中药浴液不同温度对混合痔术后相关影响的临床研究
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摘要
目的：观察浴液不同温度对混合痔外剥内扎术后疼痛、水肿、创面愈合的影响,并初步探讨其机理。
方法：将符合纳入标准的混合痔外剥内扎术后的患者,随机分为Ⅰ组、Ⅱ组和Ⅲ组,三组均以花子叶汤坐浴,Ⅰ组浴温[28,32℃],Ⅱ组浴温[33,36℃],Ⅲ组浴温[37,41℃],选择混合痔外剥内扎术后疼痛、水肿、创面愈合三个指标进行比较研究。
结果：
1.三组间一般情况均衡性的比较
性别P=0.300,年龄P=0.108,分期P=0.097,病程P=0.331,创面个数P=0.511,P均>0.05,统计学无显著差异,提示三组在一般资料方面具有可比性。
2.三组并发症治疗结果的比较
2.1三组术后肛门疼痛
术后第1、2、3、4、5天Ⅰ组与Ⅱ组比较Pd1=0.719,Pd2=0.181,Pd3=0.317,Pd4=0.521,Pd5=0.079,p均>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较肛门疼痛积分减少,P均<0.05,统计学具有显著性差异,提示Ⅲ对术后肛门疼痛的止痛效果优于Ⅰ组和Ⅱ组,而Ⅰ组和Ⅱ组止痛效果无显著差别。
2.2三组术后肛门水肿
术后第1、3、5天Ⅰ组与Ⅱ组比较Pd1=0.842,Pd3=0.783,Pd5=0.766,P均>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较肛门水肿积分减少,P均<0.05,统计学具有显著性差异,提示Ⅲ组对术后肛门水肿治疗效果优于Ⅰ组和Ⅱ组,Ⅰ组和Ⅱ组对术后肛门水肿治疗效果无显著差别。
2.3三组术后创面愈合时间
三组创面愈合时间比较,Ⅰ组与Ⅱ组P=0.424>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较创面愈合时间明显缩短,P均<0.05,统计学具有显著性差异,提示Ⅲ组术后创面愈合时间较Ⅰ组与Ⅱ组为短,Ⅰ组与Ⅱ组创面愈合时间无显著差别。
结论：
1.应用花子叶汤坐浴,浴温[37,41℃],在治疗痔术后肛门疼痛、水肿及缩短创面愈合时间方面优于[33,36℃]和[28,32℃]。
2.花子叶汤坐浴未见毒副作用和明显局部皮肤过敏反应,因此其应用于痔外剥内扎术后并发症的治疗是安全、可行的。
Objective:The effects of different hip bath temperature on the mixed hemorrhoid outside the Milligan-Morgan postoperative pain, edema, wound healing, and to explore its mechanism.
Methods:Will meet the inclusion criteria of mixed hemorrhoid outside the Milligan-Morgan surgery patients were randomly divided into groupⅠ,ⅡandⅢgroup, three groups are to spend the cotyledon Tang Bath,Ⅰgroup hip bath temperature [28,32℃], GroupⅡBath temperature [33,36℃],Ⅲgroup hip bath temperature [37,41℃], choice of mixing outside the Milligan-Morgan hemorrhoid post-operative pain, edema, wound healing and other indicators for comparative purposes.
Results:1.General balance between the two groups of comparison:gender p=0.300, age, p=0.108, stage p=0.097, course of disease p=0.331,wound number p=0.511 were >0.05, statistically no significant difference in Tip three groups were comparable information in general.
2. Three groups of complications of treatment outcomes in comparison:
2.1 The three groups of postoperative anal pain:1,2,3,4,5 days after the first groupⅠand groupⅡPd1=0.719, Pd2=0.181, Pd3=0.317, Pd4=0.521, Pd5=0.079 are>0.05, Note groupⅠandⅡwas no significant difference, while in groupⅢcompared with other groups, P<0.05, there is a statistically significant difference significant difference. Tip GroupⅢanal pain on postoperative pain is better than in groupⅠand groupⅡ,Ⅰgroup andⅡgroup was no significant difference in analgesic effect.
2.2 The three groups of postoperative anal edema:1,3,5 days after the first groupⅠand groupⅡPd1=0.842, Pd3=0.783, Pd5=0.766 are>0.05, Note groupⅠandⅡwas no significant difference, while in groupⅢcompared with other groups, P<0.05, statistically significant differences. Tip GroupⅢtreatment of postoperative edema than anal groupⅠand groupⅡ.
2.3 The three groups of postoperative wound healing time:Comparison of three groups of wound healing,Ⅰgroup andⅡgroup P=0.424> 0.05, in groupⅠandⅡgroup shows no significant difference. The groupⅢcompared with other groups, P<0.05, statistically significant differences. Tip GroupⅢwound healing time than groupⅠandⅡgroup was shorter.
