柏红痔消外洗方防治 Ⅲ 、Ⅳ度环状混合痔术后疼痛临床分析

Clinical Analysis of Baihong Zhixiao Washing Decoction in Prevention and Cure of Pains after the Circular Mixed Hemorrhoids of Ⅲ or Ⅳ Degree Surgery

目的观察柏红痔消外洗方治疗Ⅲ、Ⅳ度混合痔术后疼痛的临床疗效。方法将2015年2月—2016年1月新疆维吾尔自治区中医医院肛肠科病区的144例Ⅲ、Ⅳ度环状混合痔患者随机分为2组。治疗组选用柏红痔消外洗方坐浴治疗,对照组选用金玄痔科熏洗散坐浴治疗。比较两组患者术后当天与术后第1天、第2天、第3天、第4天、第5天的镇痛效果差异,两组使用中不良反应的情况差异。所有患者于术后第1天开始,2次/d,先熏洗后坐浴,共治疗5 d。比较两组术后创面疼痛情况、临床总有效率。结果在减轻疼痛方面,两组术后患者随着用药时间延长,疼痛评分呈下降趋势,(治疗组术后第1天坐浴前后疼痛评分:(6.62±0.991)分;(2.99±0.784)分,术后第5天坐浴前后疼痛评分:(4.51±0.734)分;(2.14±0.450)分。对照组术后第1天坐浴前后疼痛评分:(6.74±0.779)分;(4.12±0.693)分,术后第5天坐浴前后疼痛评分:(4.86±0.896)分;(2.35±0.744)分,两组术后患者排便时疼痛的高值,用药干预后疼痛评分明显低于用药前,差异有统计学意义(P<0.05)。治疗组和对照组的总有效率分别为97.22%、95.83%,差异无统计学意义(P>0.05),无论柏红痔消外洗方组还是金玄痔科熏洗散组对疼痛的干预均有效。观察中两组患者均未出现疼痛加重、过敏等不良反应。结论柏红痔消外洗方能在肛肠术后应用中有效改善患者术后疼痛,并减轻患者经济负担,值得临床广大推广。

Objective To observe the clinical curative effect of baihong zhixiao washing decoction in prevention and cure of pains after the circular mixed hemorrhoids of III or IV degree surgery. Methods 144 cases of patients with cir-cular mixed hemorrhoids of III or IV degree in our hospital from February 2015 to January 2016 were selected and randomly divided into two groups, the treatment group were treated with baihong zhixiao washing decoction, while the control group were treated with fumigation-demibain therapy in the department of jinxuanzhi, and the difference in the analgesic effect on the operative day, in 1, 2, 3, 4, 5 d after operation was compared, and the adverse reactions of the two groups was compared and the fumigation-demibain twice a day for 5 d was for patients in 1d after operation, and the postoperative wound surface pains and total clinical effective rate were compared between the two groups. Results With the prolonged mediation time after operation, the pain scores showed a decreasing trend （ the pains scores before and after demibain at first day after operation in the treatment group （6.62±0.991）points;（2.99±0.784）points, the pain scores before and after demibain at fifth day after operation：（4.51±0.734）points;（2.14±0.450）points, the pains scores be-fore and after demibain at first day after operation in the control group;（6.74±0.779）points;（4.12±0.693）points, the pain scores before and after demibain at fifth day after operation：（4.86±0.896）points;（2.35±0.744）points, and the top value of pains at defecation and pain score after medication intervention were obviously lower than those before medication, and the differences were statistically significant （ P〈0.05）, and the total effective rate in the treatment group and in the con-trol group was respectively 97.22% and 95.83% , and the difference was not statistically significant（P〉0.05）, and the intervention of baihong zhixiao washing decoction and fumigation-demibain therapy in the department of jinxuanzhi was effective, and there were no adverse reactions such as pain aggravation and allergy. Conclusion The application of bai- hong zhixiao washing decoction after the anorectal surgery can effectively improve the postoperative pains and relieve the economic burden of patients, which is worth great promotion in clinic.