肛窦切开引流术加中药直肠滴灌治疗慢性肛窦炎临床观察

Clinical observation of anal sinus incision and drainage combined with rectal drip-irrigation of Chinese medicine on chronic anal cryptitis

目的:观察肛窦切开引流术加银翘红酱解毒汤直肠滴灌治疗慢性肛窦炎(湿热下注型)的临床疗效。方法:随机将80例湿热下注型慢性肛窦炎患者(保守治疗无效或反复发作者)分为两组,每组40例,治疗组与对照组均予肛窦切开引流术,治疗组术后予银翘红酱解毒汤直肠滴灌治疗;对照组术后予复方氯已定甲硝唑栓和肛泰软膏塞肛治疗。观察两组的肛门疼痛坠胀、水肿、创口渗液等并发症消失时间和平均愈合时间,以及临床疗效和复发率。结果:治疗组肛门疼痛坠胀、水肿、创口渗液等并发症消失时间以及平均愈合时间均低于对照组,差异均有统计学意义(P<0.05)。治疗组愈显率87.5%,对照组愈显率67.5%,两组比较差异均有统计学意义(P<0.05)。术后6个月回访,治疗组复发率为5.40%,低于对照组的22.22%(P<0.05)。结论:采用肛窦切开引流术加银翘红酱解毒汤加味直肠滴灌治疗湿热下注型慢性肛窦炎具有临床疗效好、复发率低的优点。

Objective： To observe the clinical effect of anal sinus incision and drainage combined with rectal drip-irrigation of Yinqiao Hongjiang Jiedu decoction on chronic anal cryptitis of damp-heat pouring downward syndrome. Methods： 80 cases of patients with chronic anal cryptitis of damp-heat pouring downward syndrome（ who were of ineffective conservative treatment or recurrence） were divided randomly into treatment group and control group,40 cases in each group. The patients of both groups were treated with anal sinus incision and drainage. Postoperatively,the treatment group was treated with rectal drip-irrigation of Yinqiao Hongjiang Jiedu decoction,while the control group was treated with Compound Chlorhexidine Acetate and Metronidazole Suppositories and Gangtai Ointment stuffed into anus. The complications disappearance time and the average healing time of anal pain,falling and expansion,edema and wound effusion etc. as well as the clinical efficacy and recurrence rate were observed in two groups. Results： The complications disappearance time and the average healing time of anal pain,falling and expansion,edema and wound effusion etc. of treatment group were lower than those of control group,and the difference was statistically significant（ P〈0. 05）. The recovery rate was respectively 87. 5% in treatment group and 67. 5% in control group. Compared between two groups,the difference was statistically significant（ P〈0. 05）. According to postoperative follow-up for 6 months,the recurrence rate in treatment group was 5. 40%,which was lower than 22. 22% in control group. Compared between two groups,the difference was statistically significant（ P〈0. 05）. Conclusion： The clinical effect of anal sinus incision and drainage combined with rectal dripirrigation of modified Yinqiao Hongjiang Jiedu decoction on chronic anal cryptitis of damp-heat pouring downward syndrome is better,and the recurrence rate is lower.