白及對混合痔術(shù)后創(chuàng)面疼痛及愈合的臨床觀察
發(fā)布時間：2018-12-10 23:20
【摘要】：目的:手術(shù)是治療中、重度混合痔的常見干預(yù)手段,外剝內(nèi)扎術(shù)是主要術(shù)式之一。術(shù)后往往因術(shù)者、術(shù)式不同,出現(xiàn)肛門疼痛、創(chuàng)面愈合遲緩等并發(fā)癥,常導(dǎo)致治療效果的降低、住院時間的延長、醫(yī)療支出的增加,以及有限醫(yī)療資源的浪費。能有效地控制術(shù)后并發(fā)癥,將有助于提高手術(shù)的療效及增加患者的滿意度。因此,減少術(shù)后并發(fā)癥發(fā)生頻率與降低并發(fā)癥程度是目前臨床工作的重要課題。本研究意在探討白及制劑對混合痔術(shù)后并發(fā)癥的治療效果,將分別觀察肛門疼痛與創(chuàng)面愈合兩種并發(fā)癥。方法:收集自2016年1月1日至2017年2月28日于北京中醫(yī)藥大學(xué)東直門醫(yī)院肛腸科行混合痔外剝內(nèi)扎術(shù)治療并出現(xiàn)術(shù)后肛門疼痛的80例住院患者。剔除包含排除標準的患者,將同意入組且符合診斷、納入標準的病患納入研究。采取隨機分配隱藏方案的方法,按區(qū)組隨機法編制80張隨機卡片標明組號、序號,裝入不透明的信封中封存。按住院手術(shù)順序抽取卡片得到相關(guān)治療方案。治療組及對照組,共計4組,治療組包括白及粉組、白及多糖組各20例,共計40例;對照組包括凡士林組、云南白藥組各20例,共計40例。術(shù)后其他干預(yù)措施相同,于術(shù)后第一次換藥開始按方案用藥,白及粉組、白及多糖組、云南白藥組換藥后均予凡士林紗布及干紗布外敷,膠布固定,凡士林紗條組僅用凡士林紗條換藥,換藥完畢以干紗布外敷,膠條固定。每日用藥一次,療程21天。分別于第1天至第7天、第14天、第21天換藥前,換藥后立即及換藥后2小時對患者進行疼痛評分,采用視覺模擬評分法進行疼痛評分,同時換藥前對患者的術(shù)后創(chuàng)面進行評分,出院后按照術(shù)后第14天及第21天與患者預(yù)約換藥并記錄其創(chuàng)面愈合時間。將記錄的相關(guān)數(shù)據(jù)包括四組疼痛評分、創(chuàng)面愈合時間整理后進行組間對比研究。采用Stata12.0統(tǒng)計軟件進行統(tǒng)計分析,統(tǒng)計數(shù)據(jù)均經(jīng)正態(tài)檢驗,計數(shù)資料行卡方檢驗,計量資料行單變量檢驗,即分組均值t檢驗,具體方法為:對所有換藥前、換藥后立即及換藥后2小時疼痛評分求和后組間分別求平均值差值并行t檢驗。結(jié)果:本實驗共收入有效患者76例,其中實驗組37人,男性共18人,女性19人、其中白及粉組19人,白及多糖組18人;采用雙對照組,共計39人,其中凡士林組19人,云南白藥組20人,男性共23人,女性16人。實驗組中白及粉組患者年齡在18到63歲之間,平均年齡44.26± 14.11歲,白及多糖組患者年齡在24-64歲之間,平均年齡42.50± 12.47歲;對照組中凡士林組患者年齡在28-77歲之間,平均年齡46.79土15.64歲,云南白藥組中患者年齡在27-66歲之間,平均年齡43.82±14.15歲。兩組患者的性別、年齡經(jīng)比較,無統(tǒng)計學(xué)差異(P0.05),兩組患者具有可比性。各組疼痛評分經(jīng)統(tǒng)計學(xué)方法處理,證實四種藥物均能有效緩解混合痔術(shù)后疼痛,白及多糖組與其他各組間在換藥后立即比較換藥前VAS評分方面具有顯著差異(P0.05),提示白及多糖瞬時止痛效果優(yōu)于其他各組;白及粉組與白及多糖、凡士林組在換藥后2h對比換藥前VAS評分對比方面具有顯著差異性,提示白及粉持續(xù)止痛效果與云南白藥相當(P0.05),優(yōu)于其他分組,但刺激性最強。在促創(chuàng)面愈合方面,白及粉組效果優(yōu)于白及多糖組,凡士林組效果最佳,各組比較不具有統(tǒng)計學(xué)差異(P0.05)。結(jié)論:經(jīng)臨床研究證實白及可有效緩解混合痔術(shù)后疼痛,其中白及多糖粉瞬時止痛效果優(yōu)于白及粉,白及粉維持止痛效果優(yōu)于白及多糖組。同時,白及粉及白及多糖粉制劑未見明顯促進創(chuàng)面愈合功能。白及治療混合痔術(shù)后并發(fā)癥過程中未見明顯毒副作用及皮膚過敏等不良反應(yīng)。
[Abstract]:Objective: The operation is one of the common methods of intervention in the treatment of severe mixed hemorrhoid. The postoperative complications such as anal pain and delayed wound healing often result in the reduction of the treatment effect, the extension of the hospitalization time, the increase of the medical expenditure, and the waste of the limited medical resources. The effective control of postoperative complications will help to improve the efficacy of the operation and to increase the patient's satisfaction. Therefore, it is an important task to reduce the frequency of postoperative complications and to reduce the degree of complication. The purpose of this study is to study the effect of the white and the preparation on the postoperative complications of mixed hemorrhoid, and to observe the two complications of anal pain and wound healing, respectively. Methods: From January 1, 2016 to Feb. 28, 2017, 80 patients with anal pain and 80 cases of post-operative anal pain were treated with external and internal ligation of the anorectal section of the Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine. Patients who have excluded the exclusion criteria will agree to the group and meet the criteria for inclusion in the study. The method of random allocation of hidden scheme shall be adopted, and 80 random cards shall be marked with the group number and serial number according to the random method of the zone group, and sealed in an opaque envelope. The relevant treatment plan was obtained by taking the card in the procedure of hospitalization. In the treatment group and the control group, a total of 4 groups were treated. The treatment group included 20 cases of white and powder group, 20 cases of white and polysaccharide group and 40 cases. The control group included the vaseline group and 20 cases of the Yunnan Baiyao group, and the total was 40 cases. the other intervention measures after the operation are the same, the first medicine change after the operation is