中医挂线联合对口引流疗法治疗高位肛瘘的疗效及对疼痛应激反应、肛门括约肌功能的影响

目的观察中医挂线联合对口引流疗法治疗高位肛瘘的疗效及对疼痛应激反应、肛门括约肌功能的影响并探讨其机制。方法患者155例随机分为两组,对照组实施常规挂线法治疗,观察组实施挂线法联合对口引流法治疗。比较两组临床疗效、手术相关指标、术后并发症及复发情况,评价疼痛视觉模拟量表(VAS)评分、Wexner肛门失禁评分,测量肛管最长收缩时间(ALCT)、肛管最大收缩压(AMCP)、肛管静息压(ARP)和直肠静息压(RRP)。结果观察组的愈显率为87.34%,显著高于对照组的72.37%(P <0.05)。观察组的创面面积及创面愈合时间均低于对照组(P <0.05)。术后1、3、7、14 d,观察组的疼痛VAS评分均显著低于对照组(P <0.05)。术后7 d、14 d、3个月、6个月时,观察组的Wexner评分均低于对照组(P <0.05)。术后1个月,两组的ALCT比较差异均无统计学意义(P> 0.05);对照组的AMCP、ARP、RRP明显低于观察组(P <0.05)。两组术后并发症发生率比较,差异无统计学意义(P> 0.05);观察组的6个月复发率低...

Efficacy of Traditional Chinese Medicine Thread-drawing Combined with Contra-aperture Drainage Therapy for High Anal Fistula and Its influence on the Pain Stress Response and Anal Sphincter Function

Objective:To investigate the effect of traditional Chinese medicine thread-drawing combined with the contra-aperture drainage therapy for high anal fistula and its influence on the pain stress response and anal sphincter function.Methods:A total of 155 patients with high anal fistula were randomly divided into observation group(n=79)and control group(n=76).The control group received conventional thread-drawing therapy,and the observation group received traditional Chinese medicine thread-drawing combined with contra-aperture drainage therapy.The clinical efficacy,surgery-related indicators,postoperative complications and recurrence of the two groups were compared.The pain visual analog scale(VAS)score and Wexner anal incontinence score were evaluated,the longest anal contraction time(ALCT),maximum anal systolic pressure(AMCP),resting anal pressure(ARP)and resting rectal pressure(RRP)were measured.Results:The markedly rate of the observation group was significantly higher than the control group(87.34%vs 72.37%,P<0.05).The wound area and wound healing time of the observation group were lower than those of the control group(P<0.05).Compared with the control group,the pain VAS scores at 1,3,7,14 d after operation in the observation group were significantly lower(P<0.05),the Wexner scores at 7,14 d,3 and 6 months after operation in the observation group were significantly lower(P<0.05).There was no significant difference in ALCT at 1 month after operation between the two groups(P>0.05);but the AMCP,ARP and RRP of the control group were significantly lower than those of the observation group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05);the 6-month recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusion:The traditional Chinese medicine thread-drawing combined with the contra-aperture drainage therapy for high anal fistula iseffective,which can reduce the trauma,relieve postoperative pain,promote the wound healing,and cause less damage to anal sphincter function.