耳穴压豆联合药泥灸预防混合痔术后尿潴留的临床应用研究

Clinical application of auricular point pressing with cowherb seeds combined with herbal mud moxibustion in preventing urinary retention after mixed hemorrhoid surgery

目的探讨耳穴压豆联合药泥灸预防混合痔术后尿潴留的效果。方法将临沂市中医医院肛肠外科2019年7月至2020年12月接收的混合痔手术患者120例随机分为对照组A、对照组B与研究组,每组40例。对照组A实施耳穴压豆;对照组B实施药泥灸;研究组实施耳穴压豆联合药泥灸。对比3组患者术后尿潴留发生率、术后排尿后膀胱残余尿量、中医症状评分。结果对照组A 37例、对照组B 38例、研究组36例纳入最终分析。对照组A 37例中男13例,女24例,年龄(41.60±7.96)岁;对照组B 38例中男16例,女22例,年龄(39.15±8.14)岁;研究组36例中男15例,女21例,年龄(42.07±8.26)岁。研究组术后第1天[16.67%(6/36)比37.84%(14/37)]、术后第3天[8.33%(3/36)比29.73%(11/37)]的尿潴留发生率均低于对照组A,差异均有统计学意义(均P<0.05);研究组术后第1天[(62.32±16.28)ml比(74.35±22.18)ml、(71.68±21.45)ml]、术后第3天[(50.83±11.55)ml比(62.84±15.73)ml、(59.43±14.28)ml]及术后第5天[(43.16±9.57)ml比(53.48±13.29)ml、(50.79±11.46)ml]的残余尿量均低于对照组A、对照组B,差异均有统计学意义(均P<0.05);研究组术后第1天[(6.10±1.65)分比(7.35±2.08)分、(7.08±1.96)分]、术后第3天[(5.14±1.42)分比(6.12±1.94)分、(5.88±1.73)分]的中医症状评分均低于对照组A、对照组B(均P<0.05)。结论耳穴压豆联合药泥灸与仅采用耳穴压豆、药泥灸比较,预防尿潴留效果最佳,可更好地减少排尿后残余尿量,改善排尿效果。

Objective To explore the efficacy of auricular point pressing with cowherb seeds combined with medicinal mud moxibustion in preventing urinary retention after mixed hemorrhoid surgery.Methods A total of 120 cases of mixed hemorrhoid surgery in the Anorectal Surgery of Linyi Traditional Chinese Medical Hospital from July 2019 to December 2020 were randomly divided into a control group A,a control group B,and a study group,with 40 cases in each group.The control group A received auricular point pressing with cowherb seeds,the control group B received medicinal mud moxibustion,and the study group received auricular point pressing with cowherb seeds combined with herbal mud moxibustion.The incidences of postoperative urinary retention,the residual urine volumes of the bladder after urination,and the traditional Chinese medicine(TCM)symptom scores of the three groups were compared.Results Finally,37 cases in the control group A,38 cases in the control group B,and 36 cases in the study group were included in the analysis.In the control group A,there were 13 males and 24 females,aged(41.60±7.96)years;in the control group B,there were 16 males and 22 females,aged(39.15±8.14)years;in the study group,there were 15 males and 21 females,aged(42.07±8.26)years.The incidence of urinary retention in the study group was lower than that in the control group A on the postoperative 1st day[16.67%(6/36)vs.37.84%(14/37)]and the postoperative 3rd day[8.33%(3/36)vs.29.73%(11/37)],with statistically significant differences(both P<0.05).The residual urine volume of the study group was lower than those of the control group A and B on the postoperative 1st day[(62.32±16.28)mlvs.(74.35±22.18)ml,(71.68±21.45)ml],thepostoperative3rdday[(50.83±11.55)ml vs.(62.84±15.73)ml,(59.43±14.28)ml],and the postoperative 5th day[(43.16±9.57)ml vs.(53.48±13.29)ml,(50.79±11.46)ml],with statistically significant differences(all P<0.05).The TCM symptom score of the study group was lower than those of the control group A and B on the postoperative 1st day[(6.10±1.65)points vs.(7.35±2.08)points,(7.08±1.96)points]and the postoperative 3rd day[(5.14±1.42)points vs.(6.12±1.94)points,(5.88±1.73)points],with statistically significant differences(all P<0.05).Conclusion Auricular point pressing with cowherb seeds combined with herbal mud moxibustion has the best effect in preventing urinary retention,and can better reduce the residual urine volume after urination and improve the urination effect.