本文選題：化痔栓　切入點：復方角菜酸酯栓　出處：《河北醫(yī)科大學》2015年碩士論文

【摘要】：目的:肛竇炎又名為肛隱窩炎,它屬于肛竇及肛門腺內(nèi)的炎癥性病變。它是一種非常重要的隱匿性感染病灶,大概有85%肛門直腸疾病與肛竇感染有關系。因為肛竇形態(tài)和部位的特殊性,使得它極易受到破損導致感染。肛竇一旦受外界損傷,致病病菌可趁機進入肛腺而誘發(fā)肛腺炎癥。肛腺感染經(jīng)過其分支發(fā)展蔓延形成直腸肛門周圍炎,最終導致肛周膿腫,破潰后形成肛瘺。通常的治療方法是中藥坐浴、手術換藥及全身抗菌素治療等,因為發(fā)病部位比較隱蔽,藥物往往很難達到發(fā)病部位,故療效都不太理想。本文通過觀察聯(lián)合應用復方角菜酸酯栓和化痔栓對肛竇炎的治療作用,探討“肛竇炎”的中醫(yī)病機及致病特點,為臨床治療肛竇炎提供療效好,使用方便,依從性佳的藥物。方法:篩選2014年2月至2014年12月石家莊市長安區(qū)醫(yī)院肛腸科及河北醫(yī)科大學中醫(yī)院門診診斷為肛竇炎的病例56例,隨機分成二組,每組各28例,經(jīng)比較二組在年齡、性別、病情程度無差別(P0.05),具有可比性。治療組給予化痔栓及復方角菜酸酯栓入肛。對照組給予左氧氟沙星軟膏入肛,均為20天為一療程。通過仔細觀察治療前后及停藥20天后的癥狀、體征,肛門鏡檢情況結果等,評定出患者臨床癥狀:包括肛門腫脹、疼痛程度、瘙癢變化及指診的體征如觸痛情況,鏡檢肛乳頭水腫及肛竇充血等指標的變化情況,最后進行統(tǒng)計學分析。結果:治療前對兩組病例的年齡因素、性別因素、病程長短、肛門疼痛、肛門腫脹、肛周瘙癢情況,指診情況病變肛竇有無壓痛,鏡檢肛乳頭水腫、肛竇充血等進行比較,差異無統(tǒng)計學意義,二組病例具有可比性。對治療前后(停藥后20天)進行臨床對照研究并進行統(tǒng)計學分析。(1)總體療效二組病例的對比情況:對照組28例中共有12例治愈,6例好轉,10例無效,總有效率64.28%。治療組28例中共有18例治愈,8例好轉,2例無效,總有效率92.86%;經(jīng)統(tǒng)計學分析對比兩組總體療效有顯著性差異(P0.05);(2)兩組病例中肛門腫脹病情情況:兩組患者肛門腫脹在治療后及停藥20天后經(jīng)統(tǒng)計對比有顯著性差異(P0.05),聯(lián)合化痔栓及復方角菜酸酯治療優(yōu)于左氧氟沙星軟膏;(3)兩組病例中患者肛門疼痛、瘙癢情況:兩組肛門疼痛的、瘙癢患者在治療后及停藥20天后對比有顯著性差異(P0.05),聯(lián)合化痔栓及復方角菜酸酯治療優(yōu)于左氧氟沙星軟膏;(4)兩組病例中患者體征改善情況:兩組患者指診病變肛竇壓痛在治療后及停藥20天后對比有顯著性差異(P0.05),聯(lián)合化痔栓及復方角菜酸酯治療改善肛門指診壓痛方面優(yōu)于左氧氟沙星軟膏;兩組患者鏡檢肛竇充血、肛乳頭水腫、改善情況在治療后及停藥20天后對比均有統(tǒng)計學意義(P0.05);聯(lián)合化痔栓及復方角菜酸酯栓治療優(yōu)于左氧氟沙星軟膏;(5)二組病例的復發(fā)情況及不良反應情況:兩組停藥20天后的復發(fā)情況經(jīng)比較有顯著性差異(P0.05),聯(lián)合化痔栓及復方角菜酸酯治療組優(yōu)于左氧氟沙星軟膏組;用藥過程中兩組均未發(fā)現(xiàn)明顯不良反應。結論:復方角菜酸酯栓和化痔栓優(yōu)于傳統(tǒng)的一般左氧氟沙星軟膏治療。
[Abstract]:Objective: the anal sinusitis also known as anal cryptitis, it belongs to inflammatory lesions and anal anal sinus gland. It is a very important kind of occult infection, there are about 85% anorectal diseases and anal sinus infection relationship. Because of the special shape and position of anal sinus, making it vulnerable to damage lead to infection. Once the external anal sinus injury, pathogenic bacteria can take the opportunity to enter the anal gland caused by anal gland inflammation. Anal gland infection through the branches spread form of anorectal inflammation, resulting in perianal abscess formation after rupture of anal fistula. The usual treatment is in medicine bath, surgical dressing and systemic antibiotic therapy so, because the location is hidden, the drug is often very difficult to achieve the location, so the effect is not ideal. The curative effect observation of combined application of Compound Carraghenates Suppositories and HuaZhiShuan of anal sinusitis, explore the anal sinusitis The pathogenesis and pathogenic characteristics, provide good curative effect, convenient use for clinical treatment of anal sinusitis, good compliance of drugs. Methods: screening of Changan District hospital in Shijiazhuang city from February 2014 to December 2014 and the anorectal clinic of Hebei Medical University Hospital of traditional Chinese medicine diagnosis of 56 cases of anal sinusitis were randomly divided into two groups, 28 cases in each group, the comparison of the two groups in age, gender, no difference in severity (P0.05), comparable. The treatment group was given HuaZhiShuan and Compound Carraghenates Suppositories into the anus. The control group was given levofloxacin ointment into the anus, were 20 days for a course of treatment. Through careful observation before and after treatment and 20 days after drug withdrawal symptoms and signs the anus, mirror inspecting results, the evaluation of clinical symptoms: including anal swelling, pain, itching and changes of palpation signs such as tenderness, the changes of microscopic examination of anal papilla edema and anal sinus congestion index, the most Statistical analysis. Results: the age factors of the two groups of patients before treatment, gender, disease duration, anal pain, anal swelling, perianal pruritus, refers to the diagnosis of anal sinus lesions have no tenderness, microscopic examination of anal papilla edema, anal sinus congestion were compared, the difference was statistically significant, two groups were comparable. Before and after treatment (20 days after drug withdrawal) and controlled clinical study and statistical analysis. (1) comparison of the overall effect of the two groups: the control group 28 cases, 12 cases were cured, 6 cases improved, 10 cases ineffective, the total efficiency of the 28 cases with 64.28%. the treatment group 18 cases were cured, 8 cases improved, 2 cases ineffective, the total efficiency of 92.86%; the statistical analysis showed significant differences between the two groups overall efficacy (P0.05); (2) two cases anal swelling condition: two groups of patients with anal swelling after treatment and 20 days after drug withdrawal after statistical comparison significant The difference (P0.05), combined HuaZhiShuan and compoundcarraghenates treatment is superior to levofloxacin hydrochloride ointment; (3) two cases of patients with anal pain, itching: two groups of anal pain, pruritus patients had significant difference after treatment and 20 days after withdrawal contrast (P0.05), United HuaZhiShuan and compoundcarraghenates treatment is superior to levofloxacin hydrochloride ointment; (4) patients with signs of improvement in two cases: two groups of patients that have significant differences in treatment and 20 days after drug withdrawal contrast diagnosis of anal sinus tenderness lesions (P0.05), combined HuaZhiShuan and compoundcarraghenates treatment to improve rectal tenderness superior to levofloxacin ointment; two groups of patients with microscopic anal sinus congestion, edema of anal papilla, improvement after treatment and 20 days after drug withdrawal contrast were statistically significant (P0.05); United HuaZhiShuan and Compound Carraghenates Suppositories treatment is superior to levofloxacin hydrochloride ointment; (5) two groups In cases of recurrence and adverse reactions: the recurrence of two groups after 20 days and the difference was significant (P0.05), combined HuaZhiShuan and compoundcarraghenates treatment group than levofloxacin ointment group; in the process of treatment of two groups were not found obvious adverse reactions. Conclusion: levofloxacin hydrochloride ointment for Compound Carraghenates Suppositories and HuaZhiShuan is better than the traditional.

