102例阑尾周围脓肿中西医结合治疗的临床观察

Clinical observation of 102 cases of combined treatment of Chinese medicine and Western medicine in the treatment of periappendiceal abscess

目的观察中西医结合治疗阑尾周围脓肿的临床疗效。方法选取2013年5月至2014年5月首都医科大学大兴区人民医院门诊及住院收治的阑尾周围脓肿患者102例,随机分为治疗组和对照组,每组51例。对照组单用抗生素治疗,治疗组在抗生素治疗的基础上加用口服大黄牡丹汤,右下腹部外敷黄柏、石膏及硫酸镁,比较两组疗效。结果对照组治愈22例,好转18例,无效11例,治疗组治愈40例,好转9例,无效2例,两组比较差异有显著性(χ~2=1.088,P=0.001)。治疗组及对照组保守治疗无效的共13例患者均行开腹阑尾切除术,术后痊愈出院。保守治疗治愈及好转患者1年内阑尾炎复发的发生率比较,对照组40例患者1年内复发11例,复发率21%,治疗组49例患者1年内复发4例,复发率8%,两组比较差异有显著性(χ~2=1.320,P=0.005)。与对照组比较,治疗组脓肿缩小所需时间、白细胞降至正常时间、住院时间及住院费用均明显降低,差异有显著性(P<0.05)。结论大黄牡丹汤口服,右下腹部外敷黄柏、石膏及硫酸镁,同时结合抗生素治疗阑尾周围脓肿比单用抗生素更加有效,且可降低住院时间及费用,具有积极的临床价值。

Objective To observe the curative effect of combined treatment of Chinese medicine and Western medicine in the treatment of periappendieeal abscess. Methods We selected 102 patients from May, 2013 to May, 2014 in our hospital outpatient and inpatient which were diagnosed with periappendiceal abscess, and the patients were randomly divided into the treatment group and the control group （n=51）. The Patients in control group were treated with antibiotic alone. In the treatment group, Persral Dahuang Mudan decoction and external application of Cortex Phellodendri Chinensis, gypsum and magnesium sulfate on the right lower quadrant were used for the patients based on the antibiotic. Then eompare the curative effeets of the two groups. Results In the control group, 22 cases were cured, 18 cases improved and 1l cases ineffective. In the treatment group, 40 eases were cured, 9 cases improved and 2 cases ineffective. The line column of chi square test, it is concluded that P=0.001, we concluded that the cure rate and improvement rate and invalid rate of treatment group was significantly better in the treatment group （P〈0.05）. The total 13 patients of conservative treatment ineffective in two groups were treated with open appendectomy and postoperative recovery. Compared the two group＇s incidence of Appendicitis recurrence after the conservative treatment improved within 1 year, there were 11 cases patients recurrent in the control group and the treatment group were 4 cases, the chi square test P--0.005. Using Paired t test compared the time of abscess reduce and leukocyte normalized of two groups （P〈0.05）, and the time of hospital stay and treatment costs （P 〈 0.05）. Conclusions The combination of Persml Dahuang Mudan decoction, external application of Cortex Phellodendri Chinensis, gypsum and magnesium sulfate on the right lower quadrant and antibiotics is more effective than the antibiotics alone in the treatment of periappendiceal abscess, and in the aspect of the hospitalization time and cost, the combination therapy has more positive social value.