中药方剂联合马应龙麝香痔疮膏对混合痔患者RPH术后肛周创面及肛门功能的影响

Effect of Chinese medicine combined with musk hemorrhoids ointment on perianal wound and anal function in patients with mixed hemorrhoids after RPH

目的探讨中药方剂联合马应龙麝香痔疮膏对混合痔患者自动痔疮套扎术(RPH)后肛周创面及肛门功能的影响。方法混合痔患者100例RPH术后分为观察组(51例)和对照组(49例)。观察组采用自拟中药方剂熏洗坐浴(每日1次)联合马应龙麝香痔疮膏外用(每日2次)治疗2周。对照组采用1∶5000高锰酸钾坐浴(每日1次)联合马应龙麝香痔疮膏外用(每日2次)治疗2周。观察两组治疗后临床疗效和术后并发症,比较治疗前后肛周创面评分和肛门功能。结果观察组临床总有效率高于对照组(96.08%vs.77.55%)(P<0.05)。观察组术后并发症发生率低于对照组(9.80%vs.38.78%)(P<0.01)。两组治疗后,肛周创面评分降低,肛管最大收缩压、肛管舒张压和肛管静息压升高,Wexner评分降低,而肛管高压带长度缩短(P<0.05);观察组上述指标优于对照组(P<0.05)。结论中药方剂联合马应龙麝香痔疮膏能促进混合痔患者RPH术后肛周创面愈合,有效缓解疼痛,改善肛门功能,降低术后并发症发生率。

Objective To observe the effect of Chinese medicine combined with musk hemorrhoids ointment on perianal wound and anal function in the patients with mixed hemorrhoids after Ruiyun procedure for hemorrhoids(RPH).Methods One hundred patients with mixed hemorrhoids were divided into two groups of A(51 cases)and C(49 cases).Group A was treated with self-designed Chinese medicine fumigation and sitting-bath once per day combined with musk hemorrhoids ointment twice per day for external use for 2 weeks.Group C was treated with potassium permanganate 1∶5000 sitting-bath once per day combined with musk hemorrhoids ointment twice per day for external use for 2 weeks.The clinical efficacy and postoperative complications were observed.Perianal wound score and anal function were compared before and after treatment.Results The total effective rate of group A was higher than that of group C(96.08%vs.77.55%)(P<0.05).The incidence of postoperative complications in group A was lower than that in group C(9.80%vs.38.78%)(P<0.01).After treatment,perianal wound score and Wexner score were decreased,anal canal maximum systolic pressure,anal canal diastolic pressure and anal canal resting pressure were increased,while anal canal high pressure band length was shortened in both groups(P<0.05),and the above indexes in group A were better than those in group C(P<0.05).Conclusion Chinese medicine combined with musk hemorrhoids ointment can promote perianal wound healing,effectively attenuate pain,improve anal function and reduce the incidence of postoperative complications in the patients with mixed hemorrhoids after RPH.