started according to the scheme, the white and the powder groups, the white and the polysaccharide groups, the Yunnan white medicine group is changed, the vaseline gauze and the dry gauze are applied for external application, the adhesive tape is fixed, the vaseline gauze strip group is only changed with the Vaseline gauze, After the medicine is changed, the dry gauze is applied for external application, and the adhesive tape is fixed. once a day, the course of treatment is 21 days. The pain scores were measured on the first day to the seventh day, the 14th day and the 21st day after the change of the medicine, immediately after the change of the medicine and 2 hours after the change of the medicine, the pain score was performed by the visual simulation scoring method, and the postoperative wound surface of the patient was scored before the change of the medicine, On the 14th and 21st days after the discharge, the patient was given an appointment and the healing time of the wound was recorded. The recorded related data included four groups of pain scores, and the group-to-group comparative study was performed after the wound healing time was finished. The statistical analysis is carried out by using the Staa12. 0 statistical software. The statistical data is verified by the positive-state test, the counting data line card-side test and the measurement data line single-variable test, that is, the grouping mean value t test, and the specific method is as follows: before all the medicines are changed, The average value difference and the parallel t-test were respectively obtained after the two-hour pain score after the change of the drug and the 2-hour pain score after the drug change. Results: In this experiment, 76 patients were treated with total income, including 37 in the experimental group, 18 in the male and 19 in the female group, 18 of the white and powder group, 18 in the white and the polysaccharide group, 19 in the group of the vaseline, 20 in the Yunnan Baiyao group and 23 in the male. 16 women. The age of the white and powder group in the experimental group was between 18 and 63 years, with a mean age of 44. 26 and 14. 11 years. The age of the white and polysaccharide group was between 24 and 64 years, with a mean age of 42. 50 and 12. 47 years; in the control group, the age of the patients in the vaseline group ranged from 28 to 77 years, with an average age of 46. 79 in the age of 15 to 64 years. The age of the patients in the Yunnan Baiyao group ranged from 27 to 66 years, with a mean age of 43. 82 to 14. 15 years. The sex and age of the two groups were compared, there was no statistical difference (P0.05), and the two groups were comparable. The pain scores of all groups were treated by the statistical method, and it was confirmed that the four drugs can effectively relieve the pain after the operation of the mixed hemorrhoids, and the white and the polysaccharide groups have a significant difference with the other groups immediately after the change of the medicine (P0.05). The results showed that the instantaneous analgesic effect of the white and the polysaccharides was superior to that of the other groups, the white and the powder groups and the white and the polysaccharides, the vaseline group had a significant difference in the comparison of the VAS scores before the change of the drug after the change of the drug, indicating that the effect of the continuous pain and pain of the white and the powder was comparable to that of the Yunnan white medicine (P0.05), which was superior to the other groups. but the stimulation is the strongest. In the aspect of promoting wound healing, the effect of white and powder group was superior to that of white and polysaccharide group, and the effect of vaseline group was the best, and there was no statistical difference between the groups (P0.05). Conclusion: The effect of white and multi-sugar powder on the pain of mixed hemorrhoid is better than that of white and white powder, and the effect of white and powder maintenance is better than that of white and polysaccharide. At the same time, the white powder and the white and the multi-sugar powder preparation are not found to promote the wound healing function. and no adverse effects such as obvious toxic and side effect, skin allergy and the like are seen in the process of the postoperative complications of the white and the treatment of the mixed hemorrhoid.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R266
