肛门内括约肌单侧部分切断术联合中药熏洗治疗肛裂的效果研究

Study on effect of unilateral partial resection of internal anal sphincter combined with fumigation and washing of traditional Chinese medicine on anal fissure

目的探讨肛门内括约肌单侧部分切断术联合加味苦参汤中药熏洗治疗肛裂的临床效果。方法87例肛裂患者,根据治疗方式不同分为对照组(43例)和观察组(44例)。对照组单纯采用肛门内括约肌单侧部分切断术治疗,观察组采用肛门内括约肌部分切断术联合加味苦参汤中药熏洗治疗。比较两组患者的治疗效果、创面愈合情况(创面缩小率、细菌清除率、肉芽组织覆盖率以及肉芽组织生长厚度)、并发症发生情况。结果观察组患者总有效率93.18%高于对照组的76.74%,有统计学意义(P<0.05)。观察组患者创面缩小率(82.24±9.26)%、细菌清除率(85.12±9.12)%、肉芽组织覆盖率(73.12±6.45)%以及肉芽组织生长厚度(5.37±1.25)mm均高于对照组的(64.34±6.98)%、(77.95±8.44)%、(51.76±5.52)%、(3.23±0.95)mm,有统计学意义(P<0.05)。观察组患者并发症发生率4.55%低于对照组的18.60%,有统计学意义(P<0.05)。结论相比于单纯手术治疗,采用肛门内括约肌单侧部分切断术结合加味苦参汤中药熏洗治疗肛裂患者在临床效果、创面愈合情况及并发症发生率方面均有显著优势,这也提示了加味苦参汤术后熏洗肛裂具有优势,是一种值得临床推广的治疗方案。

Objective To explore the clinical effect of unilateral partial resection of internal anal sphincter combined with modified Kushen Decoction on anal fissure.Methods 87 patients with anal fissure were divided into a control group(43 cases)and an observation group(44 cases)based on different treatment methods.The control group was treated with unilateral partial resection of internal anal sphincter,and the observation group was treated with unilateral partial resection of internal anal sphincter combined with fumigation and washing of modified Kushen Decoction.Comparison was made on therapeutic effect,wound healing status(wound reduction rate,bacterial clearance rate,granulation tissue coverage rate,and granulation tissue growth thickness),and occurrence of complications between the two groups.Results The total effective rate of the observation group was 93.18%,which was higher than 76.74%of the control group,with statistical significance(P<0.05).The observation group had wound reduction rate of(82.24±9.26)%,bacterial clearance rate of(85.12±9.12)%,granulation tissue coverage rate of(73.12±6.45)%and granulation tissue growth thickness of(5.37±1.25)mm,which were higher than(64.34±6.98)%,(77.95±8.44)%,(51.76±5.52)%and(3.23±0.95)mm in the control group,with a statistical significance(P<0.05).The complication rate of the observation group was 4.55%,which was lower than 18.60%of the control group,with a statistical significance(P<0.05).Conclusion For patients with anal fissure,unilateral partial resection of internal anal sphincter combined with fumigation and washing of traditional Chinese medicine have significant advantages in terms of clinical effect,wound healing,and incidence of complications compared with simple surgical treatment.This also suggests that the modified Kushen Decoction has advantages in the treatment of anal fissure through postoperative fumigation and washing,and is a clinically worthy treatment plan for clinical promotion.