Conclusion:
1 Bath temperature [37,41℃], hemorrhoid surgery in the treatment of anal pain, edema and shorten wound healing time than other two groups.
2 flower cotyledons Tang Bath no apparent toxic side effects and local skin allergies, so its application outside the Milligan-Morgan hemorrhoid treatment of post-operative complications is safe and feasible.
方法：将符合纳入标准的混合痔外剥内扎术后的患者,随机分为Ⅰ组、Ⅱ组和Ⅲ组,三组均以花子叶汤坐浴,Ⅰ组浴温[28,32℃],Ⅱ组浴温[33,36℃],Ⅲ组浴温[37,41℃],选择混合痔外剥内扎术后疼痛、水肿、创面愈合三个指标进行比较研究。
结果：
1.三组间一般情况均衡性的比较
性别P=0.300,年龄P=0.108,分期P=0.097,病程P=0.331,创面个数P=0.511,P均>0.05,统计学无显著差异,提示三组在一般资料方面具有可比性。
2.三组并发症治疗结果的比较
2.1三组术后肛门疼痛
术后第1、2、3、4、5天Ⅰ组与Ⅱ组比较Pd1=0.719,Pd2=0.181,Pd3=0.317,Pd4=0.521,Pd5=0.079,p均>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较肛门疼痛积分减少,P均<0.05,统计学具有显著性差异,提示Ⅲ对术后肛门疼痛的止痛效果优于Ⅰ组和Ⅱ组,而Ⅰ组和Ⅱ组止痛效果无显著差别。
2.2三组术后肛门水肿
术后第1、3、5天Ⅰ组与Ⅱ组比较Pd1=0.842,Pd3=0.783,Pd5=0.766,P均>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较肛门水肿积分减少,P均<0.05,统计学具有显著性差异,提示Ⅲ组对术后肛门水肿治疗效果优于Ⅰ组和Ⅱ组,Ⅰ组和Ⅱ组对术后肛门水肿治疗效果无显著差别。
2.3三组术后创面愈合时间
三组创面愈合时间比较,Ⅰ组与Ⅱ组P=0.424>0.05,说明Ⅰ组与Ⅱ组无显著性差异,而Ⅲ组与其它两组比较创面愈合时间明显缩短,P均<0.05,统计学具有显著性差异,提示Ⅲ组术后创面愈合时间较Ⅰ组与Ⅱ组为短,Ⅰ组与Ⅱ组创面愈合时间无显著差别。
结论：
1.应用花子叶汤坐浴,浴温[37,41℃],在治疗痔术后肛门疼痛、水肿及缩短创面愈合时间方面优于[33,36℃]和[28,32℃]。
2.花子叶汤坐浴未见毒副作用和明显局部皮肤过敏反应,因此其应用于痔外剥内扎术后并发症的治疗是安全、可行的。
Objective:The effects of different hip bath temperature on the mixed hemorrhoid outside the Milligan-Morgan postoperative pain, edema, wound healing, and to explore its mechanism.
Methods:Will meet the inclusion criteria of mixed hemorrhoid outside the Milligan-Morgan surgery patients were randomly divided into groupⅠ,ⅡandⅢgroup, three groups are to spend the cotyledon Tang Bath,Ⅰgroup hip bath temperature [28,32℃], GroupⅡBath temperature [33,36℃],Ⅲgroup hip bath temperature [37,41℃], choice of mixing outside the Milligan-Morgan hemorrhoid post-operative pain, edema, wound healing and other indicators for comparative purposes.
Results:1.General balance between the two groups of comparison:gender p=0.300, age, p=0.108, stage p=0.097, course of disease p=0.331,wound number p=0.511 were >0.05, statistically no significant difference in Tip three groups were comparable information in general.
2. Three groups of complications of treatment outcomes in comparison:
2.1 The three groups of postoperative anal pain:1,2,3,4,5 days after the first groupⅠand groupⅡPd1=0.719, Pd2=0.181, Pd3=0.317, Pd4=0.521, Pd5=0.079 are>0.05, Note groupⅠandⅡwas no significant difference, while in groupⅢcompared with other groups, P<0.05, there is a statistically significant difference significant difference. Tip GroupⅢanal pain on postoperative pain is better than in groupⅠand groupⅡ,Ⅰgroup andⅡgroup was no significant difference in analgesic effect.
2.2 The three groups of postoperative anal edema:1,3,5 days after the first groupⅠand groupⅡPd1=0.842, Pd3=0.783, Pd5=0.766 are>0.05, Note groupⅠandⅡwas no significant difference, while in groupⅢcompared with other groups, P<0.05, statistically significant differences. Tip GroupⅢtreatment of postoperative edema than anal groupⅠand groupⅡ.
