中医挂线疗法治疗肛瘘疾病对肛肠动力学指标变化的影响研究

Impacts of TCM Thread Drainage Therapy on Anorectal Dynamic Indicators in the Treatment of Anal Fistula

目的探讨中医挂线疗法在肛瘘疾病患者中的治疗效果及对肛肠动力学指标变化的影响。方法选择我院2015年1月-2015年10月收治的126例肛瘘患者,按照随机数字表法将患者分为对照组与治疗组,每组63例。对照组患者采用常规挂线方法治疗,治疗组采用中医挂线手法进行治疗。对比分析两组患者临床治疗效果,观察两组治疗前后平均伤口愈合时间及创面面积,记录并统计分析两组患者治疗前后肛肠动力学指标肛管最大收缩压(AMCP)、肛管最长收缩时间(ALCT)、肛管静息压(ARP)、直肠静息压(RRP)及直肠肛门反射(RAR)的变化。结果 (1)治疗组临床治疗总有效率为95.24%(60/63),对照组总有效率为77.78%(49/63),两组总有效率比较,差异有统计学意义(P<0.05);(2)治疗后治疗组患者平均伤口愈合时间(21.39±5.47)d及创面面积(13.94±2.51)cm2与对照组(30.02±5.89)d、(17.24±2.81)cm2比较均明显缩短、缩小,两组比较差异有统计学意义(P<0.05);(3)治疗后两组患者RAR敏感率与治疗前比较均降低,两组比较差异无统计学意义(P>0.05);(4)治疗前两组动力学指标比较,差异无统计学意义(P>0.05),治疗后两组AMCP、ALCT比较,差异无统计学意义(P>0.05),两组RRP、ARP均降低,治疗组与对照组比较降低程度更加明显,差异有统计学意义(P<0.05)。结论中医挂线应用于肛瘘疾病的治疗中,提高了患者的疾病治疗效果,缩短了创面愈合时间,减少了创面面积,减轻患者疼痛,促进术后肛肠功能的恢复,具有更高的临床应用价值。

Objective To explore the therapeutic effect of TCM thread drainage therapy on anal fistula and the changes in anorectal dynamic indicators. Methods One hundred and twenty-six patients of anal fistula treated in the hospital from January 2015 to October 2015 were randomized into a control group and a treatment group,63 cases in each one. In the control group,the routine thread drainage was applied. In the treatment group,TCM thread drainage manipulation was used. The clinical therapeutic effects were compared between the two groups. The average wound healing time and wound area were observed before and after treatment in the two groups. Before and after treatment,the anorectal dynamic indicators such as AMCP,ALCT,ARP,RRP and RAR were recorded and analyzed statistically in the two groups. Results 1. The total effective rate was 95. 24%( 60 /63) in the treatment group and was 77. 78%( 49 /63) in the control group,indicating the significant difference( P < 0. 05). 2. After treatment,the average wound healing time was( 21. 39 ±5. 47) d and the wound area was( 13. 94 ± 2. 51) cm2 in the treatment group,which were reduced apparently as compared with( 30. 02 ± 5. 89) d and( 17. 24 ± 2. 81) cm2 in the control group respectively,indicating the significant differences( P < 0. 05). 3. RAP sensitive rate after treatment was reduced as compared with that before treatment in the two groups. The difference was not significant in comparison of the two groups( P >0. 05). 4. The differences in the anorectal dynamic indicators were not significant before treatment in the two groups( P > 0. 05). After treatment,the differences in AMCP and ALCT were not significant between the twogroups( P > 0. 05). The levels of RRP and ARP were all reduced in the two groups. The reducing degree in the treatment group was much more apparent as compared with the control group,indicating the significant difference( P < 0. 05). Conclusion TCM thread drainage therapy improves the therapeutic effect,shortens wound healing time,reduces wound area,alleviates pain and promotes the recovery of anal function in the treatment of anal fistula. This therapy is very valuable in clinical application.