中西医治疗痔疮手术后脓肿的疗效及安全性评价

目的观察中西医治疗痔疮手术后脓肿的临床效果及安全性。方法选取148例痔疮手术后脓肿患者,采用信封法随机分为2组,每组74例。对照组采用传统肛周脓肿一次性切开引流根治术,观察组患者在对照组基础上加用中药熏洗及马应龙痔疮栓塞肛。采用VAS评分对两组患者术后1 d、3 d、7 d疼痛程度进行评估,10分为剧痛,0分为无痛。观察两组患者术后局部创面水肿消退、术后创面愈合时间及治疗期间不良反应发生情况。结果两组患者术后第1天的VAS评分比较差异无统计学意义;术后第3天、第7天时,观察组VAS评分均明显低于对照组,两组比较差异有统计学意义(P<0.05)。观察组患者术后局部创面水肿消退及术后创面愈合时间分别为(20.5±4.2)、(22.1±3.1)d,对照组分别为(26.7±3.5)、(27.3±3.4)d,观察组均明显短于对照组,两组比较差异有统计学意义(P<0.05)。两组患者均无肛瘘、创面大出血及感染等严重不良反应发生。结论对于痔疮手术后脓肿患者,在常规手术切开引流的基础上,配合中药熏洗及马应龙痔疮栓塞肛,可明显减轻术后疼痛,促进创面愈合,临床疗效显著。

Efficacy and safety of traditional Chinese medicine combined with western medicine treatment for abscess after hemorrhoids surgery

Objective To observe the efficacy and safety of TCM combined with western medicine treatment for hemorrhoids abscess after surgery. Methods 148 cases of patients with abscess after hemorrhoid surgery were ran-domly divided into two groups by envelope method,74 cases in each group. Patients in control group received the tradi-tional one-time perianal abscess incision and drainage radical surgery;patients in observation group were given herbal fumigation and Mayinglong hemorrhoids embolism anal on the basis of the treatment of control group. The VAS score （0~10） was used to assess the degree of pain at 1 d,3 d,7 d after operation. The postoperative local wound edema, postoperative wound healing time and the occurrence of adverse reactions during treatment were observed. Results There was no significant difference in the VAS scores at first day postoperatively between the two groups;the VAS scores of observation group was lower than that of control group at 3 d and 7 d after operation,there were significant differences between the two groups （P〈0. 05）. The postoperative local edema and postoperative wound healing time were （20. 5 ＆#177; 4. 2） d,（22. 1 ＆#177; 3. 1） d in observation group,and （26. 7 ＆#177; 3. 5） d,（27. 3 ＆#177; 3. 4） d in control group,there were significant differences between the two groups （P〈0. 05）. No fistula,wound bleeding and infection and other serious adverse reactions was found. Conclusion For patients after hemorrhoid surgery,conventional surgical incision and drainage abscess combined with herbal fumigation and Mayinglong anal hemorrhoids embolism can signifi-cantly reduce postoperative pain,promote wound healing,with obvious clinical efficacy.