中药坐浴并铜离子电化学术联合外痔切除治疗混合痔患者的疗效观察
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摘要
目的:探讨中药坐浴并铜离子电化学术联合外痔切除治疗混合痔患者的临床效果。方法:选取2015年1月至2016年1月河北北方学院附属第二医院肛肠外科收治的混合痔患者64例作为研究对象,随机分为观察组及对照组,每组32例。观察组采用铜离子电化学术联合外痔切除术治疗后中药坐浴;对照组采用外剥内扎治疗法。观察2组的临床疗效,以及术后疼痛、出血、水肿及恢复情况。结果:观察组术后首次排便及术后3d换药时的疼痛程度分布情况,与对照组比较,差异有统计学意义(Z=6.823、8.130, P=0.033、0.017);观察组出血评分分布情况与对照组比较,差异有统计学意义(Z=6.541,P=0.038);观察组术后切缘水肿评分分布情况与对照组比较,差异有统计学意义(Z=13.576,P=0.001);创面恢复评分分布情况与对照组比较,差异有统计学意义(Z=7.063,P=0.029);观察组临床治愈率(78. 13%)高于对照组(46. 88%),差异有统计学意义(P<0.05)。结论:相对传统手术方法,铜离子电化学术联合外痔切除并中药坐浴治疗混合痔,具有术后疼痛轻、出血少、水肿轻及恢复快的优势。
Objective: To explore the clinical effect of traditional Chinese medicine hip bath after copper ion electrochemistry combined with external hemorrhoidectomy in the treatment of mixed hemorrhoids. Methods : Totally 64 patients with mixed hemorrhoids admitted to the Anorectal Surgery Department of the Second Affiliated Hospital of Hebei North University from January 2015 to January 2016 were selected,and randomly divided into observation group and control group, with 32 cases in each group. The observation group was treated by Chinese medicine hip bath after copper ion electrochemistry combined with traditional external hemorrhoidectomy, while the control group was treated by external stripping and internal ligation. The clinical efficacy, pain, hemorrhage, edema and recovery of the two groups were observed. Results : The pain degree distribution of the first defecation and dressing change 3 d after operation in the observation group was significantly different from that in the control group( Z = 6. 823, 8. 130, P = 0. 033, 0. 017); the distribution of bleeding scores in the observation group was significantly different from that in the control group( Z = 6. 541, P = 0. 038); the distribution of incisal margin edema scores in the observation group was significantly different from that in the control group( Z = 13. 576, P =0. 001); distribution of wound recovery scores was significantly different from that of the control group( Z = 7. 063, P = 0. 029). The clinical cure rate of the observation group was 78. 13%, which was higher than that of the control group(46. 88%), the different was significant( P < 0. 05). Conclusion:Compared with traditional operation, Chinese medicine hip bath after copper ion electrochemistry combined with external hemorrhoids excision has the advantages of less pain, less bleeding, lighter edema and faster recovery.
Objective: To explore the clinical effect of traditional Chinese medicine hip bath after copper ion electrochemistry combined with external hemorrhoidectomy in the treatment of mixed hemorrhoids. Methods : Totally 64 patients with mixed hemorrhoids admitted to the Anorectal Surgery Department of the Second Affiliated Hospital of Hebei North University from January 2015 to January 2016 were selected,and randomly divided into observation group and control group, with 32 cases in each group. The observation group was treated by Chinese medicine hip bath after copper ion electrochemistry combined with traditional external hemorrhoidectomy, while the control group was treated by external stripping and internal ligation. The clinical efficacy, pain, hemorrhage, edema and recovery of the two groups were observed. Results : The pain degree distribution of the first defecation and dressing change 3 d after operation in the observation group was significantly different from that in the control group( Z = 6. 823, 8. 130, P = 0. 033, 0. 017); the distribution of bleeding scores in the observation group was significantly different from that in the control group( Z = 6. 541, P = 0. 038); the distribution of incisal margin edema scores in the observation group was significantly different from that in the control group( Z = 13. 576, P =0. 001); distribution of wound recovery scores was significantly different from that of the control group( Z = 7. 063, P = 0. 029). The clinical cure rate of the observation group was 78. 13%, which was higher than that of the control group(46. 88%), the different was significant( P < 0. 05). Conclusion:Compared with traditional operation, Chinese medicine hip bath after copper ion electrochemistry combined with external hemorrhoids excision has the advantages of less pain, less bleeding, lighter edema and faster recovery.
引文
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[14]杨波武,刘迁乔,王瑞.铜离子电化学治疗仪治疗痔疮疗效观察[J].现代中西医结合杂志,2014,23(7):764-765.
[15]宋立峰,赵占强,孙海芳,等.中药外用治疗痔疮术后并发症研究概述[J].环球中医药,2016,9(1):105-109.
[16]吴艳玲,朴慧善.蒲公英的药理研究进展[J].时珍国医国药,2004,15(8):519-520.
[2]中华医学会外科学分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南[J].中华胃肠外科杂志,2006,9(5):461-463.
[3]李志刚,王倩倩,吴玉泉,等.铜离子电化学疗法结合痔核剥切术治疗混合痔临床疗效观察[J].中国现代普通外科进展,2015,18(6):473-476.
[4]王跃振,刘异,马恒军,等.改良术式结合中药坐浴治疗结缔组织型环状混合痔的疗效观察[J].中华中医药学刊,2015,33(7):1778-1780.
[5]王玲君.PPH与外剥内扎治疗重度混合痔疗效比较[J].中国肛肠病杂志,2007,27(4):59.
[6]何立辉,周敬学.重度痔的治疗方法研究进展[J].湖北中医药大学学报,2012,14(5):67-70.
[7]高树波,孔令玉.痔上黏膜缝扎加分段外剥术治疗多发混合痔疗效观察内扎[J].中国现代普通外科进展,2010,13(1):313-314.
[8]欧阳山,龚时文,张春兴.铜离子电化学治疗混合痔的效果分析[J].中国当代医药,2014,21(20):65-67.
[9]陈福军,牟奇荣,贺平.环状混合痔的手术治疗现状[J].结直肠肛门外科,2013,19(2):130-132.
[10]王胜,谭文,何纯刚,等.混合痔手术方式的综述[J].结直肠肛门外科,2013,19(4):264-266.
[11]李东冰,谢振华,蔡亭,等.铜离子电化学疗法结合外痔切除术治疗混合痔的临床观察[J].北京中医药,2013,32(2):120-123.
[12]程先能,黄大春,卢小刚.铜离子微创治疗内痔的临床观察[J].生物医学工程与临床,2007,11(5):396-398.
[13]陈哲,韩铁强.铜离子电化学治疗+消痔灵注射治疗老年内痔脱出的临床研究[J].北京医学,2014,36(10):878-879.
[14]杨波武,刘迁乔,王瑞.铜离子电化学治疗仪治疗痔疮疗效观察[J].现代中西医结合杂志,2014,23(7):764-765.
[15]宋立峰,赵占强,孙海芳,等.中药外用治疗痔疮术后并发症研究概述[J].环球中医药,2016,9(1):105-109.
[16]吴艳玲,朴慧善.蒲公英的药理研究进展[J].时珍国医国药,2004,15(8):519-520.