智能中药熏洗机对痔病术后患者疗效影响

【摘要】 目的 观察应用坐便式智能熏洗机对肛门术后肛门水肿非早期患者(＞72h)的效果。 方法 选取2019年4月至7月期间,于本院肛肠科进行手术治疗后,出现肛门水肿的非早期(＞72h)患者70例,并随机分为观察组和对照组(各35例)。观察组患者利用坐便式智能熏洗机进行中药熏洗,对照组患者则采用普通坐浴盆进行中药熏洗,2次/日。中药熏洗后,两组患者均常规进行微波治疗。观察两组患者的疗效、疼痛评分、肛周肿胀程度评分、水肿面积以及患者舒适度评分情况。结果 观察组患者的治疗总有效率(97％)明显高于对照组(74％),组间差异具有统计学意义(P＜0.05);术后7天,观察组患者的疼痛评分、肛周肿胀程度评分以及水肿面积均小于对照组,组间差异具有统计学意义(P＜0.05);观察组患者术后7天的舒适度评分减小,舒适持续时间延长,组间差异有统计学意义(P＜0.05)。结论 采用坐便式智能熏洗机进行中药熏洗对痔病术后患者的治疗效果优于普通坐浴盆,使患者的疼痛、水肿情况进一步缓解,延长患者舒适的持续时间,改善预后,值得临床推广应用。     

PPH联合芍倍注射术治疗直肠前突的临床观察

目的 评价吻合器痔上黏膜环形切除术(PPH)联合芍倍注射术治疗直肠前突引起的排便梗阻症状的安全性及有效性.方法 将我院2009年12月至2011年1月期间的72例诊断为中度以上直肠前突的患者随机分为PPH联合芍倍注射术组(36例)与单纯PPH组(36例),分别行PPH联合芍倍注射术及单纯PPH治疗.分别于术后l周、1个月、3个月及6个月对2组患者进行Longo排便梗阻综合征(ODS)评分,并对患者术后疼痛情况进行评估,观察患者术后尿潴留、术后出血及肛门功能情况,记录患者住院时间及恢复工作时间,并对2组的以上情况进行比较.结果 PPH联合芍倍注射术组与单纯PPH组在术后1周及1个月ODS评分比较差异均无统计学意义(P＞0.05),但PPH联合芍倍注射术组术后3个月及术后6个月ODS评分均明显低于单纯PPH组(P＜0.05).在术后疼痛评分、住院时间及恢复工作时间方面,2组比较差异均无统计学意义(P＞0.05).2组均未出现肛门功能异常情况.2组术后均有尿潴留和出血发生,但差异均无统计学意义(P＞0.05).结论 PPH术联合芍倍注射术较单纯PPH在治疗直肠前突方面疗效更好且至少和单纯PPH一样安全.     

马应龙麝香痔疮膏在治疗小儿尿布皮炎中的应用观察

目的探讨分析马应龙麝香痔疮膏在治疗小儿尿布皮炎中的临床疗效。方法将我院于2011年03月至2011年10月44例臀红新生儿随机分为观察组23例和对照组21例,均经常规处理后暴露局部,观察组外涂马应龙麝香痔疮膏治疗;对照组外涂茶油或盐酸金霉素眼膏,1个疗程后观察疗效。结果观察组痊愈17例,显效4例,好转1例,无效1例,有效率95.65%;对照组痊愈10例,显效2例,好转2例,无效7例,有效率66.67%,两组比较有显著性差异(P<0.05),观察组疗效明显优于对照组。结论马应龙麝香痔疮膏治疗小儿尿布皮炎疗效显著,值得在临床工作中推广。     

痔上粘膜环切钉合术后脱出的危险因素分析

目的分析痔上粘膜环切钉合术(PPH)后痔复发脱出的危险因素。方法回顾性分析2005-01/2012-02的178例PPH患者临床资料。结果本组患者随访时间2～87月,术后复发脱出48例(26.97%)。Ⅳ度内痔患者复发脱出率(45.16%)明显高于Ⅱ、Ⅲ度内痔患者;术后时间3年者脱出发生率(41.46%)明显高于≤3年者(14.58%),差异有统计学意义(P0.05)。性别、年龄、有无合并直肠粘膜脱垂及慢性便秘、单双荷包缝合、荷包距齿状线距离、吻合口距齿状线距离的脱出发生率间的差异无统计学意义(P0.05)。Logistic回归分析提示术后时间、痔分度、吻合口距齿状线距离是复发脱出的危险因素。结论术后时间、痔分度是PPH后痔复发脱出的独立危险因素。     

Of heliotropes and hemorrhoids

During the Middle Ages, an integral part of the therapy for certain ailments included supplication to “patron” saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, has become the patron saint for hemorrhoid sufferers.     

The DURABLE Trial Study Design: Comparing the Safety, Efficacy, and Durability of Insulin Glargine to Insulin Lispro Mix 75/25 Added to Oral Antihyperglycemic Agents in Patients with Type 2 Diabetes

Background

While studies have compared the safety and efficacy of starter insulin regimens in type 2 diabetes, none have evaluated regimen durability (length of time a patient can maintain glycemic control) or the safety and efficacy of subsequent intensification regimens in a large, multinational cohort.

