苦参汤熏洗联合透明帽辅助内镜下套扎治疗痔疮临床观察

Clinical Observation of Kushen Decoction Fumigation and Washing Combined with Transparent Cap-assisted Endoscopic Ligation in the Treatment of Hemorrhoids

目的 观察苦参汤熏洗联合透明帽辅助内镜下套扎治疗痔疮的疗效。方法 随机分组2019年7月—2021年7月于河南大学第一附属医院行透明帽辅助内镜下套扎治疗痔疮患者98例分组,对照组(49例)予常规治疗,研究组(49例)联合苦参汤熏洗。比较2组疗效、术后恢复情况、肛肠动力学、并发症、术后1年复发率,再用Logistic回归分析筛选患者术后复发的独立危险因素。结果 研究组总有效率高于对照组(P<0.05)。研究组肛缘水肿消退、疼痛缓解、创面愈合短于对照组(均P<0.05)。治疗后2组的肛管静息压(ARP)、直肠静息压(RRP)均低于治疗前,且研究组低于对照组(均P<0.05)。研究组并发症总发生率低于对照组,复发率低于对照组(P=0.004)。年龄、未进行苦参汤熏洗均是患者术后复发的独立危险因素(均P<0.05)。结论 苦参汤熏洗联合透明帽辅助内镜下套扎治疗痔疮疗效显著,促进创面愈合、肛肠动力学改善,减少并发症及复发率。

Objective To observe the curative effect of Kushen decoction fumigation and washing combined with transparent cap assisted endoscopic ligation for hemorrhoids.Methods From July 2019 to July 2021,98 patients with hemorrhoids who underwent transparent cap-assisted endoscopic ligation in the First Affiliated Hospital of Henan University were randomly grouped into two groups.The control group of 49 cases received conventional treatment,and the study group of 49 cases combined with Fushen decoction fumigation and washing.The curative effect,postoperative recovery,anorectal dynamics,complications,and 1-year postoperative recurrence rate were compared,and the independent risk factors of postoperative recurrence were screened by Logistic regression analysis.Results The total effective rate of the study group was higher than that of the control group(P<0.05).Anal edema subsided,pain relief and wound healing in the study group were shorter than those in the control group(all P<0.05).After treatment,the anal canal resting pressure(ARP) and rectal resting pressure(RRP) of the 2 groups were lower than before treatment,and the study group was lower than the control group(all P<0.05).The total complication rate and recurrence rate of the study group were lower than those of the control group(P=0.004).Age and absence of fumigation with sophora flavescens were independent risk factors for postoperative recurrence(P<0.05).Conclusion Kushen decoction fumigation and washing combined with transparent cap-assisted endoscopic ligation is effective in treating hemorrhoids,which can promote wound healing,improve anorectal dynamics,reduce complications and recurrence rate.