针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀临床观察

Clinical observation on anal pendant expansion after PPH of mixed hemorrhoid treated with acupuncture at Xialiao(BL 34)and Changqiang(GV 1)

目的:比较针刺下髎、长强穴与口服西药地奥司明片治疗混合痔吻合器痔上黏膜环切术(PPH术)后肛门坠胀的临床疗效差异。方法:将60例行PPH术的混合痔患者随机分为观察组和对照组,每组30例。观察组在术后第1d开始针刺下髎、长强穴,得气后留针30min,每天1次,共治疗7d;对照组在术后第1d开始口服地奥司明片,每次0.9g,每日2次,共治疗7d。比较两组患者术后第1、2、3、7d的肛门坠胀程度、坠胀持续时间及疼痛评分情况,并评定其疗效。结果:在术后第1d,两组肛门坠胀程度、坠胀持续时间评分比较差异无统计学意义(均P>0.05),但观察组肛门疼痛评分低于对照组(P<0.05),且低于治疗前(P<0.05);在术后第2、3、7d,两组肛门坠胀程度、坠胀持续时间及肛门疼痛评分均低于治疗前(均P<0.05),且观察组优于对照组(均P<0.05);疗程结束时(术后第7d),观察组总有效率高于对照组[90.0%(27/30)vs 83.3%(25/30),P<0.05]。结论:针刺下髎、长强穴治疗混合痔PPH术后肛门坠胀疗效优于口服地奥司明片。

Objective To compare the difference in the clinical efficacy on anal pendant expansion after PPH（procedure for prolapse and hemorrhoids）of mixed hemorrhoid between acupuncture at Xialiao（BL 34）and Changqiang（GV 1）and oral administration of diosmin.Methods Sixty cases of mixed hemorrhoids after PPH were randomized into an observation group and a control group,30 cases in each one.In the observation group,since the 1st day,acupuncture had been applied to Xialiao（BL 34）and Changqiang（GV 1）.The needles were retained for 30 min after qi arrival,and the treatment was given once a day,totally for 7days.In the control group,diosmin tablets had been prescribed for oral administration since the 1st day,0.9g each time,twice a day,totally for7 days.The degree,persistent time and the pain score of anal pendant expansion were compared on the 1st,2nd,3rd and 7th days after PPH between the two groups and the efficacy was evaluated.Results On the 1st day after PPH,the diffe-rences in the scores of the degree and persistent time of anal pendant expansion were not significant statistically between the two groups（all P〈0.05）,but the pain score in the observation group was lower than that in the control group（P〈0.05）and lower than that before treatment（P〈0.05）.On the 2nd,3rd and 7th days after PPH,the degree and persistent time of anal pendant expansion and pain score in the two groups were all lower than those before treatment（all P〈0.05）.The results in the observation group were better than those in the control group（all P〈0.05）.At the end of treatment（on the 7th day after PPH）,the total effective rate in the observation group was higher than that in the control group[90.0%（27/30）vs 83.3%（25/30）,P〈0.05].Conclusion Acupuncture at Xialiao（BL 34）and Changqiang（GV 1）achieves the superior efficacy on anal pendant expansion after PPH of mixed hemorrhoids as compared with diosmin tablets.