肛裂洗剂治疗Ⅰ、Ⅱ期肛裂的临床疗效观察

Clinical Effect of Anal Fissure Lotion in the Treatment of StageⅠandⅡAnal Fissures

目的探讨肛裂洗剂对Ⅰ、Ⅱ期肛裂患者的临床疗效及对肛管静息压(ASRP)的影响。方法选取2020年12月至2021年12月就诊于银川市中医医院肛肠科门诊且符合标准的120例Ⅰ、Ⅱ期肛裂患者,按随机数表法分为治疗组和对照组,每组60例。对照组用复方荆芥熏洗剂治疗,治疗组用肛裂洗剂治疗,比较两组患者在治疗前及治疗第7、14天疼痛、便血、便后疼痛缓解时间、裂口面愈合情况、症状总积分及治疗前后肛管静息压(ASRP)等指标,并观察治疗3个月后两组患者的复发次数。结果治疗组总有效率为86.7%,对照组总有效率为66.7%,治疗组高于对照组(P<0.05);患者的主要症状评分及症状总积分的时间主效应差异均有统计学意义(P均<0.05);便血、裂口愈合情况和症状总积分的组别主效应和交互效应差异均有统计学意义(P均<0.05);两组的疼痛评分及便后疼痛缓解时间评分的组别主效应和交互效应,差异均无统计学意义(P均>0.05);与对照组相比,治疗组的ASRP降低,复发次数更少(P均<0.05)。结论肛裂洗剂治疗Ⅰ、Ⅱ期肛裂的疗效明显,复发次数少,是一种可行的保守治疗方法。

Objective To investigate the clinical efficacy and effect on the anal sphincter resting pressure(ASRP)of anal fissure lotion on patients with stageⅠandⅡanal fissures.Methods A total of 120 patients with stageⅠandⅡanal fissures who consulted the outpatient clinic of the Department of Anorectology,Traditional Chinese Medicine Hospital of Yinchuan from December 2020 to December 2021 and met the criteria were selected and divided into the treatment group(n=60)and the control group(n=60)according to the number table method.The control group was treated with compound schizonepeta fumigation lotion,and the treatment group was treated with anal fissure lotion.The pain,hematochezia,time of pain relief after stool,healing of fissure surface and total symptom scores before and on the 7th and 14th day of treatment between two groups,ASRP before and after treatment were observed in both groups,and the number of recurrence was observed at followed up(after 3 months).Results The total effective rate of the treatment group was 86.7%,and that of the control group was 66.7%.The difference between the two groups was statistically significant(P<0.05).There were significant differences in the main symptom score and total symptom score of patients(P all<0.05).There were significant differences in the main effect and interaction effect of blood in stool,wound healing and total score of symptoms(P all<0.05).There was no significant difference between the two groups in the main effect and interaction effect of pain score and pain relief time score after defecation(P all>0.05).Compared with the control group,the ASRP in the treatment group was lower and the recurrence rate was less(P all<0.05).Conclusion Anal fissure lotion has definite efficacy in the treatment of stageⅠandⅡanal fissures,with fewer recurrences,meanwhile is a feasible and conservative treatment method.