| 摘要: |
| 目的:探讨外用中药辨证分期换药干预混合痔术后创面并发症的临床效果。方法:选择首都医科大学附属北京中医医院肛肠科2023年2月—10月行手术治疗的混合痔患者96例，按照随机数字表法分为对照组和治疗组各48例。对照组予灭菌凡士林纱条换药治疗，治疗组予止血粉、珠香散、乌梅粉辨证分期换药治疗，1次/d，直至创面完全愈合。治疗后分别对两组患者创面渗血、肛缘水肿、伤口疼痛、肉芽生长情况的创面并发症进行观察评价，治疗前后对两组患者进行生活质量评分比较，比较两组创面愈合时间。结果:术后1 d，两组患者在创面渗血、肛缘水肿、伤口疼痛、肉芽生长情况评分方面差异无统计学意义(P ＞0.05)，术后7 d、14 d，治疗组的创面渗血、肛缘水肿、伤口疼痛、肉芽生长情况评分均低于对照组，差异有统计学意义(P ＜0.05)。治疗组创面愈合时间短于对照组，差异有统计学意义(P ＜0.05)。术前，两组患者在生活质量评分(QOL)，包括睡眠、疼痛、精神、日常生活评分差异无统计学意义(P ＞0.05)，术后14 d，治疗组在睡眠、疼痛、精神、日常生活的评分均高于对照组，差异有统计学意义(P ＜0.05)。结论:外用中药辨证分期换药能够明显减轻混合痔术后患者创面渗血、肛缘水肿、伤口疼痛的创面并发症，促进肉芽组织正常生长，缩短创面愈合时间，减轻患者痛苦，提升患者生活质量。 |
| 关键词: 混合痔 术后 并发症 分期换药 创面愈合 |
| DOI：10.3969/j.issn.1007-6948.2024.06.019 |
| 投稿时间：2024-05-28 |
| 基金项目:中华中医药学会雏鹰计划中医临床青年人才研修项目(CYJH2024024)；中华中医药学会青年人才托举工程项目(CACM-2022-QNRC2-A03)；北京市医院管理中心创新梦工场经费资助(202122) |
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| Observation on the clinical effect of syndrome differentiation, staging, and dressing change intervention on postoperative wound complications of mixed hemorrhoids |
| LIU Jian-qiao，WU Cheng-dong，LIU Reng-hai |
| Department of Anorectal Medicine, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing(100010), China |
| Abstract: |
| Objective To explore the clinical effect of using traditional Chinese medicine for external use to intervene in wound complications after mixed hemorrhoid surgery based on syndrome differentiation, staging, and dressing change. Methods 96 patients with mixed hemorrhoids who underwent surgical treatment at the Department of Anorectal Surgery, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, from February 2023 to October 2023 were randomly divided into a control group and a treatment group, with 48 cases in each group, using a random number table method. The control group was treated with sterilized Vaseline gauze strip dressing change, while the treatment group was treated with hemostatic powder, Zhuxiang powder, and Wumei powder in stages based on syndrome differentiation. Once a day, with a course of 14 days. After treatment, two groups of patients were observed and evaluated for wound complications such as wound bleeding, anal edema, wound pain, and granulation growth. Quality of life scores were compared between the two groups of patients before and after treatment. Calculate the healing time of the wound. Results There was no statistically significant difference in the scores of wound bleeding, anal margin edema, wound pain, and granulation growth between the two groups of patients on the 1st day after surgery(P >0.05). After treatment, the scores of wound bleeding, anal margin edema, wound pain, and granulation growth in the treatment group were lower than those in the control group on the 7th and 14th days after surgery, and the difference was statistically significant (P <0.05). The wound healing time in the treatment group was shorter than that in the control group, and the difference was statistically significant (P <0.05). Before treatment, there was no statistically significant difference between the two groups of patients in terms of quality of life scores, including sleep, pain, mental state, and daily life scores (P >0.05). After treatment, the treatment group had higher scores in sleep, pain, mental state, and daily life than the control group, and the difference was statistically significant (P <0.05). Conclusion Traditional Chinese medicine for external use can significantly reduce the complications of wound bleeding, anal edge edema, and wound pain in patients after mixed hemorrhoid surgery, promote normal growth of granulation tissue, shorten wound healing time, alleviate patient pain, and improve patient quality of life. |
| Key words: Mixed hemorrhoids postoperative complications staged dressing change wound healing |