【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R574.8

【參考文獻】

相關期刊論文 前10條

1 金蕾;章紅華;鄧琳;;淺談中藥灌腸療法治療肛竇炎[J];遼寧中醫(yī)藥大學學報;2008年04期

2 梁園園;于天浩;陳萍;董強;;黃柏的藥理活性及在化妝品中的應用[J];遼寧中醫(yī)藥大學學報;2013年01期

3 何嘉輝;彭水清;;痔疾洗液熏洗聯(lián)合復方角菜酸酯栓治療肛竇炎的臨床觀察[J];嶺南現(xiàn)代臨床外科;2013年05期

4 張媛;趙寶明;;近十年來國內(nèi)肛腸病中藥栓劑研究概況[J];遼寧中醫(yī)藥大學學報;2014年02期

5 魏楚蓉;伍趕球;;冰片的藥理作用及其機制研究進展[J];國際病理科學與臨床雜志;2010年05期

6 酈金龍;趙文婷;王盼;蘇春元;劉歡;李輝尚;殷麗君;;蜂膠的研究應用進展[J];中國食物與營養(yǎng);2011年06期

7 景建中，，李國棟;中西醫(yī)結合治療肛腸病的進展第6講肛竇炎的診治[J];中級醫(yī)刊;1994年07期

8 李杰;文屏;;蒙藥外用潰瘍散局部治療肛腸科疾病的研究概況[J];中國民族醫(yī)藥雜志;2010年06期

9 耿學斯,陳贊慶,趙斌;新癀片合雙氯芬酸鈉栓治療肛竇炎50例[J];中國中西醫(yī)結合雜志;2003年11期

10 劉磊;劉佃溫;;牛黃痔清栓治療肛竇炎的臨床研究[J];中醫(yī)臨床研究;2012年14期

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