本文編號：2371397
[Abstract]:Objective: The operation is one of the common methods of intervention in the treatment of severe mixed hemorrhoid. The postoperative complications such as anal pain and delayed wound healing often result in the reduction of the treatment effect, the extension of the hospitalization time, the increase of the medical expenditure, and the waste of the limited medical resources. The effective control of postoperative complications will help to improve the efficacy of the operation and to increase the patient's satisfaction. Therefore, it is an important task to reduce the frequency of postoperative complications and to reduce the degree of complication. The purpose of this study is to study the effect of the white and the preparation on the postoperative complications of mixed hemorrhoid, and to observe the two complications of anal pain and wound healing, respectively. Methods: From January 1, 2016 to Feb. 28, 2017, 80 patients with anal pain and 80 cases of post-operative anal pain were treated with external and internal ligation of the anorectal section of the Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine. Patients who have excluded the exclusion criteria will agree to the group and meet the criteria for inclusion in the study. The method of random allocation of hidden scheme shall be adopted, and 80 random cards shall be marked with the group number and serial number according to the random method of the zone group, and sealed in an opaque envelope. The relevant treatment plan was obtained by taking the card in the procedure of hospitalization. In the treatment group and the control group, a total of 4 groups were treated. The treatment group included 20 cases of white and powder group, 20 cases of white and polysaccharide group and 40 cases. The control group included the vaseline group and 20 cases of the Yunnan Baiyao group, and the total was 40 cases. the other intervention measures after the operation are the same, the first medicine change after the operation is started according to the scheme, the white and the powder groups, the white and the polysaccharide groups, the Yunnan white medicine group is changed, the vaseline gauze and the dry gauze are applied for external application, the adhesive tape is fixed, the vaseline gauze strip group is only changed with the Vaseline gauze, After the medicine is changed, the dry gauze is applied for external application, and the adhesive tape is fixed. once a day, the course of treatment is 21 days. The pain scores were measured on the first day to the seventh day, the 14th day and the 21st day after the change of the medicine, immediately after the change of the medicine and 2 hours after the change of the medicine, the pain score was performed by the visual simulation scoring method, and the postoperative wound surface of the patient was scored before the change of the medicine, On the 14th and 21st days after the discharge, the patient was given an appointment and the healing time of the wound was recorded. The recorded related data included four groups of pain scores, and the group-to-group comparative study was performed after the wound healing time was finished. The statistical analysis is carried out by using the Staa12. 