| 摘要: |
| 目的:探讨加味薏苡附子败酱散联合常规换药在复杂性肛瘘术后患者中的疗效观察及对视觉模拟疼痛(VAS)评分的影响。方法:选择复杂性肛瘘患者106例作为对象，电脑抽取随机数法分为两组，各53例。两组均采用手术治疗，对照组术后常规换药干预，观察组在对照组基础上联合加味薏苡附子败酱散干预，术后14 d对患者效果进行评估，并完成6个月随访，比较两组术后肛门功能、VAS评分、术后创面愈合评分及术后并发症、复发率。结果:观察组术后14 d排便干燥(0.68±0.14)分、不自主气体(0.70±0.16)分、需要衬垫(0.69±0.15)分、生活方式(0.72±0.18)分及稀便评分(0.63±0.12)分均低于对照组[排便干燥(1.69±0.45)分、不自主气体(2.10±0.46)分、需要衬垫(1.84±0.42)分、生活方式(1.67±0.36)分及稀便评分(2.16±0.39)分，差异有统计学意义(t=7.591、5.434、6.316、6.019、5.693，P<0.001)；观察组手术后14 d VAS评分(1.15±0.32)分、渗液(0.56±0.09)分及肉芽生长评分(1.72±0.16)分均低于对照组[VAS评分(3.24±0.41)分、渗液(1.69±0.11)分及肉芽生长评分(2.15±0.23)分]，差异有统计学意义(t=7.493、5.671、6.434，P<0.001)；两组术后尿潴留、切口感染及肛门失禁发生率、术后1、3个月复发率差异均无统计意义(χ2 =0.343、1.101、1.039、1.101、0.343，P=0.558、0.315、0.308、0.315、0.558)；观察组术后6个月复发率低于对照组(χ2 =4.970，P=0.026)。结论:加味薏苡附子败酱散联合常规换药用于复杂性肛瘘术后患者能提高患者肛门功能，减轻疼痛，能促进创面愈合，可降低术后复发率，且未增加手术并发症发生率。 |
| 关键词: 加味薏苡附子败酱散 复杂性肛瘘术 视觉模拟疼痛 肛门功能 复发率 |
| DOI：10.3969/j.issn.1007-6948.2021.03.018 |
| 投稿时间：2020-12-19 |
| 基金项目: |
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| Clinical Observation of Modified Coix Aconite Patrinia Powder in Complex Anal Fistula Operation |
| FENG Qi,GE Li-na,WU Jian-xiao |
| First Department of Anorectal, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang (050051), China |
| Abstract: |
| Objective To investigate the curative effect of Jiawei Yiyifuzi Baijiang Powder combined with conventional dressing change in patients with complicated anal fistula surgery and its effect on visual analog pain (VAS) score. Methods 106 patients with complex anal fistula were selected as subjects. The computerized random number method was divided into two groups, with 53 cases in each group. Both groups were treated with surgery. The control group was treated with routine dressing changes after the operation, and the observation group was combined with Jiawei Coix Fuzi Baijiang San on the basis of the control group. The effect of the patients was evaluated 14 days after the operation and a 6-month follow-up was completed to compare the two Group postoperative anal function, VAS score, postoperative wound healing score, postoperative complications, recurrence rate. Results The observation group had dry defecation ( 0 . 68 ±0 . 14 ) points, involuntary gas (0.70±0.16) points, need pads (0.69±0.15) points, lifestyle (0.72±0.18) points, and loose stools score (0.63±0.12) points after 14 days, which were lower than those of the control group for dry defecation (1.69±0.45) points, involuntary gas (2.10±0.46) points, padding (1.84±0.42) points, lifestyle (1.67±0.36) points, and loose stools points (2.16±0.39) points (t=7.591, 5.434, 6.316, 6.019, 5.693, P<0.001); The 14 days VAS score (1.15±0.32) points, exudate (0.56±0.09) points and granulation growth score of the observation group 14 days after surgery (1.72±0.16) points were lower than those of the control group, which VAS score (3.24±0.41), exudate (1.69±0.11) and granulation growth score (2.15±0.23) (t=7.493, 5.671, 6.434, P<0.001)). The incidence of postoperative urinary retention, incision infection and anal incontinence, and the recurrence rate at 1 and 3 months after surgery were not statistically signi?cant (χ2=0.343, 1.101, 1.039, 1.101, 0.343, P=0.558, 0.315, 0.308 , 0.315, 0.558). The recurrence rate of the observation group at 6 months after operation was lower than that of the control group (χ2=4.970, P=0.026). Conclusion Modi?ed Yiyi Fuzi Baijiang Powder combined with conventional dressing change can improve the patient' s anal function, reduce the patient' s pain, promote the wound healing of the patient and reduce the recurrence rate after surgery without increasing the incidence of surgical complications rate. It is worth promoting and applying. |
| Key words: Jiawei Yiyifuzi Baijiang San complicated anal ?stula surgery visual simulation of pain anal function recurrence rate |
