西贝助便操及其源流初探

西贝助便操由贾小强主任医师在总结多年临床经验,结合古代中医思想上创立的防治慢性便秘的功法。此功法以中医升清降浊为理论依据,以传统导引术、服气法、撮谷道、摩法、捏脊等疗法为动作基础,运用意念、呼吸、动作配合,对阳明胃经、任脉、督脉、太阳膀胱经相关穴位进行有序导引和推揉,改善脏腑气机升降机能,促进腑气畅通,恢复大肠传导功能,从而达到治疗慢性便秘的作用。

Effect of High Suspension and Low Incision Surgery Based on Traditional Ligation of Chinese Medicine in Treatment of Mixed Haemorrhoids:A Multi-centre,Randomized,Single-Blind,Non-inferiority Clinical Trial

Objective:To observe the clinical effect of high suspension and low incision(HSLI)surgery on mixed haemorrhoids,compared with Milligan-Morgan haemorrhoidectomy.Methods:A multi-centre,randomized,singleblind,non-inferiority clinical trial was performed.Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing Rectum Hospital,Air Force Medical Center of People's Liberation Army of China,and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018.By using a blocked randomization scheme,participants were assigned to two groups.The experimental group was treated with HSLI,while the control group was treated with Milligan-Morgan haemorrhoidectomy.The primary outcome was the clinical effect evaluated at 12 weeks after operation.The secondary outcomes included the number of haemorrhoids treated during the operation,pain scores,use of analgesics,postoperative oedema,wound healing,incidence of anal stenosis,anorectal manometry after operation,as well as surgical duration,length of stay and total hospitalization expenses.A safety evaluation was also conducted.Results:In total,246 eligible participants were enrolled,with 123 cases in each group.There was no significant difference in the clinical effect between the two groups(100.00% vs.99.19%,P>0.05).Compared with the control group,the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group(P<0.05 or P<0.01);the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group(P<0.05).There was no significant difference in the incidence of anal stenosis,the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation(P>0.05).The surgical duration and length of stay in the experimental group were significantly longer than those in the control group,and the total hospitalization expense was significantly higher than that in the control group(all P<0.05).No adverse events were reported in either group during the whole trial or follow-up period.Conclusion:HSLI had the advantages of preserving the skin of anal canal completely,alleviating postsurgical pain and promoting rapid recovery after operation.(Registration No.Chi CTR1900022883).

肛周湿疹的治疗进展

肛周湿疹是肛肠科常见疾病,约占肛肠疾病的10%,是最常见的肛门周围皮肤疾病。属非传染性、过敏性炎症疾病,以瘙痒、渗出、反复发作为主要临床特征,严重影响患者的工作和生活。近年来,众多学者运用多种方法治疗肛周湿疹,在取得一定疗效的同时,不同疗法又存在各自的优势和不足。笔者在查阅大量文献后,从中医治疗、西医治疗、中西医结合治疗及其他治疗角度对肛周湿疹的治疗方法作一概述。