Methods

The DURABLE (Assessing the DURAbility of Basal vs Lispro Mix 75/25 Insulin Efficacy) trial will compare the ability of glargine once daily vs lispro mix 75/25 (75% insulin lispro protamine suspension, 25% lispro) twice daily added to oral antihyperglycemic agents to achieve and maintain hemoglobin A1c (HbA1c) goals. This randomized, open label, parallel study will enroll over 2000 insulin-naïve patients with type 2 diabetes from 11 countries, ages 30 to 80, with HbA1c >7.0% on at least two oral antihyperglycemic agents. At the completion of the 6-month initiation phase, safety and efficacy of the two regimens will be compared. Patients who achieve an HbA1c ≤7.0% at 6 months will continue into the 24-month maintenance phase to evaluate durability.In a substudy, patients not achieving HbA1c ≤7.0% at 6 months may be randomized to one of two intensification comparisons: patients previously on glargine will receive lispro mix 75/25 twice daily or basal/bolus therapy (glargine + thrice-daily mealtime lispro) and patients previously on lispro mix 75/25 will receive lispro mix 50/50 (50% insulin lispro protamine suspension, 50% lispro) thrice daily or basal/bolus therapy.

Results

Upon completion, this trial will provide new information about starter insulin durability, defined as the length of time patients can maintain HbA1c control (HbA1c ≤7.0%, or >7.0% but with an increase of <0.4% from the most recent HbA1c ≤7.0%). Additionally, the study will provide comparative data on HbA1c, blood glucose profiles, 1,5-anhydroglucitol, hypoglycemic episodes, weight change, and insulin dose for starter insulin regimens following 6 and 24 months of treatment, as well as intensified insulin via the 6-month substudy.

Conclusion

This trial aims to broaden clinicians'' understanding of the ability of starter insulin and insulin intensification regimens to achieve and maintain glycemic control in patients with type 2 diabetes.     

叶腾辉名老中医仙方活命饮临床治验

仙方活命饮是临床常用方剂,被前人称之为“疮疡之圣药,外科之首方”。叶老师取其清热解毒,活血止痛之法,应用本方对热毒壅盛、气血瘀滞引起的胃脘痛、淋证、痔疮进行治疗,收效良好。     

吻合器痔上黏膜环切术与传统痔切除术治疗Ⅲ度混合痔的临床对比研究

目的探讨吻合器痔上黏膜环切术(PPH)与传统痔切除术治疗Ⅲ度混合痔的临床效果。方法选取2009年7月至2013年7月佛山市顺德区龙江医院住院治疗的Ⅲ度混合痔患者168例,根据手术方式分为PPH组和传统痔切除术组,观察2组患者术后一般情况、并发症及疗效。结果 PPH组患者手术时间、住院时间短于传统手术组,差异有统计学意义(P<0.05);PPH组患者术后疼痛、尿潴留、便血发生少于传统手术组,差异有统计学意义(P<0.05);PPH组患者术后肛门控制功能、手术疗效与传统手术组比较差异无统计学意义(P>0.05)。结论 PPH治疗Ⅲ度混合痔比传统痔切除术优势明显。     

安氏芍倍注射液与消痔灵注射液治疗Ⅰ–Ⅲ阶段内痔的疗效比较：一项前瞻性队列研究

Objective:To compare the effect of An's Shaobei Injection(安氏勺倍注射液) with Xiaozhiling Injection(消痔灵注射液) in patients with internal hemorrhoids of grade Ⅰ-Ⅲ.Methods:This cohort study included 1,520 internal hemorrhoids patients with grade Ⅰ-Ⅲ who were scheduled for liquid injection treatment from July 2003 to July 2009.The cohort included patients who underwent either An's Shaobei Injection treatment(the treatment group,760 cases) or Xiaozhiling Injection treatment(the control group,760 cases).All patients were followed up regularly for 3 years;the observing indices included anal function recovery and clinical response after operation.Results:Among the 1,520 patients,1,508(99.2%) completed the 3-year follow-up.The efficacy rate was 97.5%in the treatment group,significantly higher than the control group(91.8%,P0.01).The recurrence rate in the treatment group was 0.5%,significantly lower than that of the control group(1.3%,P0.01).In addition,perianal callosity occurred in 8 cases(1.1%) and anorectal stricture in 26 cases(3.5%)after operation in the control group.There was no perianal callosity and anorectal stricture in the treatment group.Conclusion:The treatment with An's Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.     

国产吻合器改良PPH术治疗Ⅲ°、Ⅳ°混合痔的临床研究

目的观察国产吻合器改良痔上黏膜环形切除钉合术（procedureforprolapseandhemorrhoids,PPH）治疗Ⅲ。、Ⅳ。混合痔的有效性。方法采用国产吻合器经改良PPH术治疗Ⅲ°、Ⅳ°混合痔186例,分析其手术操作理论及技巧,并随机选择190例Ⅲ°、Ⅳ°混合痔患者行外剥内扎术（Milligan-Morganhemorrhoidectomy,MMH）,将两组手术疗效、手术时间、术后住院时间、术后疼痛、出血、精细控便功能等进行比较观察。结果PPH组显愈率为94．0％,MMH组显愈率为92．1％,两组间差异无统计学意义（P〉0．115）,两组手术时问、术后住院时间、疼痛、出血及精细控便功能下降等差异有统计学意义（P〈0．01）,经改良后,PPH组切除标本上下径平均为2．5（2．3～3．5）cm,吻合口距齿状线位置平均为2．1（1．7～2．5）cm,肛垫保留及悬吊效果好。结论国产吻合器改良PPH术可有效治疗Ⅲ°、Ⅳ°混合痔,在达到手术效果同时,能更好地保留肛垫及其精细控便功能。