解痉止痛方结合肛安软膏外敷治疗慢性肛裂临床研究

Clinical Study on Jiejing Zhitong Prescription Combined with External Application of Gang'an Ointment for Chronic Anal Cleft

目的:观察解痉止痛方结合肛安软膏外敷治疗慢性肛裂(CAF)的临床效果。方法:选取156例CAF患者为研究对象,按随机数字表法分为2组各78例。对照组在硝酸甘油软膏治疗的基础上给予肛安软膏外敷治疗,试验组在对照组基础上给予解痉止痛方治疗。比较2组中医疗效,比较2组治疗前后中医证候积分、肛管静息压(IASP)、视觉模拟评分法(VAS)评分、大便失禁严重度评分(Wexner)、世界卫生组织生活质量测定量表(WHOQOL)评分。结果:试验组中医总有效率97.44%,高于对照组88.46%(P<0.05)。治疗前,2组各中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组各中医证候积分均下降(P<0.05),且试验组低于对照组(P<0.05)。治疗前,2组IASP、VAS评分、Wexner评分比较,差异无统计学意义(P>0.05);治疗后,2组IASP、VAS评分、Wexner评分均降低(P<0.05),且试验组低于对照组(P<0.05)。治疗前,2组WHOQOL各项评分及总分比较,差异无统计学意义(P>0.05);治疗后,2组WHOQOL各项评分及总分均上升(P<0.05),且试验组高于对照组(P<0.05)。结论:解痉止痛方结合肛安软膏外敷治疗CAF效果显著,可有效缓解中医证候,恢复临床指标,改善疼痛程度,提高肛门功能及生活质量。

Objective:To observe the clinical effect of Jiejing Zhitong Prescription combined with external application of Gang'an Ointment for chronic anal cleft(CAF).Methods:A total of 156 cases of CAF patients were selected as the study subjects and divided into two groups according to the random number table method,with 78 cases in each group.Based on the treatment of Nitroglycerin Ointment,the control group was additionally given external application of Gang'an Ointment,and the Trial group was additionally treated with Jiejing Zhitong Prescription based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores,IAS basal pressure(IASP),Visual Analogue Scale(VAS)scores,Wexner Continence Grading Scale scores,and World Health Organization Quality of Life(WHOQOL)scores before and after treatment as well as the curative effects of TCM therapy were compared between the two groups.Results:The total effective rate of TCM therapy was 97.44%in the trial group,higher than that of 88.46%in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of TCM syndrome scores between the two groups(P>0.05);after treatment,TCM syndrome scores in the two groups were decreased(P<0.05),and the scores in the trial group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of IASP and the scores of VAS and Wexner between the two groups(P>0.05);after treatment,IASP and the scores of VAS and Wexner in the two groups were decreased(P<0.05),and the above indexes in the trial group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of single score and the total scores in WHOQOL between the two groups(P>0.05);after treatment,each single score and the total scores in WHOQOL in the two groups were increased(P<0.05),and the scores in the trial group were higher than those in the control group(P<0.05).Conclusion:Jiejing Zhitong Prescription combined with external application of Gang'an Ointment has a significant effect in treating CAF,which can effectively relieve TCM syndromes,recover clinical indexes,and improve the degree of pain,anal function and quality of life.