益气桃红汤联合无张力疝修补术治疗嵌顿性腹股沟斜疝随机平行对照研究

Qi Taohong Decoction Combined with Tension-free Hernia Repair in Treatment of Strangulated Inguinal Hernia in a Randomized Controlled Study

[目的]观察益气桃红汤联合无张力疝修补术治疗嵌顿性腹股沟斜疝疗效。[方法]使用随机平行对照方法,将60例住院患者按随机数字表法分为两组。平衡水电解质,常规应用抗生素。对照组30例,27例腹股沟切口(连续硬膜外麻醉),3例腹部切口(全身麻醉)。依次切开皮肤,打开疝囊,绞窄坏死切除。结扎疝囊。13例填充式无张力疝修补术,17例行平片无张力修补术,将疝囊缝合固定,并放置引流管负压引流。治疗组30例益气桃红汤黄茂50g,桃仁、人参各20g,升麻、白术、炙甘草各15g,陈皮、当归各、红花、丹参、元胡各10g。1剂/d,水煎250mL,早晚服用。其他治疗同对照组。连续治疗14d为1疗程。观测临床症状、留置导尿管时间、下床活动时间、肛门排气时间、住院时间、不良反应。连续治疗1疗程,判定疗效。随访2年观察两组患者的留置导尿管时间、下床活动时间、肛门排气时间、住院时间等。[结果]治疗组痊愈12例,显效10例,有效6例,无效2例,总有效率93.33%。对照组痊愈8例,显效7例,有效6例,无效9例,总有效率70.00%。治疗组疗效优于对照组(P<0.05)。指标改善治疗组优于对照组(P<0.05)。[结论]益气桃红汤联合无张力疝修补术治疗嵌顿性腹股沟斜疝方面效果显著,值得推广。

[Objective]Observe the effect of Taohong decoction combined with tension-free hernia repair in treatment of strangulated inguinal hernia treatment.[Methods]Using randomized controlled Methods,will be randomly divided into two groups of 60 cases of hospitalized patients.Routine ECG,blood and urine routine,liver and kidney function,correct water and electrolyte balance,routine use of antibiotics.A control group of 30 cases of tension-free hernia repair in 27 cases with inguinal incision,continuous epidural anesthesia;3 cases with abdominal incision,given general anesthesia.Routine sterilization shop towel,followed by skin incision,find the hernia sac and to open,to confirm for the strangulation and necrosis after intestinal resection.Ligation of the hernia sac,with iodine,saline lavage wild.13 cases of filling tension-free hernia repair,the other 17 patients underwent tension-free hernia repair,the suture fixation,and the drainage tube in the incision side leads to make negative pressure drainage.The treatment group of 30 cases and pink soup Huang Mao 50g,peach kernel,ginseng,Rhizoma Atractylodes,20g,licorice,dried tangerine peel,angelica each 15g each,safflower,Danshen,Rhizoma Corydalis each 10g.Decoction 250mL,agent/d,morning and evening 2.Other treatment with the control group.Continuous treatment with 14d for 1 courses.Observation of clinical symptoms,indwelling catheter time,ambulation time,anal exhaust time,hospitalization time,adverse reaction.Continuous 1 courses of treatment,the curative effect.In 60 patients after 6 months to 2 years follow-up.[Results]the treatment group 12 cases were cured,10 cases markedly effective,effective 6 cases,invalid 2 cases,the total efficiency of 93.33%.The control group cured 8 cases,effective in 7 cases,effective 6 cases,invalid 9 cases,the total efficiency of 70%.The efficacy of the treatment group than in control group(P<0.05).Related index were improved in treatment group than in control group(P<0.05).[Conclusion]Qi Taohong decoction combined with tension-free hernioplasty for inguinal hernia at block effect significantly,worthy of promotion.