湿热熨法用于混合痔术后的临床疗效观察
|
摘要
[目的]观察湿热熨法用于混合痔术后的临床疗效,初步评价湿热熨法的有效性及安全性。[方法]将72例混合痔术后患者随机分为湿热熨法组及常规组,每组各36例,术后分别使用湿热熨法及常规熏洗坐浴法进行治疗。于手术当天及术后第3、7、10天观察两组患者手术切口疼痛、肛缘水肿、出血及渗出情况并记录症状积分;于手术当天及术后第7、10天测量并记录创面面积,并对两组创面面积、愈合率、愈合天数进行比较。[结果]术后第7、10天湿热熨法组患者术后疼痛、出血、水肿、渗液等并发症方面显著优于常规组(P<0.05),湿热熨法组患者术后愈合天数明显短于常规组(P=0.003)。[结论]与熏洗坐浴法比较,湿热熨法能更有效地减轻混合痔患者术后切口疼痛、肛缘水肿、出血及渗出,且能显著缩短创面愈合时间,无不良反应,安全性高。
[Objective] Through comparing a dampness-heat ironing method for reduction of complications after hemorrhoidectomy. The study aims to verify the efficacy and security of the dampness-heat ironing method. [Methods]A total of 72 patients with symptomatic grade Ⅲ or Ⅳ hemorrhoids, who underwent hemorrhoidectomy in the anorectal department of Shuguang Hospital, were randomly allocated into 2 groups. 36 patients in dampness-heat ironing group use Dampness-heat ironing method during the postoperation period, while regular group using Chinese herbal formula to steam and wash the wound. Clinical parameter sincluding pain, edema, bleeding and effusion were ranked into 4 grades which later were transcribed to scores for assessing treatment outcomes in both groups. In addition, the scale of the wound was also measured. Data was analyzed with statistics. [Results] There was no obvious difference in age or gender distribution between two groups. There were no difference in scores for pain, edema, bleeding, effusion or the wound area at the baseline between two groups(P>0.05). And there were no significant difference in scores of complications on the third day after surgery between two groups. However, the dampness-heat ironing group reported significantly decreased pain( P<0.01), edema(P<0.01), bleeding(P<0.01) and effusion(P<0.01) on the last day compared with regular group. At the end of the ten-day-long trail of postoperative follow-up period, 61.11% patients in dampnessheat ironing group and 30.56% patients in regular group showed remarkable therapeutic effects.There were no significant differences in postoperative scale of wound between two groups(P>0.05). [Conclusion] The results demonstrated that the dampness-heat ironing method could provide a safe and more effective treatment for the patient during post-hemorrhoidectomy period.
[Objective] Through comparing a dampness-heat ironing method for reduction of complications after hemorrhoidectomy. The study aims to verify the efficacy and security of the dampness-heat ironing method. [Methods]A total of 72 patients with symptomatic grade Ⅲ or Ⅳ hemorrhoids, who underwent hemorrhoidectomy in the anorectal department of Shuguang Hospital, were randomly allocated into 2 groups. 36 patients in dampness-heat ironing group use Dampness-heat ironing method during the postoperation period, while regular group using Chinese herbal formula to steam and wash the wound. Clinical parameter sincluding pain, edema, bleeding and effusion were ranked into 4 grades which later were transcribed to scores for assessing treatment outcomes in both groups. In addition, the scale of the wound was also measured. Data was analyzed with statistics. [Results] There was no obvious difference in age or gender distribution between two groups. There were no difference in scores for pain, edema, bleeding, effusion or the wound area at the baseline between two groups(P>0.05). And there were no significant difference in scores of complications on the third day after surgery between two groups. However, the dampness-heat ironing group reported significantly decreased pain( P<0.01), edema(P<0.01), bleeding(P<0.01) and effusion(P<0.01) on the last day compared with regular group. At the end of the ten-day-long trail of postoperative follow-up period, 61.11% patients in dampnessheat ironing group and 30.56% patients in regular group showed remarkable therapeutic effects.There were no significant differences in postoperative scale of wound between two groups(P>0.05). [Conclusion] The results demonstrated that the dampness-heat ironing method could provide a safe and more effective treatment for the patient during post-hemorrhoidectomy period.
引文
[1]瞿胤,杨巍,郑德,等.促愈熏洗方在肛瘘术后应用[J].中成药,2012,34(12):2298-2301.
