消痔靈注射液聯合PPH術治療脫垂痔伴便秘的效果

于麗 葛寧 趙倩 李晶如

[摘要] 目的 探討不同固脫法治療脫垂痔伴便秘的效果。 方法 選取2017年3月～2018年3月北京中醫藥大學東直門醫院肛腸科病房收治的108例脫垂痔伴便秘患者作為研究對象，按照隨機數字表法將其分為對照組與觀察組，每組各54例。對照組患者采用吻合器痔上黏膜環切術（PPH術）進行治療，觀察組在對照組的基礎上結合消痔靈注射液進行治療。比較兩組患者的排便次數、住院時間及并發癥發生率。兩組患者均隨訪6個月，觀察兩組的治療效果。 結果 觀察組總有效率低于對照組，差異有統計學意義（P < 0.05）;觀察組排便次數多于對照組，住院時間短于對照組，差異有統計學意義（P < 0.05）;觀察組并發癥總發生率低于對照組，差異有統計學意義（P < 0.05）。 結論 消痔靈注射液聯合PPH術可有效治療脫垂痔伴便秘，提高治療有效率，值得推廣應用。

[關鍵詞] 固脫法;脫垂痔;便秘;辨證

[中圖分類號] R657.1? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）07（c）-0185-04

Effect of Xiaozhiling Injection combined with PPH on prolapse hemorrhoids with constipation

YU Li? ?GE Ning? ?ZHAO Qian? ?LI Jingru

Anorectal Ward， Dongzhimen Hospital of Beijing University of Chinese Medicine， Beijing? ?100700， China

[Abstract] Objective To explore the effect of different solid doff methods in the treatment of prolapse hemorrhoids with constipation. Methods A total of 108 cases of prolapsed hemorrhoids with constipation in Anorectal Ward of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from March 2017 to March 2018 were selected as the research objects. According to the random number table method， the patients were divided into the control group and the observation group， 54 cases in each group. The patients in the control group were treated with procedure for prolapse and hemorrhoids （PPH）， while the patients in the observation group were treated with Xiaozhiling Injection on the basis of the control group. The defecation times， hospitalization time and the incidence of complications were compared between the two groups. Patients of two groups were followed up for 6 months and the therapeutic effect was observed. Results The total effective rate of the observation group was lower than that of the control group， and the difference was statistically significant （P < 0.05）. The defecation times of the observation group were more than those of the control group， and the hospitalization time of the observation group was shorter than that of the control group， the differences were statistically significant （P < 0.05）. The total incidence of complications in the observation group was lower than that in the control group， the difference was statistically significant （P < 0.05）. Conclusion Xiaozhiling Injection combined with PPH can effectively treat prolapsed hemorrhoids with constipation and improve the treatment efficiency， which is worthy of popularization and application.

[Key words] Solid doff method; Prolapse hemorrhoids; Constipation; Syndrome differentiation

固脫療法歷史悠久，“固脫”一詞經常出現在中醫內治法治療急癥方面，主要用于虛脫證，如益氣固脫、升陽固脫、扶正固脫等。在中醫外科學發展過程中，“固脫”一詞的提出較晚，其以祖國醫學“酸可收澀，澀可固脫”的理論為基礎，應用收斂固澀藥劑治療組織器官不在其位、不司其職的脫證，使組織器官歸其位、司其職。臨床中固脫技術用于治療肛門疾病，如脫垂痔、直腸黏膜脫垂、脫肛、直腸前突等。趙寶明[1]教授應用注射固脫法和吻合器痔上黏膜環切術（PPH術）結合治療Ⅱ、Ⅲ度直腸脫垂，術后感染概率小、恢復快、效果好，臨床療效滿意。

痔瘡是臨床常見病、多發病，歷來有十人九痔之說[2-3]。對其認識從最初的靜脈曲張學說、血管增生學說，發展至肛墊下移學說。中醫學將痔辨證分為虛實兩端，實證者包括濕熱下注證、氣滯血瘀證、風傷腸絡證;虛證者包括脾虛氣陷證[4-6]。……