止痛如神汤结合西医常规疗法对混合痔湿热下注证患者外剥内扎术后疼痛的影响

Effect of Zhitong-Rushen Decoction combined with conventional modern medical therapy on postoperative pain of anal mixed hemorrhoids for patients with syndrome of dampness-heat diffusing downward

目的探讨止痛如神汤结合西医常规疗法对肛门混合痔患者外剥内扎术后疼痛的影响。方法将符合入选标准的2017年1月-2019年1月本院90例混合痔患者按随机数字表法分为2组,每组45例。2组均施以混合痔外剥内扎术,对照组于术后注射复方亚甲蓝溶液,治疗组在对照组基础上服用止痛如神汤。2组均治疗7 d,随访1个月。参考WHO疼痛分级标准于术后不同时间进行疼痛分级评估,观察并记录术后首次排便时间及并发症发生情况,评价临床疗效。结果治疗组总有效率为84.4%(38/45)、对照组为66.7%(30/45),2组比较差异有统计学意义(χ^(2)=3.850,P=0.049)。对照组术后2、6、12 h,疼痛分级中0、Ⅰ级患者分布明显高于对照组,Ⅱ、Ⅲ级患者分布明显低于对照组(Z值分别为17.787、10.020、5.380,P值均<0.01)。治疗组术后首次排便时间早于对照组(Z=-3.181,P=0.001)。治疗组术后并发症发生率为24.4%(11/45)、对照组为26.7%(12/45),2组比较差异无统计学意义(χ^(2)=0.058,P=0.809)。结论止痛如神汤结合西医常规疗法可有效减轻肛门混合痔患者外剥内扎术后的疼痛,降低并发症的发生。

Objective To investigate the effect of Zhitong-Rushen Decoction combined with conventional modern medical therapy on postoperative pain of anal mixed hemorrhoids for patients with syndrome of dampness-heat diffusing downward.Methods A total of 90 patients with mixed hemorrhoids admitted to our hospital from January 2017 to January 2019 were divided into two groups according to the random number table method,with 45 cases in each group.Both groups were treated with external stripping and internal ligation of mixed hemorrhoids.The control group was injected with compound methylene blue solution after operation,while the treatment group was treated with Zhitong-Rushen Decoction on the basis of the control group.Both groups were treated for 7 days and followed up for one month.The postoperative pain grading according to WHO pain grading standard,the pain grading was evaluated at different time after operationof the two groups was evaluated,the first defecation time and postoperative complications were observed and recorded,and the clinical efficacy was evaluated.Results The total effective rate of the treatment group was 84.4%(38/45),which was significantly higher than that of the control group 66.7%(30/45),and the difference was statistically significant(χ^(2)=-3.850,P=0.049).At 2,6,12 h after the operation,the distribution of patients with pain grade 0 and gradeⅠin the control group were significantly higher than those in the control group,while the distribution of patients with gradeⅡand gradeⅢwere significantly lower than those in the control group(Z=17.787,10.020,5.380,P<0.01).The first defecation time of the treatment group was earlier than that of the control group(Z=-3.181,P=0.001).There was no significant difference in postoperative complications between the two groups(χ^(2)=0.058,P=0.809).Conclusion Zhitong-Rushen Decoction combined with conventional modern medical therapy can effectively reduce the pain after hemorrhoids surgery and reduce the occurrence of relavant complications.