针刺联合补中益气汤及生物反馈治疗Ⅰ、Ⅱ度直肠脱垂临床研究
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摘要
目的 :临床对于Ⅰ、Ⅱ度直肠脱垂的患者使用针刺法联合补中益气汤,同时辅以现代生物反馈疗法内外兼治,研究观察该联合疗法对直肠脱垂患者的治疗效果。方法 :选取2016年3月—2017年5月在我院接受治疗的96例Ⅰ、Ⅱ度直肠脱垂患者作为主要研究对象,按照随机数字法患者分为针药组32例(使用针刺行补法配合补中益气汤治疗),生物反馈组32例(生物反馈治疗),治疗组32例(使用针刺行补法、补中益气汤治配合生物反馈治疗)。3周为1个疗程,每组均需连续治疗8个疗程。记录3组患者治疗前1周及治疗结束1周后的排便情况,治疗结束2周后随访比较3组的直肠脱出程度及疗效;观察治疗后3个月内3组直肠脱垂的复发率及发生的不良反应。结果 :3组治疗后的排便情况及直肠脱垂程度均优于治疗前,差异有统计学意义(P<0.05);治疗结束1周后,治疗组的排便次数为(6.17±1.41)次分别高于针药组的(5.62±1.35)次及生物反馈组的(5.43±1.28)次,治疗组每次排便时间为(17.92±2.07)min、直肠脱垂程度为(0.27±0.11)分,分别低于针药组的(20.06±2.18)min、(0.43±0.12)分及生物反馈组的(19.75±2.11)min、(0.48±0.15)分,以上差异均有统计学意义(P<0.05);治疗结束2周后,治疗组的总治疗有效率为93.75%分别高于生物反馈组的81.25%及针药组的84.37%,差异有统计学意义(P<0.05);治疗后3个月内,针药组复发率为3.13%,生物反馈组复发率为6.25%,治疗组复发率为0,差异均有统计学意义(P<0.05);治疗组不良反应发生率为3.13%分别低于针药组的12.50%及生物反馈组为15.63%,差异均有统计学意义(P<0.05)。结论 :针刺辅以补中益气汤及生物反馈治疗能够有效缓解患者直肠脱垂程度,减轻患者痛苦,又可根除患病内因,改善人体内环境,达到标本兼治的目的,同时还可以提高患者的生活质量,有效控制病情复发率,疗效显著,具有临床应用价值。
Objective :For patients with grade Ⅰ or Ⅱ rectal prolapse,acupuncture combined with Buzhong Yiqi Decoction,and modern biofeedback therapy for internal and external treatment,were used to observe the therapeutic effect of this combined therapy on patients with rectal prolapse. Methods :96 patients withⅠ and Ⅱ degree rectal prolapse who were treated in our hospital from March 2016 to May 2017 were selected as the main subjects. According to the random number method,32 patients were divided into acupuncture groups(using acupuncture combined with Buzhong Yiqi Decoction),32 patients in the biofeedback group(biofeedback therapy)and 32 patients in the treatment group(using acupuncture,Buzhong Yiqi Decoction combined with biofeedback treatment). Three weeks were a course of treatment,and each group was required continuous treatment for 8 courses. The defecation of the three groups of patients 1 week before treatment and 1 week after treatment was recorded. The degree of rectal prolapse and the efficacy of the three groups were compared after 2 weeks of treatment. The recurrence rate and incidence of adverse reactions of rectal prolapse in the three groups were observed within 3 months after treatment.Results :The defecation and rectal prolapse of the three groups were better than those before treatment,and the difference was statistically significant(P<0.05). After 1 week of treatment,the number of defecation times in the treatment group was(6.17±1.41)times higher than(5.62±1.35)times in the acupuncture group and(5.43±1.28)times in the biofeedback group,the defecation time of the treatment group was(17.92±2.07) min and the degree of rectal prolapse was(0.27±0.11)point,which were lower than(20.06±2.18)min,(0.43±0.12)point of the acupuncture group and(19.75±2.11)min,(0.48±0.15)point of the biofeedback group respectively,the differences were statistically significant(P<0.05);After 2 weeks of treatment,the total effective rate of treatment in the treatment group was 93.75%,which was higher than 81.25% in the biofeedback group and 84.37% in the acupuncture group,the difference was statistically significant(P<0.05). Within 3 months after treatment,the recurrence rate was 3.13% in the acupuncture group,6.25% in the biofeedback group,and 0 in the treatment group,the difference was statistically significant(P<0.05). The incidence of adverse reactions in the treatment group was 3.13%,which was lower than 12.50% in the acupuncture group and 15.63% in the biofeedback group. The difference was statistically significant(P<0.05). Conclusion :Acupuncture combined with Buzhong Yiqi Decoction and biofeedback treatment can effectively improve the degree of rectal prolapse,relieve the pain of patients,eradicate the internal causes of illness,improve the environment of the human body,achieve the purpose of treating both the symptoms and the root causes,and also improve the patients' quality of life, control of disease recurrence rate effectively,and the treatment method has significant curative effect and clinical application value.
