康复新液联合生物反馈治疗对复杂性肛瘘切口愈合及肛门功能恢复的影响
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摘要
目的观察康复新液联合生物反馈治疗对复杂性肛瘘切口愈合及肛门功能恢复的影响。方法选取2015年10月至2017年1月接收的复杂性肛瘘患者106例为研究对象,随机分为对照组与研究组,各53例。两组均给予常规治疗,对照组在此基础上给予康复新液治疗,研究组在对照组的基础上给予生物反馈治疗。统计两组术后7、14、21 d创面疼痛评分、渗液评分和肉芽生长评分,记录两组术后创面愈合所用天数,观察两组入院时及术后2个月排便情况、肛门功能Williams评分及健康调查简表(SF-36)评分。结果术后7、14、21 d研究组疼痛评分、渗液评分及肉芽生长评分均显著低于对照组(P均<0.01);研究组创面愈合时间显著少于对照组(P<0.01);术后2个月两组排便次数、排便困难、排便不尽感等评分均比入院时显著降低(P均<0.01),且研究组显著低于对照组(P均<0.01);术后2个月两组Williams评分良好率均比入院时显著提高(P<0.05,P<0.01),且研究组显著优于对照组(P<0.05);术后2个月两组SF-36各维度评分均比入院时显著提高(P均<0.05),且研究组显著高于对照组(P均<0.05)。结论康复新液联合生物反馈治疗复杂性肛瘘患者,有利于促进术后切口愈合及肛门功能恢复。
Objective To observe the influences of Kangfuxin liquid combined with biofeedback therapy on wound healing and anal function recovery of complex anal fistula. Methods A total of 106 patients with complex anal fistula treated from October 2015 to January 2017 were selected as study objects and were divided into control group and study group randomly( n = 53,each). The conventional treatment plus Kangfuxin liquid was given in control group,and the biofeedback therapy was given in study group based on the regimen of control group. Wound pain score,percolation score and granulation growth score at 7-,14-and 21-day after surgery were recorded; the time of wound healing was recorded after surgery; defecation,anal Williams function score and 36-Item short form health survey( SF-36) score were observed at admission and 2 postoperative months. Results The scores of pain,percolation and granulation tissue growth at 7-,14-and 21-day after surgery were significantly lower in study group than those in control group( all P < 0. 01). Compared with control group,the time of wound healing significantly decreased in study group( all P < 0. 01). The scores of defecation frequency,defecation difficulty and defecation disorder at postoperative two months were significantly lower than those at admission in both two groups( all P < 0. 01) and were significantly lower in study group than those in control group( all P < 0. 01). At postoperative two months,both Williams score and SF-36 dimension scores were significantly higher than those at admission in two groups( P < 0. 05,P < 0. 01) and were significantly higher in study group than those in control group( all P <0. 05). Conclusion Kangfuxin liquid combined with biofeedback therapy can promote postoperative wound healing and recovery of anal functionin in patients with complex anal fistula.
Objective To observe the influences of Kangfuxin liquid combined with biofeedback therapy on wound healing and anal function recovery of complex anal fistula. Methods A total of 106 patients with complex anal fistula treated from October 2015 to January 2017 were selected as study objects and were divided into control group and study group randomly( n = 53,each). The conventional treatment plus Kangfuxin liquid was given in control group,and the biofeedback therapy was given in study group based on the regimen of control group. Wound pain score,percolation score and granulation growth score at 7-,14-and 21-day after surgery were recorded; the time of wound healing was recorded after surgery; defecation,anal Williams function score and 36-Item short form health survey( SF-36) score were observed at admission and 2 postoperative months. Results The scores of pain,percolation and granulation tissue growth at 7-,14-and 21-day after surgery were significantly lower in study group than those in control group( all P < 0. 01). Compared with control group,the time of wound healing significantly decreased in study group( all P < 0. 01). The scores of defecation frequency,defecation difficulty and defecation disorder at postoperative two months were significantly lower than those at admission in both two groups( all P < 0. 01) and were significantly lower in study group than those in control group( all P < 0. 01). At postoperative two months,both Williams score and SF-36 dimension scores were significantly higher than those at admission in two groups( P < 0. 05,P < 0. 01) and were significantly higher in study group than those in control group( all P <0. 05). Conclusion Kangfuxin liquid combined with biofeedback therapy can promote postoperative wound healing and recovery of anal functionin in patients with complex anal fistula.
引文
[1]荣新奇,马瑛.中西医结合治疗肛瘘的研究进展[J].湖南中医杂志,2013,29(6):142-145.
[2]毛春梅.肛瘘手术前后的护理体会[J].中外健康文摘,2012(33):363.
[3]丛继伟,周健.中药康复新液对肛瘘术后创面愈合临床效果观察及安全性评价[J].中华中医药学刊,2014,32(11):2809-2811.
[4]李文东,孙秀荣.中药白苇饮联合康复新液对复发性口腔溃疡患者唾液EGF及血清TNF-α水平的影响[J].中国临床研究,2016,29(4):533-536.
[5]俞汀,汤玉蓉,吴高珏,等.如何提高生物反馈治疗慢性便秘的疗效[J].中华内科杂志,2016,55(4):330-331.
[6]中华中医药学会肛肠分会.痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案)[J].中国肛肠病杂志,2004,24(4):42-43.
[7]李万华.中西医结合治疗肛周脓肿术后创面愈合的临床观察[J].中医药导报,2014,20(10):71-73.
[8]尹万斌,赵晓堂,戴雷,等.肛门括约肌功能测定方法的研究进展[J].国际外科学杂志,2015,42(8):567-570.
