手术联合自拟益气健脾润肠通便方治疗女性直肠前突所致出口梗阻型便秘的效果观察

目的 探讨手术联合自拟益气健脾润肠通便方治疗女性直肠前突所致出口梗阻型便秘的疗效及安全性。方法 选取2017年6月—2020年5月在石家庄市中医院行手术治疗的80例女性直肠前突致出口梗阻型便秘患者为研究对象。采用随机数字表法将其分为对照组和观察组，每组40例。两组均行经阴道修补术、痔上黏膜环形错位套扎吻合术（EPH），观察组在此基础上于术后2 d开始口服自拟益气健脾润肠通便中药方，14 d为1个疗程，连续服用2个疗程后评估疗效，记录不良反应发生情况，比较远期疗效。结果 观察组治疗前后排便频率、排便困难程度、粪便性状、排便时间、排便不尽感、头昏、乏力、口干口渴评分的差值大于对照组（P <0.05）。观察组患者临床有效率高于对照组（95.00% VS 80.00%，P <0.05）。两组患者的腹胀/腹泻、恶心/呕吐、出血、疼痛、尿潴留发生率及不良反应总发生率比较，差异无统计学意义（P >0.05），且上述不良反应均为轻度，无重度不良反应。观察组治疗前后出口梗阻型便秘评分（ODS）的差值大于对照组（P <0.05），复发率低于对照组（P <0.05）。结论 经阴道修补术、EPH术后口服自拟益气健脾润肠通便中药方，可有效改善女性直肠前突所致出口梗阻型便秘临床症状，提高近、远期疗效，降低复发率，且不增加不良反应发生风险。

Effect of operation combined with Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel in the treatment of female patients with outlet obstruction constipation caused by rectocele

Objective To investigate the effect of operation combined with Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel in the treatment of female patients with outlet obstruction constipation caused by rectocele.Methods Eighty female patients with outlet obstruction constipation caused by rectocele were randomly divided into control group (n = 40) and observation group (n = 40). Both groups were treated with transvaginal repair and the eastern rubber band ligation and coincide of dislocation for prolapse and hemorrhoid (EPH). The observation group was additionally treated with self-made Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel from 2 days after operation, with 14 days as a course of treatment. After 2 courses of treatment, the therapeutic effect was evaluated, and the occurrence of adverse reactions was recorded.Results The differences of scores in the defecation frequency, degree of difficulty in defecation, stool characteristics, defecation time, feeling of incomplete defecation, dizziness, fatigue, dry mouth and thirst before and after the treatment of the observation group were higher than those of the control group (P < 0.05). After treatment, the clinical effective rate of the observation group was higher than that of the control group (95.00% VS 80.00%, P < 0.05). There was no significant difference in the incidence of abdominal distension or diarrhea, nausea or vomiting, bleeding, pain, urinary retention and the overall rate of adverse reactions between the two groups (P > 0.05), and all the adverse reactions were mild and no severe adverse reactions were observed. The difference of obstructive defecation syndrome (ODS) score before and after treatment in the observation group was greater than that in the control group (P < 0.05), and the recurrence rate was lower in the observation group than that in the control group (P < 0.05).Conclusions Oral administration of self-made Decoction for Tonifying Qi, Invigorating Spleen and Relaxing Bowel after transvaginal repair and EPH effectively ameliorates the clinical symptoms of outlet obstruction constipation caused by rectocele in female patients, improves the short-term and long-term treatment effects, reduces the recurrence rate, and does not increase the risk of adverse reactions.