2.3 The three groups of postoperative wound healing time:Comparison of three groups of wound healing,Ⅰgroup andⅡgroup P=0.424> 0.05, in groupⅠandⅡgroup shows no significant difference. The groupⅢcompared with other groups, P<0.05, statistically significant differences. Tip GroupⅢwound healing time than groupⅠandⅡgroup was shorter.
Conclusion:
1 Bath temperature [37,41℃], hemorrhoid surgery in the treatment of anal pain, edema and shorten wound healing time than other two groups.
2 flower cotyledons Tang Bath no apparent toxic side effects and local skin allergies, so its application outside the Milligan-Morgan hemorrhoid treatment of post-operative complications is safe and feasible.
引文
[1]陆金根.中西医结合肛肠病学[M],中国中医药出版社,2009,112.
[2]苏本兵,苏道广.减轻肛肠术后疼痛机制探讨[J],中医药临床杂志,2005,2(17)：196.
[3]Clifford J. woolf MB. Pree mptive analgesia-teating postoperative pain by preventing the establishment of centeral sensitization[J]. Anesth Alalg,1993,77:362.
[4]Treede RD, Meyer Raja, SN, etal. Peripheral and central mechanismsoff cutaneous hyperalgesia [J]. Plog Neurobiol,1992,38:397.
[5]陈孝平.外科学[M],人民卫生出版社,2005,189.
[6]胡兴国.术后镇痛：外周和中枢敏感化及治疗对策[J].国外医学·麻醉与复苏分册,1999,20(2)：74.
[7]方善光.混合痔术后水肿原因分析及防治[J],浙江中西医结合杂志,2005,15(9)：552.
[8]张振勇,张霓.挑断部分内括约肌对改善环状混合痔剥扎术后肛缘水肿、疼痛的观察[J].安徽中医学院学报,1996,18(6)：43-44.
[9]梁健.肛肠病术后并发症的中西医结合治疗[J].右江医学,2000,28(1)：47-48.
[10]史仁杰,杨关根.痔术后水肿的原因及防治[J].现代中西医结合杂志,2003,12(9)：954.
[11]金莉.痔瘘术后发生肛门水肿的原因及护理[J].解放军护理杂志.2000,17(6)：39.
[12]Bucknall TE. Probl Gen Surg 1989,6(2):194-219.
[13]张静,张仲,胡永清等.伤口愈合的研究进展[J].中华骨科杂志,2005,25(1)：58.
[14]Tudor Ours Times 1992,88(19):70-74.
[15]刘霞,高峰.创伤愈合的分子机制研究进展[J].医学综述,2005,11(3)199-201.
[16]程明德.试论中药熏洗在痔科的应用机理[J].成都医药1994,20(4)252.
[17]明·陈实功著,张印生,韩学杰点校,中医古籍出版社[M],1999.
[18]朱仁康.中医外科学[M].人民卫生出版社,1987.
[19]张恒.熏洗疗法原理探究[J].中医药研究,1994(2)：10.
[20]王济平.药物肛疗机理初探,中医外治杂志[J].1995.4(6)：3-5.
[21]郑荣慧,潘振亮.中药熏洗对肛周疾病的作用机理分析[J].辽宁中医学院学报,2005,7(3)：216.
[22]中华人民共和国药典[M].国家药典委员会,化学工业出版社,2005.
[23]中华本草[M].国家中医药管理局《中华本草》编委会,上海科学技术出版社,1999.
[24]中药大辞典[M](上下册)(第二版)南京中医药大学编著,上海科学技术出版社,2006.
[25]宋光熠.中药药理学[M],人民卫生出版社,2009.
[26]杜如昱,王杉,汪建平译.结肠与直肠外科学(第五版)[M],人民卫生出版社,2009：160.
[1]黄丽平,余瑞鹏,蔡文碧等.中药熏洗减轻混合痔术后疼痛的疗效[J].中国乡村医药,2009,16(4)：53.
[2]张秋实.中药熏洗治疗痔术后水肿100例[J].辽宁中医杂志2006,33(5)：574.
[3]隋艳安.消痛汤用于混合痔术后疼痛的疗效观察[J].中国民康学,2009,21(8)：849.
[4]曾莉,阎赵飞.祛毒洗剂治疗混合痔术后肛门疼痛临床研究[J].辽宁中医杂 志,2006,33(10)：1302.
[5]杭春平.洗痔肿痛方熏洗治疗混合痔术后水肿的临床观察[J].光明中医,2008,23(4)：475.
[6]黄立功,秦素娥,丁爱萍.消痔煎剂坐浴治疗痔瘘术后并发症482例观察[J].湖南中医药导报,2002,8(12)：764-765.
[7]张积青.痔消液在混合痔术后应用的临床观察[J].中医药导报,2007,13(1)：42.
