不同中药坐浴方案治疗肛周疾病术后肛门水肿的临床研究
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摘要
目的探讨不同中药坐浴方案在肛周疾病术后肛门水肿中的治疗效果。方法选取在我院肛肠科治疗的肛周疾病术后并发肛门水肿患者160例为研究对象,根据坐浴的温度及频次分为A、B、C、D四组,每组40例。A组每天早上坐浴1次,温度37℃;B组每天早上坐浴1次,温度42℃;C组每天早上、晚上各坐浴一次。温度37℃;D组每天早上、晚上各坐浴一次,温度42℃。观察术后疼痛程度、创面愈合情况、皮肤不良反应、临床疗效。结果D组患者总有效率95.0%,显著高于A、B、C三组患者(P<0.05);D组患者治疗后疼痛评分显著低于A、B、C三组,差异有统计学意义(P<0.05);D组患者在水肿消失时间、渗出物消失时间及创面愈合时间上面均显著优于其他三组(P<0.05);各组患者在红肿、瘙痒、过敏、溃烂及灼痛不良反应方面,D组患者略低于其余三组,但差异无统计学意义(P>0.05)。结论针对肛周疾病术后并发肛门水肿患者采用自拟参花洗剂方给予每天早晚2次坐浴,坐浴温度设置为42℃左右能够有效促进水肿的消退,缓解患者的疼痛程度,具有较好的治疗效果,值得进一步研究推广。
Objective To explore the therapeutic effect of different Chinese medicine bathing regimen on anal edema after the surgery perianal disease. Methods A total of 160 patients with anal edema after the surgery of perianal diseases who were treated in the Department of Proctology in our hospital were selected as the research subjects. According to the bathing temperature and frequency, the patients were divided into A, B, C, D four groups, with 40 patients in each group. Group A was given bathing once every morning, with the temperature of 37℃; group B was given bathing once every morning, with the temperature of 42℃; group C was given bathing once every morning and every night, with the temperature of 37 ℃; group D was given bathing once every morning and every night, with the temperature of 42℃.The degree of postoperative pain, wound healing, skin adverse reactions, and clinical efficacy were observed. Results The total effective rate was 95.0% in group D, which was significantly higher than that in group A, B and C(P<0.05);the scores of pain in group D were significantly lower than those in group A, B and C, and the differences were statistically significant(P<0.05); the time of disappearance of edema, time of exudate disappearance and wound healing time were significantly higher in group D than in other groups(P<0.05); the patients in group D were slightly lower than those in the other three groups in terms of redness, itching, allergies, ulcers, burning and other adverse reactions, but the differences were not statistically significant(P>0.05). Conclusion The bathing once every morning and every night by selfmade Shenhua lotion for the patients with anal edema after the surgery of perianal diseases, with the bathing temperature of 42℃ or so, can effectively promote the regression of edema, ease the pain degree of patients, which has a good therapeutic effect and is worthy of further study and promotion.
Objective To explore the therapeutic effect of different Chinese medicine bathing regimen on anal edema after the surgery perianal disease. Methods A total of 160 patients with anal edema after the surgery of perianal diseases who were treated in the Department of Proctology in our hospital were selected as the research subjects. According to the bathing temperature and frequency, the patients were divided into A, B, C, D four groups, with 40 patients in each group. Group A was given bathing once every morning, with the temperature of 37℃; group B was given bathing once every morning, with the temperature of 42℃; group C was given bathing once every morning and every night, with the temperature of 37 ℃; group D was given bathing once every morning and every night, with the temperature of 42℃.The degree of postoperative pain, wound healing, skin adverse reactions, and clinical efficacy were observed. Results The total effective rate was 95.0% in group D, which was significantly higher than that in group A, B and C(P<0.05);the scores of pain in group D were significantly lower than those in group A, B and C, and the differences were statistically significant(P<0.05); the time of disappearance of edema, time of exudate disappearance and wound healing time were significantly higher in group D than in other groups(P<0.05); the patients in group D were slightly lower than those in the other three groups in terms of redness, itching, allergies, ulcers, burning and other adverse reactions, but the differences were not statistically significant(P>0.05). Conclusion The bathing once every morning and every night by selfmade Shenhua lotion for the patients with anal edema after the surgery of perianal diseases, with the bathing temperature of 42℃ or so, can effectively promote the regression of edema, ease the pain degree of patients, which has a good therapeutic effect and is worthy of further study and promotion.
引文
[1]赵梅青,陈诚豪,钱弘泉.混合痔PPH加外剥内扎术后中药熏洗疗效观察[J].浙江中西医结合杂志,2013,23(6):473-474.
[2]何琳.肛周脓肿细菌感染的病原菌分布及耐药性[J].中华医院感染学杂志,2012,22(11):2452-2454.
[3]江城.中药坐浴促进肛周脓肿术后创面愈合效果观察[J].亚太传统医药,2015,11(13):85-86.
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[8]周立红,田建华.痔康洗剂坐浴浓度与不同坐浴时段对混合痔术后疼痛及水肿疗效的临床观察[J].中国保健营养(中旬刊),2014,24(1):238-239.