[2]郑德,沈德海,应光耀,等.促愈熏洗方不同浓度和熏洗时间对痔术后并发症疗效的影响[J].上海中医药大学学报,2012,26(3):54-57
[3]中华中医药学会.中医肛肠科常见病诊疗指南[M].北京:中国中医药出版社,2012:1-3.
[4]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国中医药出版社,2012:53.
[5]于立恒.蒲公英药理作用研究进展[J].实用中医药杂志,2012,28(7):617-620.
[6]沙莎,孙裕光,谭剑虹,等.虎杖抑菌抗病毒的药理作用研究[J].上海畜牧兽医通讯,2009(3):19-20.
[7]公衍玲,王宏波,赵文英,等.虎杖及配伍醇提液不同极性提取物的抑菌活性[J].青岛科技大学学报(自然科学版),2008,29(5):419-421.
[8]倪士峰,刘惠,孙平文,等.苦参药理学研究新进展[J].时珍国医国药,2008,19(6):1506-1507.
[9]杨钰萍,沈祥春.氧化苦参碱药理作用的研究进展[J].中国医院药学杂志,2009,29(5):405-407.
[10]郭姝彤,刘永仙,艾彩莲,等.五倍子有效成分提取分离、药理作用及临床应用研究进展[J].陕西中医,2015,36(6):762-764.
[11]孙继梅,郑伟,周秀珍,等.蒲公英体外抑菌活性的研究[J].中国误诊学杂志,2009,9(11):2542-2543.
[12]冯学花,梁肖蕾.当归化学成分与药理作用的研究进展[J].广州化工,2012,40(22):16-18.
[13]黄海量.中药虎杖药理作用研究进展[J].西部中医药,2012,25(4):100-103.
[14]邹文芹,孙启荣,姚迪.中药苦参汤湿敷与熏洗坐浴对混合痔术后切口愈合的效果比较[J].结直肠肛门外科,2015,21(S1):81-83.
[15]马影蕊,张玉倩.烫熨疗法的现代临床应用[J].世界中西医结合杂志,2016,11(6):868-870.
[16]王琛,周倩.体位与直肠内容物对脱垂型痔疮患者肛门直肠压力的影响[J].复旦学报(自然科学版),2013,52(5):669-673.
[2]郑德,沈德海,应光耀,等.促愈熏洗方不同浓度和熏洗时间对痔术后并发症疗效的影响[J].上海中医药大学学报,2012,26(3):54-57
[3]中华中医药学会.中医肛肠科常见病诊疗指南[M].北京:中国中医药出版社,2012:1-3.
[4]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国中医药出版社,2012:53.
[5]于立恒.蒲公英药理作用研究进展[J].实用中医药杂志,2012,28(7):617-620.
[6]沙莎,孙裕光,谭剑虹,等.虎杖抑菌抗病毒的药理作用研究[J].上海畜牧兽医通讯,2009(3):19-20.
[7]公衍玲,王宏波,赵文英,等.虎杖及配伍醇提液不同极性提取物的抑菌活性[J].青岛科技大学学报(自然科学版),2008,29(5):419-421.
[8]倪士峰,刘惠,孙平文,等.苦参药理学研究新进展[J].时珍国医国药,2008,19(6):1506-1507.
[9]杨钰萍,沈祥春.氧化苦参碱药理作用的研究进展[J].中国医院药学杂志,2009,29(5):405-407.
[10]郭姝彤,刘永仙,艾彩莲,等.五倍子有效成分提取分离、药理作用及临床应用研究进展[J].陕西中医,2015,36(6):762-764.
[11]孙继梅,郑伟,周秀珍,等.蒲公英体外抑菌活性的研究[J].中国误诊学杂志,2009,9(11):2542-2543.
[12]冯学花,梁肖蕾.当归化学成分与药理作用的研究进展[J].广州化工,2012,40(22):16-18.
[13]黄海量.中药虎杖药理作用研究进展[J].西部中医药,2012,25(4):100-103.
[14]邹文芹,孙启荣,姚迪.中药苦参汤湿敷与熏洗坐浴对混合痔术后切口愈合的效果比较[J].结直肠肛门外科,2015,21(S1):81-83.
[15]马影蕊,张玉倩.烫熨疗法的现代临床应用[J].世界中西医结合杂志,2016,11(6):868-870.
[16]王琛,周倩.体位与直肠内容物对脱垂型痔疮患者肛门直肠压力的影响[J].复旦学报(自然科学版),2013,52(5):669-673.