[8]罗春生.痔疾宁洗液对减轻肛肠术后疼痛水肿的临床研究[J].亚太传统医药,2008,4(7)：40.
[9]陈建华,成敏.痔痛消洗液坐浴治疗肛门水肿30例[.J].时珍国医国药2004,15(9)：603.
[10]李晶.肛肠坐浴1号坐浴治疗混合痔术后水肿50例[J].广西中医药,2000,23(4)：48.
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[14]吕秉文.足部按摩治疗痔疮28例的临床观察[J].双足与保健,2000,6：29.
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[2]苏本兵,苏道广.减轻肛肠术后疼痛机制探讨[J],中医药临床杂志,2005,2(17)：196.
[3]Clifford J. woolf MB. Pree mptive analgesia-teating postoperative pain by preventing the establishment of centeral sensitization[J]. Anesth Alalg,1993,77:362.
[4]Treede RD, Meyer Raja, SN, etal. Peripheral and central mechanismsoff cutaneous hyperalgesia [J]. Plog Neurobiol,1992,38:397.
[5]陈孝平.外科学[M],人民卫生出版社,2005,189.
[6]胡兴国.术后镇痛：外周和中枢敏感化及治疗对策[J].国外医学·麻醉与复苏分册,1999,20(2)：74.
[7]方善光.混合痔术后水肿原因分析及防治[J],浙江中西医结合杂志,2005,15(9)：552.
[8]张振勇,张霓.挑断部分内括约肌对改善环状混合痔剥扎术后肛缘水肿、疼痛的观察[J].安徽中医学院学报,1996,18(6)：43-44.
[9]梁健.肛肠病术后并发症的中西医结合治疗[J].右江医学,2000,28(1)：47-48.
[10]史仁杰,杨关根.痔术后水肿的原因及防治[J].现代中西医结合杂志,2003,12(9)：954.
[11]金莉.痔瘘术后发生肛门水肿的原因及护理[J].解放军护理杂志.2000,17(6)：39.
[12]Bucknall TE. Probl Gen Surg 1989,6(2):194-219.
[13]张静,张仲,胡永清等.伤口愈合的研究进展[J].中华骨科杂志,2005,25(1)：58.
[14]Tudor Ours Times 1992,88(19):70-74.
[15]刘霞,高峰.创伤愈合的分子机制研究进展[J].医学综述,2005,11(3)199-201.
[16]程明德.试论中药熏洗在痔科的应用机理[J].成都医药1994,20(4)252.
[17]明·陈实功著,张印生,韩学杰点校,中医古籍出版社[M],1999.
[18]朱仁康.中医外科学[M].人民卫生出版社,1987.
[19]张恒.熏洗疗法原理探究[J].中医药研究,1994(2)：10.
[20]王济平.药物肛疗机理初探,中医外治杂志[J].1995.4(6)：3-5.
[21]郑荣慧,潘振亮.中药熏洗对肛周疾病的作用机理分析[J].辽宁中医学院学报,2005,7(3)：216.
[22]中华人民共和国药典[M].国家药典委员会,化学工业出版社,2005.
[23]中华本草[M].国家中医药管理局《中华本草》编委会,上海科学技术出版社,1999.
[24]中药大辞典[M](上下册)(第二版)南京中医药大学编著,上海科学技术出版社,2006.
[25]宋光熠.中药药理学[M],人民卫生出版社,2009.
[26]杜如昱,王杉,汪建平译.结肠与直肠外科学(第五版)[M],人民卫生出版社,2009：160.
[1]黄丽平,余瑞鹏,蔡文碧等.中药熏洗减轻混合痔术后疼痛的疗效[J].中国乡村医药,2009,16(4)：53.
[2]张秋实.中药熏洗治疗痔术后水肿100例[J].辽宁中医杂志2006,33(5)：574.
[3]隋艳安.消痛汤用于混合痔术后疼痛的疗效观察[J].中国民康学,2009,21(8)：849.
[4]曾莉,阎赵飞.祛毒洗剂治疗混合痔术后肛门疼痛临床研究[J].辽宁中医杂 志,2006,33(10)：1302.
[5]杭春平.洗痔肿痛方熏洗治疗混合痔术后水肿的临床观察[J].光明中医,2008,23(4)：475.
[6]黄立功,秦素娥,丁爱萍.消痔煎剂坐浴治疗痔瘘术后并发症482例观察[J].湖南中医药导报,2002,8(12)：764-765.
[7]张积青.痔消液在混合痔术后应用的临床观察[J].中医药导报,2007,13(1)：42.
[8]罗春生.痔疾宁洗液对减轻肛肠术后疼痛水肿的临床研究[J].亚太传统医药,2008,4(7)：40.
[9]陈建华,成敏.痔痛消洗液坐浴治疗肛门水肿30例[.J].时珍国医国药2004,15(9)：603.
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