0 statistical software. The statistical data is verified by the positive-state test, the counting data line card-side test and the measurement data line single-variable test, that is, the grouping mean value t test, and the specific method is as follows: before all the medicines are changed, The average value difference and the parallel t-test were respectively obtained after the two-hour pain score after the change of the drug and the 2-hour pain score after the drug change. Results: In this experiment, 76 patients were treated with total income, including 37 in the experimental group, 18 in the male and 19 in the female group, 18 of the white and powder group, 18 in the white and the polysaccharide group, 19 in the group of the vaseline, 20 in the Yunnan Baiyao group and 23 in the male. 16 women. The age of the white and powder group in the experimental group was between 18 and 63 years, with a mean age of 44. 26 and 14. 11 years. The age of the white and polysaccharide group was between 24 and 64 years, with a mean age of 42. 50 and 12. 47 years; in the control group, the age of the patients in the vaseline group ranged from 28 to 77 years, with an average age of 46. 79 in the age of 15 to 64 years. The age of the patients in the Yunnan Baiyao group ranged from 27 to 66 years, with a mean age of 43. 82 to 14. 15 years. The sex and age of the two groups were compared, there was no statistical difference (P0.05), and the two groups were comparable. The pain scores of all groups were treated by the statistical method, and it was confirmed that the four drugs can effectively relieve the pain after the operation of the mixed hemorrhoids, and the white and the polysaccharide groups have a significant difference with the other groups immediately after the change of the medicine (P0.05). The results showed that the instantaneous analgesic effect of the white and the polysaccharides was superior to that of the other groups, the white and the powder groups and the white and the polysaccharides, the vaseline group had a significant difference in the comparison of the VAS scores before the change of the drug after the change of the drug, indicating that the effect of the continuous pain and pain of the white and the powder was comparable to that of the Yunnan white medicine (P0.05), which was superior to the other groups. but the stimulation is the strongest. In the aspect of promoting wound healing, the effect of white and powder group was superior to that of white and polysaccharide group, and the effect of vaseline group was the best, and there was no statistical difference between the groups (P0.05). Conclusion: The effect of white and multi-sugar powder on the pain of mixed hemorrhoid is better than that of white and white powder, and the effect of white and powder maintenance is better than that of white and polysaccharide. At the same time, the white powder and the white and the multi-sugar powder preparation are not found to promote the wound healing function. and no adverse effects such as obvious toxic and side effect, skin allergy and the like are seen in the process of the postoperative complications of the white and the treatment of the mixed hemorrhoid.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R266
【參考文獻】
相關(guān)期刊論文 前10條
1 劉艷華;王金偉;倪秀茹;;仙方活命飲加減坐浴治療混合痔PPH術(shù)后肛門疼痛療效觀察[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2017年07期
2 譚建勤;劉興高;王偉;胡相冰;譚啟玲;;止痛如神湯對痔瘡手術(shù)后傷口愈合及疼痛的影響[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2017年07期
3 萬大群;趙仁全;劉海;冉茂鴻;;白及的成分、藥理作用和臨床應(yīng)用研究進展[J];中國藥業(yè);2017年02期
4 楊志勇;李書芹;杜雪菲;宋長亮;王亞飛;張曉慧;張振軍;;復(fù)方白及粉治療急性放射性食管炎的療效分析[J];遼寧中醫(yī)雜志;2016年09期
5 楊鎧銀;;白及藥理作用研究進展[J];科技展望;2016年24期
6 王彬彬;尚錦秀;;黃連膏換藥促進混合痔術(shù)后創(chuàng)面愈合的臨床療效觀察[J];中西醫(yī)結(jié)合研究;2016年03期
7 劉秋江;林明惠;林康泉;謝翔宇;葉海榮;梁秋萍;;中藥超聲霧化熏洗對混合痔術(shù)后創(chuàng)面修復(fù)影響的臨床研究[J];世界復(fù)合醫(yī)學(xué);2016年01期
8 郭文濤;高秋霞;郭航勇;李一兵;;清涼膏促進混合痔電切凝術(shù)后創(chuàng)面愈合的臨床研究[J];陜西中醫(yī)藥大學(xué)學(xué)報;2016年02期
9 成娟;;穴位貼敷緩解痔瘡術(shù)后疼痛的效果評價[J];中國藥物與臨床;2016年02期
10 王巍;程明和;高靜;張曉潔;;白及止血海綿止血作用的實驗研究[J];藥學(xué)實踐雜志;2016年01期
，本文編號：2371397
本文鏈接：http://sikaile.net/shoufeilunwen/mpalunwen/2371397.html
最近更新
教材專著
