电针董氏“三其穴”配合耳穴贴压治疗复杂性肛瘘术后并发症:一项真实世界研究

Electroacupuncture at Dong’s Sanqixue combined with auricular point sticking in treatment of post-operative complications of complex anal fistula: a real world research

目的:评价电针董氏"三其穴"配合耳穴贴压治疗复杂性肛瘘术后并发症的临床疗效。方法:回顾性分析318例复杂性肛瘘手术患者资料,根据患者术后是否接受电针双侧董氏"三其穴"联合耳穴贴压治疗分为观察组(157例)和对照组(161例)。采用1︰1最邻近匹配法成功匹配125对患者,比较两组患者术后第1、7、14天视觉模拟量表(VAS)评分,术后第1、3天尿潴留发生率,手术前后肛肠动力学指标(肛管静息压、直肠静息压、肛管最大收缩压、直肠最低敏感量),并比较两组临床疗效。结果:VAS评分方面:治疗方法与治疗时间存在交互作用(P<0.05),治疗方法在VAS评分上主效应显著(P<0.05),治疗时间在VAS评分上主效应不显著(P>0.05)。两组术后第7、14天VAS评分均低于术后第1天(P<0.05),且观察组第7、14天VAS评分低于对照组(P<0.05)。术后第3天观察组尿潴留发生率低于对照组[0.8%(1/125)vs 9.6%(12/125),P<0.05]。术后第14天观察组肛管静息压、肛管最大收缩压、直肠最低敏感量低于对照组(P<0.05),直肠静息压高于对照组(P<0.05)。术后1个月观察组总有效率为96.0%(120/125),高于对照组的80.8%(101/125,P<0.05)。结论:电针董氏"三其穴"配合耳穴贴压可减轻复杂性肛瘘术后患者疼痛程度,减少术后尿潴留发生,改善肛门排便功能,提高临床治疗效果。

Objective To evaluate the clinical therapeutic effect of electroacupuncture(EA) at Dong’s Sanqixue combined with auricular point sticking on post-operative complications of complex anal fistula. Methods The data of 318 patients undergoing anal fistula surgery were analyzed retrospectively. In accordance with whether accepted the combined treatment with EA at bilateral Dong’s Sanqixue and auricular point sticking or not after operation, they were divided into an observation group(157 cases) and a control group(161 cases). At the ratio of 1︰1, the nearest neighbor matching method was adopted to match 125 pairs of patients. The score of visual analogue scale(VAS) on day 1, 7 and 14 after operation, the incidence of urine retention on day 1 and 3 after operation, the anorectal dynamical indexs(anal resting pressure, rectal resting pressure, anal maximum systolic pressure and rectal minimum sensitivity) before and after operation, as well as the clinical therapeutic effect were compared in the patients between the two groups separately. Results For VAS score, there was an interaction between therapeutic method and treatment duration(P<0.05);the main effect was significant for therapeutic method(P<0.05), while, it was not significant for treatment time(P>0.05). On day 7 and 14 after operation, VAS scores were lower than those on day 1 in the two groups(P<0.05), and VAS scores on day 7 and 14 after operation in the observation group were lower than those in the control group(P<0.05). On day 3 after operation, the incidence of urine retention in the observation group was lower than that in the control group(0.8% [1/125] vs 9.6% [12/125], P<0.05). On day 14 after operation, anal resting pressure, anal maximum systolic pressure and rectal minimum sensitivity in the observation group were lower than those in the control group(P<0.05), and rectal resting pressure was higher than that in the control group(P<0.05). In 1 month after operation, the total effective rate was 96.0%(120/125) in the observation group, higher than 80.8%(101/125) in the control group(P<0.05). Conclusion Electroacupuncture at Dong’s Sanqixue combined with auricular point sticking therapy alleviates pain, reduces the incidence of urine retention, improves anal defecation function and clinical therapeutic effect in the patients after complex anal fistula surgery.