimental group and control group were 3. 64% and 20. 00%,and the difference was statistically significant( P < 0. 05). One-year follow-up showed that recurrence rate of experimental group and control group were 3. 64% and 27. 27%,and the difference was statistically significant( P < 0. 05). Conclusion Anal canal dilataltion plus demibain using TCM could alleviate pain symptoms of elderly patients with anal fissure,accelerate wound healing,reduce recurrence rate,and improve prognosis.It was worthy to be promoted due to high safety and efficacy.