[9]Ware JE,Sherbourne CD.The MOS 36-ltem Short-Form Health Survey(SF-36)[J].Medical Care,1992,30(6):473-483.
[10]Tabry H,Farrands PA.Update on anal fistulae:surgical perspectives for the gastroenterologist[J].Can J Gastroenterol,2011,25(12):675-680.
[11]曲鹏飞,王红,韩俊泉,等.邓鹤鸣教授关于肛瘘瘘道病理变化的临床研究总结[J].中医学报,2014,29:504.
[12]Sileri P,Giarratano G,Franceschilli L,et al.Ligation of the intersphincteric fistula tract(LIFT):a minimally invasive procedure for complex anal fistula:two-year results of a prospective multicentric study[J].Surg Innov,2014,21(5):476-480.
[13]王传英,朱春生,彭虹.肛瘘患者手术切口应用生肌玉红膏纱布治疗的效果观察[J].护理学报,2013,20(13):60-61.
[14]赵炳会,刘国涛,王焕伶.坐浴方治疗高位复杂性肛瘘术疗效观察[J].陕西中医,2013,34(11):1523-1524.
[15]杨方武,马健,李祥龙,等.复杂性肛瘘两种手术方式治疗的临床效果对比[J].中外医学研究,2016,14(5):11-12.
[16]刘童婷,黄秀深,陈瑾,等.康复新液对慢性胃溃疡愈合环境和营养的影响[J].中成药,2013,35(12):2738-2740.
[17]康惠娟.康复新液灌肠治疗溃疡性结肠炎的护理体会[J].中国社区医师,2014(32):138.
[18]李羽西,李春雨.康复新液对低位肛瘘创面愈合的临床与实验研究[J].山西医药杂志,2014,43(7):751-753.
[19]胡可慧,李阳安,熊高华,等.康复训练联合肌电生物反馈治疗对脑卒中偏瘫患者运动功能的影响[J].中国康复,2013,28(1):37-38.
[20]穆云,王顺和,姚健,等.生物反馈治疗功能性排便障碍型便秘41例临床疗效观察[J].结直肠肛门外科,2014,20(1):10-13.
[21]李博.电刺激联合生物反馈治疗女性压力性尿失禁的临床观察[J].湖南中医药大学学报,2016,36:748-749.
[2]毛春梅.肛瘘手术前后的护理体会[J].中外健康文摘,2012(33):363.
[3]丛继伟,周健.中药康复新液对肛瘘术后创面愈合临床效果观察及安全性评价[J].中华中医药学刊,2014,32(11):2809-2811.
[4]李文东,孙秀荣.中药白苇饮联合康复新液对复发性口腔溃疡患者唾液EGF及血清TNF-α水平的影响[J].中国临床研究,2016,29(4):533-536.
[5]俞汀,汤玉蓉,吴高珏,等.如何提高生物反馈治疗慢性便秘的疗效[J].中华内科杂志,2016,55(4):330-331.
[6]中华中医药学会肛肠分会.痔、肛瘘、肛裂、直肠脱垂的诊断标准(试行草案)[J].中国肛肠病杂志,2004,24(4):42-43.
[7]李万华.中西医结合治疗肛周脓肿术后创面愈合的临床观察[J].中医药导报,2014,20(10):71-73.
[8]尹万斌,赵晓堂,戴雷,等.肛门括约肌功能测定方法的研究进展[J].国际外科学杂志,2015,42(8):567-570.
[9]Ware JE,Sherbourne CD.The MOS 36-ltem Short-Form Health Survey(SF-36)[J].Medical Care,1992,30(6):473-483.
[10]Tabry H,Farrands PA.Update on anal fistulae:surgical perspectives for the gastroenterologist[J].Can J Gastroenterol,2011,25(12):675-680.
[11]曲鹏飞,王红,韩俊泉,等.邓鹤鸣教授关于肛瘘瘘道病理变化的临床研究总结[J].中医学报,2014,29:504.
[12]Sileri P,Giarratano G,Franceschilli L,et al.Ligation of the intersphincteric fistula tract(LIFT):a minimally invasive procedure for complex anal fistula:two-year results of a prospective multicentric study[J].Surg Innov,2014,21(5):476-480.
[13]王传英,朱春生,彭虹.肛瘘患者手术切口应用生肌玉红膏纱布治疗的效果观察[J].护理学报,2013,20(13):60-61.
[14]赵炳会,刘国涛,王焕伶.坐浴方治疗高位复杂性肛瘘术疗效观察[J].陕西中医,2013,34(11):1523-1524.
[15]杨方武,马健,李祥龙,等.复杂性肛瘘两种手术方式治疗的临床效果对比[J].中外医学研究,2016,14(5):11-12.
[16]刘童婷,黄秀深,陈瑾,等.康复新液对慢性胃溃疡愈合环境和营养的影响[J].中成药,2013,35(12):2738-2740.
[17]康惠娟.康复新液灌肠治疗溃疡性结肠炎的护理体会[J].中国社区医师,2014(32):138.
[18]李羽西,李春雨.康复新液对低位肛瘘创面愈合的临床与实验研究[J].山西医药杂志,2014,43(7):751-753.
[19]胡可慧,李阳安,熊高华,等.康复训练联合肌电生物反馈治疗对脑卒中偏瘫患者运动功能的影响[J].中国康复,2013,28(1):37-38.
[20]穆云,王顺和,姚健,等.生物反馈治疗功能性排便障碍型便秘41例临床疗效观察[J].结直肠肛门外科,2014,20(1):10-13.
[21]李博.电刺激联合生物反馈治疗女性压力性尿失禁的临床观察[J].湖南中医药大学学报,2016,36:748-749.