中医扩肛加激素注射结合养血润肠颗粒剂治疗耻骨直肠肌综合征型便秘疗效观察

Observation on therapeutic effect of anal dilatation plus hormone injection combined with Yangxue Runchang granule on constipation of puborectal muscle syndrome

目的评价中医扩肛加激素注射结合养血润肠颗粒剂治疗耻骨直肠肌综合征便秘的临床疗效。方法将2019年12月—2021年12月在广安门医院肛肠科就诊的50例耻骨直肠肌综合征型便秘患者随机分为观察组26例与对照组24例。对照组采用中医扩肛加激素注射治疗,术后不给予其他治疗;观察组在对照组治疗基础上,术后口服养血润肠颗粒剂3个月。观察2组术后3个月总有效率,术前、术后1周、术后3个月时Wexner便秘量化评分和术前及术后1周排粪造影情况。结果术后3个月观察组和对照组总有效率分别为92.3%(24/26)和91.7%(22/24),2组比较差异无统计学意义(P>0.05)。2组术后1周和术后3个月排便频率评分、每次排便时间评分均明显低于术前(P均<0.05),且观察组术后3个月不完全排空感评分明显低于术前(P<0.05);观察组术后3个月不完全排空感评分、每次排便时间评分均明显低于同期对照组(P均<0.05)。术后1周,2组力排时肛直角角度较术前明显变大(P均<0.05),但2组间比较差异无统计学意义(P>0.05);2组静息时肛直角角度与术前比较及组间比较差异均无统计学意义(P均>0.05)。结论中医扩肛加激素注射的手术方式能有效缓解耻骨直肠肌综合征型便秘患者症状,结合口服养血润肠颗粒剂治疗远期疗效更好。

Objective It is to evaluate the clinical efficacy of anal dilatation plus hormone injection combined with Yangxue Runchang granule in the treatment of constipation of puborectal muscle syndrome.Methods Fifty patients with constipation of puborectal muscle syndrome treated in the Anorectal Department of Guang’anmen Hospital from December 2019 to December 2021 were randomly divided into observation group with 26 cases and control group with 24 cases.The control group was treated with anal dilatation plus hormone injection,and no other treatment was performed after operation;the observation group was treated with Yangxue Runchang granule orally for 3 months on the basis of the treatment of the control group.The total effective rate at 3 months after operation,Wexner's constipation quantitative score before operation,at 1 week and 3 months after operation,and defecography before operation and at 1 week after operation were observed in the two groups.Results The total effective rates of the observation group and the control group at 3 months after operation were 92.3%(24/26)and 91.7%(22/24),respectively,there was no significant difference between the two groups(P>0.05).The scores of defecation frequency and each defecation time at one week and 3 months after operation were significantly lower than those before operation in the two groups(all P<0.05),and the scores of incomplete emptying sensation at 3 months after operation in the observation group were significantly lower than that before operation(P<0.05);the scores of incomplete emptying sensation and defecation time in the observation group at 3 months after operation were significantly lower than those in the control group at the same period(all P<0.05).At one week after operation,the angle of anal right angle when forced defecation was significantly larger than that before operation in the two groups(all P<0.05),but there was no significant difference between the two groups(P>0.05);there was no significant difference in the angle of anus right angle at rest compared with that before treatment in the two groups,as well as between the two groups(all P>0.05).Conclusion Anal dilatation plus hormone injection can effectively relieve the symptoms of patients with constipation of puborectal muscle syndrome,and the long-term effect is better when combined with oral Yangxue Runchang gran-ules.