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[11]赵雨坤,李立,刘学,等.基于系统药理学探索甘草有效成分甘草甜素的药理作用机制[J].中国中药杂志,2016,41(10):1916-1920.
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[13]张秀平,周维华.中药坐浴在血液病患者肛周感染中的效果观察[J].医药前沿,2014,(34):347.
[14]黄伟,黄华丽,周阿成,等.消肿止痛方在肛周脓肿切开引流术后的临床疗效分析[J].贵州医药,2016,40(12):1279-1281.
[15]刘尔东,刘丹,刘杨,等.浅谈医用生物胶体分散剂与中药制剂用于治疗重度肛周脓肿45例[J].当代临床医刊,2015,(4):1557-1557.
[16]杨小毛,庞晓健.仙方活命饮加减坐浴对35例肛周脓肿术后创面愈合的临床观察[J].世界中医药,2011,6(5):394-396.
[17]刘晶,杨国玲.中药熏蒸坐浴对肛周疾病术后的护理影响[J].中国现代药物应用,2015,(10):194-195.
[18]蔡云霞,张春,黄碧彦,等.肛肠洗剂坐浴及辨证施护对肛周脓肿患者术后的疗效观察[J].吉林医学,2017,38(4):796-797.
[19]赵建芳,姚一多.坐浴对肛周脓肿术后创面愈合作用的研究进展[J].结直肠肛门外科,2012,18(6):407-408.
[20]蔺海波.消肿止痛方坐浴治疗肛门疾病术后疼痛水肿的疗效观察[J].东方食疗与保健,2015,(7):224,232.
[21]徐世文,朱国羿,李风华,等.苦参汤加减方联合肛门熏洗坐浴治疗痔术后肛缘水肿的临床疗效[J].临床合理用药杂志,2017,10(9):97-98.
[2]何琳.肛周脓肿细菌感染的病原菌分布及耐药性[J].中华医院感染学杂志,2012,22(11):2452-2454.
[3]江城.中药坐浴促进肛周脓肿术后创面愈合效果观察[J].亚太传统医药,2015,11(13):85-86.
[4]郑德,汪庆明,时良慧,等.不同熏洗时间影响混合痔术后并发症治疗效果的临床观察[J].中国综合临床,2012,28(8):813-816.
[5]魏永红,胡谍燕.中药洗剂坐浴治疗痔疮的疗效观察[J].医学信息,2013,(22):113-114.
[6]严姝霞,殷翠云,葛永盛,等.不同熏洗方式对混合痔术后疗效影响的比较研究[J].中华现代护理杂志,2016,22(32):4634-4637.
[7]胡智亮,肖航.中药熏洗坐浴改善肛肠科常规术后疼痛水肿的观察[J].中国中医急症,2010,19(12):2147-2148.
[8]周立红,田建华.痔康洗剂坐浴浓度与不同坐浴时段对混合痔术后疼痛及水肿疗效的临床观察[J].中国保健营养(中旬刊),2014,24(1):238-239.
[9]颜景颖,陈诗伟.中药苦参汤坐浴用于混合痔外剥内扎术后的疗效观察[J].实用医学杂志,2009,25(20):3504-3505.
[10]乔海元.中药坐浴方联合一次根治术治疗肛周脓肿的临床观察[J].临床合理用药杂志,2014,(18):168-169.
[11]赵雨坤,李立,刘学,等.基于系统药理学探索甘草有效成分甘草甜素的药理作用机制[J].中国中药杂志,2016,41(10):1916-1920.
[12]裴利霞.中药消栓通络方有效成分组及相关成分的药动学研究[D].中国协和医科大学,2008.
[13]张秀平,周维华.中药坐浴在血液病患者肛周感染中的效果观察[J].医药前沿,2014,(34):347.
[14]黄伟,黄华丽,周阿成,等.消肿止痛方在肛周脓肿切开引流术后的临床疗效分析[J].贵州医药,2016,40(12):1279-1281.
[15]刘尔东,刘丹,刘杨,等.浅谈医用生物胶体分散剂与中药制剂用于治疗重度肛周脓肿45例[J].当代临床医刊,2015,(4):1557-1557.
[16]杨小毛,庞晓健.仙方活命饮加减坐浴对35例肛周脓肿术后创面愈合的临床观察[J].世界中医药,2011,6(5):394-396.
[17]刘晶,杨国玲.中药熏蒸坐浴对肛周疾病术后的护理影响[J].中国现代药物应用,2015,(10):194-195.
[18]蔡云霞,张春,黄碧彦,等.肛肠洗剂坐浴及辨证施护对肛周脓肿患者术后的疗效观察[J].吉林医学,2017,38(4):796-797.
[19]赵建芳,姚一多.坐浴对肛周脓肿术后创面愈合作用的研究进展[J].结直肠肛门外科,2012,18(6):407-408.
[20]蔺海波.消肿止痛方坐浴治疗肛门疾病术后疼痛水肿的疗效观察[J].东方食疗与保健,2015,(7):224,232.
[21]徐世文,朱国羿,李风华,等.苦参汤加减方联合肛门熏洗坐浴治疗痔术后肛缘水肿的临床疗效[J].临床合理用药杂志,2017,10(9):97-98.