Objective :For patients with grade Ⅰ or Ⅱ rectal prolapse,acupuncture combined with Buzhong Yiqi Decoction,and modern biofeedback therapy for internal and external treatment,were used to observe the therapeutic effect of this combined therapy on patients with rectal prolapse. Methods :96 patients withⅠ and Ⅱ degree rectal prolapse who were treated in our hospital from March 2016 to May 2017 were selected as the main subjects. According to the random number method,32 patients were divided into acupuncture groups(using acupuncture combined with Buzhong Yiqi Decoction),32 patients in the biofeedback group(biofeedback therapy)and 32 patients in the treatment group(using acupuncture,Buzhong Yiqi Decoction combined with biofeedback treatment). Three weeks were a course of treatment,and each group was required continuous treatment for 8 courses. The defecation of the three groups of patients 1 week before treatment and 1 week after treatment was recorded. The degree of rectal prolapse and the efficacy of the three groups were compared after 2 weeks of treatment. The recurrence rate and incidence of adverse reactions of rectal prolapse in the three groups were observed within 3 months after treatment.Results :The defecation and rectal prolapse of the three groups were better than those before treatment,and the difference was statistically significant(P<0.05). After 1 week of treatment,the number of defecation times in the treatment group was(6.17±1.41)times higher than(5.62±1.35)times in the acupuncture group and(5.43±1.28)times in the biofeedback group,the defecation time of the treatment group was(17.92±2.07) min and the degree of rectal prolapse was(0.27±0.11)point,which were lower than(20.06±2.18)min,(0.43±0.12)point of the acupuncture group and(19.75±2.11)min,(0.48±0.15)point of the biofeedback group respectively,the differences were statistically significant(P<0.05);After 2 weeks of treatment,the total effective rate of treatment in the treatment group was 93.75%,which was higher than 81.25% in the biofeedback group and 84.37% in the acupuncture group,the difference was statistically significant(P<0.05). Within 3 months after treatment,the recurrence rate was 3.13% in the acupuncture group,6.25% in the biofeedback group,and 0 in the treatment group,the difference was statistically significant(P<0.05). The incidence of adverse reactions in the treatment group was 3.13%,which was lower than 12.50% in the acupuncture group and 15.63% in the biofeedback group. The difference was statistically significant(P<0.05). Conclusion :Acupuncture combined with Buzhong Yiqi Decoction and biofeedback treatment can effectively improve the degree of rectal prolapse,relieve the pain of patients,eradicate the internal causes of illness,improve the environment of the human body,achieve the purpose of treating both the symptoms and the root causes,and also improve the patients' quality of life, control of disease recurrence rate effectively,and the treatment method has significant curative effect and clinical application value.
引文
[1]陈朝文.直肠脱垂的外科治疗[J].中国医刊,2012,47(1):23-25.
[2]周勇,常伟.三联疗法治疗II~III度直肠脱垂39例观察[J].陕西医学杂志,2015(9):564.
