【摘要】：痔是肛腸科常見(jiàn)病,其在臨床上的主要表現(xiàn)有肛門處出現(xiàn)水腫、疼痛、瘙癢甚至肛門墜脹等癥狀,并伴隨大便出血等現(xiàn)象。采用手術(shù)治療快捷有效,但是術(shù)后創(chuàng)面的水腫,疼痛以及創(chuàng)面的延期愈合,嚴(yán)重影響手術(shù)的治療效果。大量的臨床試驗(yàn)及資料證明中藥熏洗坐浴對(duì)混合痔術(shù)后創(chuàng)面具有良好的促愈作用。1目的:對(duì)混合痔術(shù)后患者采用消腫止痛洗劑進(jìn)行熏洗坐浴,驗(yàn)證其對(duì)創(chuàng)面的促愈作用。2方法:本課題的病例均來(lái)源于滁州市中西醫(yī)結(jié)合醫(yī)院肛腸科,時(shí)間為2015年6月份到2015年12月,在此時(shí)間段的住院的混合痔患者60人。然后隨機(jī)的把這病例分組,治療組和對(duì)照組各30例,治療組術(shù)后第1天排便后開(kāi)始使用消腫止痛洗劑(藥物組成:大黃、芒硝、蒼術(shù)、黃柏、苦參、赤芍、白芷)熏洗坐浴,隨后用馬應(yīng)龍痔瘡膏換藥。對(duì)照組給予1/5000高錳酸鉀液熏洗坐浴,隨后用馬應(yīng)龍痔瘡膏外用。主要觀察和記錄患者的諸多癥狀,比如疼痛、水腫、有無(wú)滲液、肉芽形態(tài),成纖維細(xì)胞的數(shù)量情況,創(chuàng)面愈合時(shí)間等作為主要指標(biāo)進(jìn)行觀察,收集臨床數(shù)據(jù),進(jìn)行統(tǒng)計(jì)學(xué)分析。3結(jié)果:經(jīng)統(tǒng)計(jì)學(xué)處理,對(duì)患者的疼痛,水腫,創(chuàng)面滲液狀況進(jìn)行對(duì)比,以術(shù)后2天,術(shù)后7天,術(shù)后14天為時(shí)間節(jié)點(diǎn)觀察比較。疼痛狀況術(shù)后2天,7天的數(shù)值顯示:均有顯著性差異(P0.05),術(shù)后14天(P0.05)無(wú)顯著差異。水腫情況:術(shù)后第2天(P0.05),無(wú)顯著差異。術(shù)后7天,14天均有顯著性差異(P0.05)。對(duì)患者創(chuàng)面滲液情況進(jìn)行對(duì)比,術(shù)后第2天創(chuàng)面滲液較對(duì)照組多,但是術(shù)后第7天,第14天(P0.05),說(shuō)明早期形成濕潤(rùn)的創(chuàng)面環(huán)境,中后期明顯減少創(chuàng)面滲液。觀察肉芽生長(zhǎng)狀況對(duì)比,術(shù)后第7天和第14天的肉芽生長(zhǎng)情況比較,(P0.05)。治療組明顯優(yōu)于對(duì)照組。創(chuàng)面愈合時(shí)間方面,(P0.05),治療組明顯優(yōu)于對(duì)照組。觀察成纖維細(xì)胞第3天(P0.05),兩組數(shù)字無(wú)差異。第8天(P0.05),說(shuō)明治療組數(shù)量比對(duì)照組多。4結(jié)論:通過(guò)應(yīng)用消腫止痛洗劑用于混合痔患者術(shù)后,能減輕術(shù)后疼痛,消除水腫,有利于成纖維細(xì)胞生長(zhǎng),縮短創(chuàng)面愈合時(shí)間,促進(jìn)創(chuàng)面愈合。此外且在臨床熏洗過(guò)程中及出院隨訪中均未出現(xiàn)任何毒副作用及皮膚過(guò)敏現(xiàn)象。中藥熏洗應(yīng)用實(shí)施簡(jiǎn)單方便,安全有效,患者依從性好。
[Abstract]:Hemorrhoids is a common disease in anorectal department. Its clinical manifestations include edema, pain, itching and even anal distention, accompanied by stool bleeding and so on. The surgical treatment is quick and effective, but the edema, pain and delayed healing of the wound after operation seriously affect the curative effect of the operation. A large number of clinical trials and data have proved that traditional Chinese medicine fumigation and sitting bath has a good effect on the healing of postoperative wounds of mixed hemorrhoids. 1 objective: to take fumigation and sit bath with anti-swelling and analgesic lotion for patients with mixed hemorrhoids after operation. Methods: all the patients in this study were from the anorectal department of Chuzhou integrated Chinese and western medicine hospital, from June 2015 to December 2015. 60 patients with mixed hemorrhoids were hospitalized in this period. Then the cases were randomly divided into treatment group (30 cases) and control group (30 cases). The treatment group began to use detumescence and analgesic lotion (drug composition: rhubarb, mirabilite, Atractylodes, Cortex Phellodendri, Sophora flavescens, Radix Paeoniae Alba, Radix angelicae dahurica) after the first day of defecation. Then with Ma Ying long hemorrhoids ointment change medicine. The control group was given 1 / 5 000 potassium permanganate solution to fumigation and wash sit bath, then used Ma Ying long hemorrhoids ointment for external use. We mainly observed and recorded many symptoms of the patients, such as pain, edema, exudation, granulation morphology, the number of fibroblasts, wound healing time and so on, and collected clinical data. Results: after statistical treatment, the pain, edema and exudation of the wound were compared, and the two days, seven days and fourteen days after the operation were observed and compared. Pain status 2 days, 7 days value showed: there were significant differences (P0.05), postoperative 14 days (P0.05) no significant difference. Edema: on the second day after operation (P0.05), there was no significant difference. There were significant differences on 7 days and 14 days after operation (P0.05). On the second day after operation, there was more exudate on the wound surface than in the control group, but on the 7th and 14th days after operation (P0.05), the wet wound environment was formed in the early stage and the wound effusion was significantly reduced in the middle and late stage. The granulation growth was compared on the 7th day and the 14th day after operation (P0.05). The treatment group was superior to the control group. Wound healing time, (P0.05), the treatment group was significantly better than the control group. The fibroblasts were observed on the 3rd day (P0.05), and there was no difference between the two groups. On the 8th day (P0.05), the number of the treatment group was more than that of the control group. Conclusion: the treatment group can reduce the postoperative pain, eliminate the edema and benefit the growth of fibroblasts by using detumescence and analgesic lotion for the patients with mixed hemorrhoids. Shorten wound healing time and promote wound healing. In addition, there were no toxic side effects and skin allergy in the course of clinical fumigation and discharge. The application of traditional Chinese medicine fumigation is simple and convenient, safe and effective, and patient compliance is good.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R266

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