综合疗法治疗原发性肛门瘙痒症的临床研究

Comprehensive Therapy for Treating Primary Anal Pruritus： Clinical Research

为探讨一种简单易行、行之有效的治疗原发性肛门瘙痒症的方法，本研究将90例原发性肛门瘙痒症患者随机分为3组，分别采用口服抗组胺类药物配合外用药膏（A组）、亚甲蓝局部注射配合外用药膏（B组）、曲安奈德局部注射配合外用药膏（C组）治疗。分别于治疗后2周评价近期疗效，治疗后6、12个月随访评价其远期疗效，并观察急性期并发症的发生情况，以及有效控制致病因素与1年后总有效率间的关系。结果显示，B组近期疗效显著，但并发症发生率明显高于A组和C组；3组远期疗效比较无明显差异。能有效控制致病因素患者1年后的总有效率明显高于未能有效控制致病因素的患者。结果表明，对于症状较重的急性期原发性肛门瘙痒症，可采用亚甲蓝局部注射配合外用药膏法治疗；对于症状轻者及慢性期肛门瘙痒症，可采用口服抗组胺类药物配合外用药膏法治疗。该病治疗重在针对病因病机，关键是去除可能的致病因素。

This study was to explore an easy,practical and effective method to treat primary anal pruritus; divided 90 cases of this disease into three group randomly; three groups all externally used ointment, but also oral administration of antihistamines drugs,as group A,also local injecting methylene blue,as group B, also local injecting triamcinolone,as group C, respectively.At the 2nd weeks after treatment, the short-term efficacy was evaluated; through the follow-up of 6,12 months after treatment, the long-term efficacy was evaluated,and the occurrence status of complications at the acute stage and the relationship between controlling pathogenic factor effectively and total efficacy after one year were observed.As results, the shortterm efficacy in group B was obvious, but the occurrence rate of complications in group B was significantly higher than that in group A and group C.Comparing the long-term efficacy of the three groups,there was no significant difference（ P 〉0.05）.The total efficacy rate of patients after one year who can controlled pathogenic factors effectively was significantly higher than that who can not controlled pathogenic factor effectively.Results show that primary anal pruritus with severe symptoms at acute stage can adopt methylene blue combined with using ointment externally;primary anal pruritus with mild and chronicsymptoms can adopt oral administration of antihistamines drugs combined with using ointment externally.The treatment of this disease emphasizes on the etiology and pathogenesis, the key is to remove the possible pathogenic factors.