加味苦参汤坐浴联合挂线疗法治疗高位肛周脓肿的疗效观察

Study on Clinical Curative Effect of Modified Kushen Decoction Combined with Seton Therapy in Treatment of High Perianal Abscess

目的:探讨加味苦参汤坐浴联合挂线疗法治疗高位肛周脓肿的临床疗效。方法:自2016年3月-2017年12月选择本院高位肛周脓肿患者82例,随机分为对照组和观察组,分别为41例,对照组采用脓肿切开挂线疗法联合高锰酸钾治疗;观察组采用脓肿切开挂线疗法联合加味苦参汤坐浴治疗,术后2个月进行评定,比较两组间临床疗效、住院时间、脓腔愈合时间、腐肉脱落时间及视觉模拟评分法(Visual analogue scale,VAS)、Wexner量表,并对患者进行1年随访。结果:对照组有效率为80. 49%,观察组有效率为95. 12%,两组间有效率比较,差异有统计学意义(P <0. 05)。对照组在脓腔愈合时间、腐肉脱落时间及住院时间上,均高于观察组,差异有统计学意义(P <0. 05)。治疗后对照组和观察组VAS量表评分分别为(1. 52±1. 01)分、(0. 67±0. 59)分,Wexner量表评分分别为(1. 58±0. 65)分、(1. 19±0. 42)分,对照组和观察组上述指标比较,差异有统计学意义(P <0. 05)。对照组和观察组在创面感染、肛门功能障碍,差异无统计学意义(P> 0. 05)。随访1年,对照组复发率为17. 07%(7/41),观察组复发率为2. 44%(1/41),两组间复发率比较,差异有统计学意义(P <0. 05)。结论:加味苦参汤坐浴联合挂线疗法治疗高位肛周脓肿的临床疗效确切,有利于缩短恢复时间,减轻疼痛,且复发率低,值得广泛推广。

Objective:To investigate the clinical curative effect of Modified Kushen Decoction combined with Seton therapy in the treatment of high perianal abscess.Methods:Eighty-two patients with high peri anal abscess from March 2016 to December2017 were selected and randomly divided into control group and study group(41 cases).The control group received abscess incision and hanging line therapy combined with Potassium Permanganate treatment,and the study group addtionally received Modified Kushen Decoction.After 2 months,the clinical efficacy,the time of hospitalization,the healing time of the septic cavity,the time of the abscess of the septic cavity,the time of shedding of the meat and the visual analogue scale(VAS)and the Wexner scale were compared and the patients were followed up for 1 year.Results:The effective rate of the control group(80.49%)was lower than that of the study group(95.12%).The difference between the two groups was statistically significant(P<0.05).The control group’s healing time of pus cavity,decay time and hospitalization time were higher than those of the study group and the differences were statistically significant(P<0.05).After treatment,the scores of the VAS scale in the control group and the study group were 1.52±1.01 and 0.67±0.59,and the scores of the Wexner scale in two groups were 1.58±0.65 and 1.19±0.42.The differences were statistically significant(P<0.05).There was no significant difference between the control group and the study group on the wound infection or anal dysfunction(P>0.05).After 1 year of follow-up,the recurrence rate of the control group was 17.07%(7/41)and the recurrence rate of the study group was 2.44%(1/41).The recurrence rate of the two groups was statistically significant(P<0.05).Conclusion:The therapeutic effect of Modified Kushen Decoction combined with hanging line therapy on high peri anal abscess is effective,which is beneficial to shorten the recovery time,reduce the pain and have low recurrence rate.It is worthy of popularizing widely.