联合应用复方角菜酸酯栓和化痔栓治疗肛窦炎的临床研究

发布时间：2018-04-02 22:37

本文选题：化痔栓　切入点：复方角菜酸酯栓　出处：《河北医科大学》2015年硕士论文

【摘要】：目的:肛窦炎又名为肛隐窝炎,它属于肛窦及肛门腺内的炎症性病变。它是一种非常重要的隐匿性感染病灶,大概有85%肛门直肠疾病与肛窦感染有关系。因为肛窦形态和部位的特殊性,使得它极易受到破损导致感染。肛窦一旦受外界损伤,致病病菌可趁机进入肛腺而诱发肛腺炎症。肛腺感染经过其分支发展蔓延形成直肠肛门周围炎,最终导致肛周脓肿,破溃后形成肛瘘。通常的治疗方法是中药坐浴、手术换药及全身抗菌素治疗等,因为发病部位比较隐蔽,药物往往很难达到发病部位,故疗效都不太理想。本文通过观察联合应用复方角菜酸酯栓和化痔栓对肛窦炎的治疗作用,探讨“肛窦炎”的中医病机及致病特点,为临床治疗肛窦炎提供疗效好,使用方便,依从性佳的药物。方法:筛选2014年2月至2014年12月石家庄市长安区医院肛肠科及河北医科大学中医院门诊诊断为肛窦炎的病例56例,随机分成二组,每组各28例,经比较二组在年龄、性别、病情程度无差别(P0.05),具有可比性。治疗组给予化痔栓及复方角菜酸酯栓入肛。对照组给予左氧氟沙星软膏入肛,均为20天为一疗程。通过仔细观察治疗前后及停药20天后的症状、体征,肛门镜检情况结果等,评定出患者临床症状:包括肛门肿胀、疼痛程度、瘙痒变化及指诊的体征如触痛情况,镜检肛乳头水肿及肛窦充血等指标的变化情况,最后进行统计学分析。结果:治疗前对两组病例的年龄因素、性别因素、病程长短、肛门疼痛、肛门肿胀、肛周瘙痒情况,指诊情况病变肛窦有无压痛,镜检肛乳头水肿、肛窦充血等进行比较,差异无统计学意义,二组病例具有可比性。对治疗前后(停药后20天)进行临床对照研究并进行统计学分析。(1)总体疗效二组病例的对比情况:对照组28例中共有12例治愈,6例好转,10例无效,总有效率64.28%。治疗组28例中共有18例治愈,8例好转,2例无效,总有效率92.86%;经统计学分析对比两组总体疗效有显著性差异(P0.05);(2)两组病例中肛门肿胀病情情况:两组患者肛门肿胀在治疗后及停药20天后经统计对比有显著性差异(P0.05),联合化痔栓及复方角菜酸酯治疗优于左氧氟沙星软膏;(3)两组病例中患者肛门疼痛、瘙痒情况:两组肛门疼痛的、瘙痒患者在治疗后及停药20天后对比有显著性差异(P0.05),联合化痔栓及复方角菜酸酯治疗优于左氧氟沙星软膏;(4)两组病例中患者体征改善情况:两组患者指诊病变肛窦压痛在治疗后及停药20天后对比有显著性差异(P0.05),联合化痔栓及复方角菜酸酯治疗改善肛门指诊压痛方面优于左氧氟沙星软膏;两组患者镜检肛窦充血、肛乳头水肿、改善情况在治疗后及停药20天后对比均有统计学意义(P0.05);联合化痔栓及复方角菜酸酯栓治疗优于左氧氟沙星软膏;(5)二组病例的复发情况及不良反应情况:两组停药20天后的复发情况经比较有显著性差异(P0.05),联合化痔栓及复方角菜酸酯治疗组优于左氧氟沙星软膏组;用药过程中两组均未发现明显不良反应。结论:复方角菜酸酯栓和化痔栓优于传统的一般左氧氟沙星软膏治疗。
[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.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R574.8

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