痔病术后并发症的中医药治疗进展
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摘要
综述了痔病术后并发症的中医辨证治疗及外用疗法。痔病术后并发症的中医辨证治疗可从湿热、瘀血、气虚论治,分别采用清热利湿、活血化瘀、补中益气治疗;其他疗法有外用中药熏洗、针灸、外用中药栓剂和中药软膏等。认为目前中医药治疗痔病术后并发症的方式较多,今后临床治疗痔病术后并发症应多法联用,根据患者的体质和证型,辨证内服中药,结合中药熏洗、针灸、外用中药栓剂和中药软膏等,以快速改善痔病术后并发症。同时可结合现代医学研究成果,采用中西医结合的内服与外用疗法以提高痔病术后并发症的治疗效果。
This article reviewed the syndrome-differentiation oral and external treatment with Chinese herbs for the postoperative complications of hemorrhoids in recent years. Postoperative complications of hemorrhoids can be differentiated into damp heat,blood stasis and Qi deficiency,which can be treated with the corresponding therapy of clearing heat and draining dampness,activating blood and resolving stasis,and strengthening middle energizer to nourish Qi. The external treatment covered fumigation and washing with Chinese herbs, acupuncture and moxibustion,external application of Chinese medicine suppository and ointment,etc. In recent years,there are various traditional Chinese medicine therapies for the treatment of postoperative complications of hemorrhoids. To rapidly relieve the postoperative complications of hemorrhoids,it is suggested that the combination of syndromedifferentiation oral and external treatment(including fumigation and washing with Chinese herbs,acupuncture and moxibustion, external application of Chinese medicine suppository and ointment)can be used according the constitutions and the syndromes of the patients; to enhance the therapeutic effect for the postoperative complications of hemorrhoids,oral use and external use of Chinese medicine combined with western medicine are recommended.
This article reviewed the syndrome-differentiation oral and external treatment with Chinese herbs for the postoperative complications of hemorrhoids in recent years. Postoperative complications of hemorrhoids can be differentiated into damp heat,blood stasis and Qi deficiency,which can be treated with the corresponding therapy of clearing heat and draining dampness,activating blood and resolving stasis,and strengthening middle energizer to nourish Qi. The external treatment covered fumigation and washing with Chinese herbs, acupuncture and moxibustion,external application of Chinese medicine suppository and ointment,etc. In recent years,there are various traditional Chinese medicine therapies for the treatment of postoperative complications of hemorrhoids. To rapidly relieve the postoperative complications of hemorrhoids,it is suggested that the combination of syndromedifferentiation oral and external treatment(including fumigation and washing with Chinese herbs,acupuncture and moxibustion, external application of Chinese medicine suppository and ointment)can be used according the constitutions and the syndromes of the patients; to enhance the therapeutic effect for the postoperative complications of hemorrhoids,oral use and external use of Chinese medicine combined with western medicine are recommended.
引文
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[2]田振国,吴斌.肛肠病术后并发症[J].中国实用内科杂志,2000,20(10):594.
[3]柴存社.TST与PPH治疗脱垂性痔临床疗效及对术后肛管口径变化的影响[J].结直肠肛门外科,2015,21(s1):80.
[4]高雪,韩霞.仙方活命饮临床治验[J].中国中医药信息杂志,2010,17(1):79.
[5]石岩.应用肿痛消减汤预防混合痔外剥内扎术后出现并发症的临床价值分析[J].辽宁中医药大学学报,2015,17(7):209.
[6]刘艳华,王金伟,倪秀茹.仙方活命饮加减坐浴治疗混合痔PPH术后肛门疼痛疗效观察[J].现代中西医结合杂志,2017,26(7):739.
[7]方芳.清热祛湿汤对痔TST术后恢复的疗效观察[J].四川中医,2018,36(11):166.
[8]明·李中梓.内经知要[M].北京:人民卫生出版社,2007.
[9]薛昶,王翔,邓森田.复元活血汤在痔术后应用的临床观察[J].陕西中医,2014,35(5)∶543.
[10]易满.复元活血汤预防痔手术后并发症40例[J].河南中医,2016,36(1):97.
[11]顾凯平.辨证治疗混合痔术后脾肺气虚证33例[J].陕西中医,2000,21(3):107.
[12]赵文树,陆金根,曹永清.补中益气丸治疗混合痔术后顽固性疼痛35例[J].中医药信息,2008,25(3):42.
[13]周润禾.补中益气汤治疗脾虚气陷型痔病术后并发症的临床研究[D].济南:山东中医药大学,2016
[14]汪毓敏,刘林峰.中药熏洗对吻合器痔上黏膜环切术术后疼痛的Meta分析[J].四川医学,2015,36(3):348.
[15]张平.中药熏洗方联合通理汤治疗痔疮PPH术后并发症临床疗效观察[J].四川医学,2017,35(2):108.
[16]于靖亮,令狐庆.中药熏洗对环状混合痔术后水肿、疼痛的治疗现状及研究进展[J].吉林中医药,2010,30(1):26.
[17]林晖,孙炼,孙健.肛愈散熏洗治疗混合痔术后并发症的临床疗效观察[J].结直肠肛门外科,2010,16(1):16.
[18]霍巨,刘丽辉.中药熏洗坐浴治疗湿热下注型混合痔术后并发症临床研究[J].辽宁中医杂志,2015,42(5):1010.
[19]王悦辉.中药熏洗坐浴改善肛肠科常规术后疼痛水肿的临床研究[J].中国医药科学,2015,5(23):107.
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[22]李宁.电针承山长强穴治疗痔疮疼痛疗效观察[J].中国针灸,2008,28(11):792.
[23]张思奋,赵江宁,袁东辉,等.穴位埋线超前镇痛对肛门病术后β-内啡肽和一氧化氮影响的研究[J].新中医,2010,42(12):104.
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[25]于晓华,马祖彬.电针对痔疮术后中重度疼痛的止痛时程的观察[J].上海针灸杂志,2012,31(8):587.
[26]薛昶,邓森田,陈静,等.穴位埋线法在肛肠手术后镇痛的应用[J].陕西中医,2015,36(8):1066.
[27]易进,张强,丁敏.长强穴埋线治疗混合痔术后创面疼痛临床观察[J].河北中医,2015,37(1):91.
[28]张恒,普俊学,王乙鸿,等.中药栓剂的临床应用及其新剂型[J].安徽医药,2015,19(10):1841.
[29]王海霞.普济痔疮栓用于混合痔术后临床观察[J].光明中医,2017,32(24):3571.
[30]谷见,张小元,李淑霞,等.大黄消痔栓用于混合痔术后60例的疗效观察[J].中医外治杂志,2015,24(5):26.
[31]关瑞剑,巢阳发,赵江宁,等.复方四黄栓用于混合痔术后镇痛的临床观察[J].新中医,2011,43(3):59.
[32]苗明三,郭艳,伊俊涛.中药外用研究的思路[J].时珍国医国药,2009,20(10):2574.
[33]何颖华,寇玉明,赖旖.复方四黄膏治疗混合痔术后疼痛及水肿30例[J].陕西中医,2009,30(11):1490.
[34]尤春霞,苏红梅,缪红莉.消肿止痛膏促进老年混合痔术后愈合的疗效研究[J].四川中医,2017,35(11):1579.