PPH联合补中益气汤加减治疗直肠内脱垂60例

Clinical effect of procedure for prolapse and hemorrhoids combined with modified Buzhong Yiqi decoction in treatment of intrarectal proctoptosis: An analysis of 60 cases

目的:探讨痔上黏膜环切术(PPH)联合补中益气汤加减治疗直肠内脱垂的临床疗效。方法:将直肠内脱垂患者120例,随机分为治疗组和对照组,每组各60例。对照组行PPH术治疗,治疗组在对照组基础上服用补中益气汤加减治疗。比较2组综合疗效、治疗前后肠道菌群参数和主要症状积分。结果:2组总有效率均为100%(60/60);治疗后2组肠杆菌、肠球菌数量较治疗前减少,乳杆菌、双歧杆菌数量增加,且治疗组改善程度优于对照组,差异均有统计学意义(P<0.05);2组治疗后1、3、6个月主要症状积分均较治疗前减少,差异有统计学意义(P<0.05),但组间比较,仅治疗后6个月时差异有统计学意义(P<0.05)。结论:PPH联合补中益气汤加减能明显减轻直肠内脱垂患者的临床症状,纠正肠道菌群失调,巩固术后远期疗效,效果优于单用PPH手术治疗。

Objective: To investigate the clinical effect of procedure for prolapse and hemorrhoids(PPH) combined with modified Buzhong Yiqi decoction in the treatment of intrarectal proctoptosis.Methods: A total of 120 patients with intrarectal proctoptosis wererandomly divided into treatment group and control group, with 60 patients in each group.The patients in the control group were given PPH,andthose in the treatment group were given oral modified Buzhong Yiqi decoction in addition to the treatment in the control group.The two groups were compared in terms of overall response, gut microbiota parameters before and after treatment, and scores of major symptoms.Results: Both groups achieved an overall response rate of 100%(60/60).After treatment, both groups had significant reductions in the numbers of Enterobacter and Enterococcus and significant increases in the numbers of Lactobacillus and Bifidobacterium, andthe treatment group had significantly better improvements than the control group(P<0.05).Both groups had significant reductions in the scores of major symptoms at 1,3,and 6 months after treatment(P<0.05),but there were only significant differences between the two groups at 6 months after treatment(P<0.05).Conclusion: For patients with intrarectal proctoptosis, PPH combined with modified Buzhong Yiqi decoctioncan significantly alleviate clinical symptoms, correctgut microbiota dysbiosis, and consolidate long-term outcome after surgery, with a better clinical effect than PPH surgery alone.