[3]徐伟健,吴建忠,胡国金,等.补中益气丸联合生物反馈技术治疗气虚型便秘的临床研究[J].实用老年医学,2012,2(2):127-130.
[4]赵爽,史玉林.电刺激生物反馈联合补中益气汤治疗产后I度子宫脱垂疗效观察[J].辽宁中医药大学学报,2017,19(3):199-201.
[5]陈振宇,刘长宝.针刺联合生物反馈训练法治疗盆底痉挛综合征50例观察[J].中国临床医生杂志,2015(3):43-46.
[6]胡静,熊莉.生物反馈电刺激治疗联合补中益气汤对产后盆底康复疗效观察[J].中国妇幼保健,2016,31(8):1766-1768.
[7]赵燕,李成林.直肠脱垂的诊断和治疗[J].湖南中医药大学学报,2012,32(2):51-52.
[8]夏宇虹,王振宜.直肠脱垂的中医治疗进展[J].吉林中医药,2013,33(9):963-966.
[9]赵东京,令狐庆.小儿直肠脱垂中西医治疗6法[J].吉林中医药,2013,33(2):146-147.
[10]马志雄.补中益气汤治疗小儿脱肛55例疗效观察[J].西部中医药,2011,24(5):62.
[11]彭安娇.生物反馈疗法治疗直肠癌前切除术后综合征的疗效[J].中国普外基础与临床杂志,2013(1):32.
[12]吴许雄.针刺结合生物反馈治疗盆底失弛缓型便秘的临床研究[J].湖南中医药大学学报,2016(2):711-712.
[13]孟德霞,张苏闽.补中益气汤在肛肠科疾病中的临床应用[J].中医学报,2013,28(7):1072-1075.
[14]郑玲,丁曙晴,丁义江,等.针刺联合生物反馈治疗功能性肛门直肠痛疗效分析[J].中华胃肠外科杂志,2016,19(12):766.
[2]周勇,常伟.三联疗法治疗II~III度直肠脱垂39例观察[J].陕西医学杂志,2015(9):564.
[3]徐伟健,吴建忠,胡国金,等.补中益气丸联合生物反馈技术治疗气虚型便秘的临床研究[J].实用老年医学,2012,2(2):127-130.
[4]赵爽,史玉林.电刺激生物反馈联合补中益气汤治疗产后I度子宫脱垂疗效观察[J].辽宁中医药大学学报,2017,19(3):199-201.
[5]陈振宇,刘长宝.针刺联合生物反馈训练法治疗盆底痉挛综合征50例观察[J].中国临床医生杂志,2015(3):43-46.
[6]胡静,熊莉.生物反馈电刺激治疗联合补中益气汤对产后盆底康复疗效观察[J].中国妇幼保健,2016,31(8):1766-1768.
[7]赵燕,李成林.直肠脱垂的诊断和治疗[J].湖南中医药大学学报,2012,32(2):51-52.
[8]夏宇虹,王振宜.直肠脱垂的中医治疗进展[J].吉林中医药,2013,33(9):963-966.
[9]赵东京,令狐庆.小儿直肠脱垂中西医治疗6法[J].吉林中医药,2013,33(2):146-147.
[10]马志雄.补中益气汤治疗小儿脱肛55例疗效观察[J].西部中医药,2011,24(5):62.
[11]彭安娇.生物反馈疗法治疗直肠癌前切除术后综合征的疗效[J].中国普外基础与临床杂志,2013(1):32.
[12]吴许雄.针刺结合生物反馈治疗盆底失弛缓型便秘的临床研究[J].湖南中医药大学学报,2016(2):711-712.
[13]孟德霞,张苏闽.补中益气汤在肛肠科疾病中的临床应用[J].中医学报,2013,28(7):1072-1075.
[14]郑玲,丁曙晴,丁义江,等.针刺联合生物反馈治疗功能性肛门直肠痛疗效分析[J].中华胃肠外科杂志,2016,19(12):766.