摘要
目的探讨大C环术加直肠黏膜点状缝扎固定术合补中益气汤治疗直肠黏膜内脱垂型便秘的临床疗效。方法选取2021年1月—2022年8月期间就诊于福建省人民医院的直肠黏膜内脱垂型便秘患者60例,按随机数字表法分为对照组和治疗组各30例。对照组行吻合器痔上黏膜环切术,治疗组行大C环术加直肠黏膜点状缝扎固定术,术后均予口服补中益气汤。治疗14 d后,观察比较两组患者的临床总有效率、肛门疼痛评分,治疗前后临床症状积分、高分辨固态肛门直肠压力的差异。结果治疗后治疗组临床总有效率96.67%(29/30)与对照组93.33%(28/30)比较,差异无统计学意义(P>0.05)。治疗后两组患者临床症状排便困难、排便不尽、排便频率积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组临床症状排便困难、排便不尽、排便频率积分均较对照组明显降低,差异有统计学意义(P<0.05)。两组患者术后第2天、第4天、第7天VAS评分比较,差异无统计学意义(P>0.05)。治疗后两组患者肛管静息压力平均值、肛管收缩压力平均值、肛管收缩压力最大值、肛管功能长度指标均较优于治疗前,差异有统计学意义(P<0.05);且治疗组肛管功能长度指标明显小于对照组,差异有统计学意义(P<0.05)。结论大C环术加直肠黏膜点状缝扎固定术辅以补中益气汤,可有效减轻直肠黏膜内脱垂型患者的便秘症状,值得临床推广使用。
Objective To investigate the clinical efficacy of major Arc-shape procedure for prolapse and hemor⁃rhoids combined with rectal mucosal punctal suture fixation plus Buzhong Yiqi Decoction in the treatment of rectal internal mucosa prolapse(RIMP)related constipation.Methods Sixty patients with RIMP related constipation who visited Fujian Provincial People′s Hospital from January 2021to August 2022 were selected and randomly divided into a control group and a treatment group with 30 cases each according to the random number table method.The patients in the control group un⁃derwent stapler suprahemorrhoidal mucosal circumcision,and the patients in the treatment group underwent major Arc-shape procedure for prolapse and hemorrhoids combined with rectal mucosal punctal suture fixation,and both were given o⁃ral BuzhongYiqi Decoction after the operation.After 14 days of treatment,the difference in clinical total effective rate,anal pain score,clinical symptom score,and high-resolution solid anorectal pressure was compared between the two groups of patients.Results The clinical total effective rate of the treatment group was 96.67%(29/30)compared to the control group of 93.33%(28/30),and the difference was not statistically significant(P>0.05).After treatment,the scores of clinical symptoms including difficult defecation,incomplete defecation and frequency of defecation in the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).Moreover,the scores of clini⁃cal symptoms including difficult defecation,incomplete defecation and frequency of defecation in the treatment group were lower than those in the control group,and the differences were statistically significant(P<0.05.There was no significant difference in VAS scores between the two groups on the 2nd,4th and 7th day after surgery(P>0.05).After treatment,the mean value of anal canal resting pressure,mean value of anal canal systolic pressure,maximum value of anal canal systolic pressure,and functional length of the anal canal of the two groups of patients were elevated compared with those before treatment,and the difference was statistically significant(P<0.05).The functional length of the anal canal of the patients in the treatment group was significantly smaller than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Major Arc-shape procedure for prolapse and hemorrhoids combined with rectal mucosal punc⁃tal suture fixation plus Buzhong Yiqi Decoction can effectively improve the IRMP related constipation,and is worthy of clin⁃ical promotion.
作者
李阳
汪昭楚
赵晨孜
简愿
吴涵彬
林朱敏
石荣
LI Yang;WANG Zhao-chu;ZHAO Chen-zhi;JIAN Yuan;WU Han-bin;LIN Zhu-min;SHI Rong(The Affiliated People′s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350004;Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350122;Chen min-fan TCM Master Inheritance Studio,Fuzhou Fujian 350004)
出处
《世界中西医结合杂志》
2023年第10期2011-2015,2020,共6页
World Journal of Integrated Traditional and Western Medicine
基金
福建省科技厅社会发展科技引导性项目(2020Y0049)
国家中医药管理局2022年陈民藩国医大师传承工作室建设项目(国中医药办人教函[2022]245号)。
关键词
直肠黏膜内脱垂
大C环术
直肠黏膜点状缝扎固定术
补中益气汤
便秘
Rectal Internal Mucosa Prolapse
Major Arc-Shape Procedure for Prolapse And Hemorrhoids
Rectal Mucosal Punctal Suture Fixation
Buzhong Yiqi Decoction
Constipation
