The Cutting Seton Therapy Of Traditional Chinese Medicine In The Treatment Of High Anal Fistula Of Anal Funciton Clinical Assessment

Traditional chinese medicine characteristics of cutting seton therapy in the treatment of high anal fistula. Documented in ancient China "line fall dates or 10 day and a half months, not more than 20 day" point of view, where "line the sunset period" the rubber band off time now, descriptions in ancient physicians have been shedding of note thread time is of great significance in the cutting seton therapy.Current domestic scholars on the rubber band off time for research and exploration, the corresponding view, recognizing that the rubber band off time and postoperative anal function exists.But without the rubber band off time and thread-drawing system of evaluation of anal function before and after treatment of traditional Chinese medicine research.We design the study to further explore and study on the rubber band off time and the relationship between postoperative anal function.Take the rubber band off time as group by,on different time periods to assess the rubber band off anal function,into the rubber band off the statistical analysis a suitable time frame.Thesis is divided into two parts:Part I:Documental summary1,Research progress on traditional Chinese and Western medicine of anal fistula.2,The cutting seton therapy in the treatment of high anal fistula of application profiles.3,High anal fistula treatment anus functional evaluation research overview.PartⅡ:Clinical researchObject:Research by different time periods before and after surgery and elastic loop tendon anus functions, and the time of the evaluation function anus, finding a suitable time off, in the period of time,a relatively small damage anus, anus function better protection of the assessment indicators are located in a better future.Method:During 2009.3～2010.1 on 62 cases of high anal fistula cases (both Guang An Men Hospital of Chinese Academy of Traditional Chinese Medicine Anorectal patients),underwent surgery Low-position incision and high-position cutting seton therapy.The elastic loop off after time (t) for the group by randomly divided into three experimental groups.Test a set of rubber band off time less than 14 days, that is t <10days;test two groups of the rubber band off time more than or equal to 14 days and less than or equal to 20 days,iell16.Observational study of indicators before and after surgery of anorectal manometry, wexner score, tight line number refers to the preoperative diagnosis,MRI diagnosis and surgery in the diagnosis rate of recurrence six months follow-up rate.Result:Three groups before surgery and recovered are comparative statistical analysis of anorectal pressure change rate results, comparison between test 1 and test 2 group p=0.00<0.05,statistically significant differences, comparison between test 1 and test 3 group p=0.00<0.05, statistically significant differences, comparison between test 2 and test 3 group p=0.051>0.05,the difference was not statistically significant.Different rubber band shedding time range and resting pressure change rate, shrinkage squeeze pressure change rate, associated press exists between rate of pressure change, rubber band shedding time spans 11 at≤t≤16 of anorectal pressure change rate significantly lower than the rubber band off time range t<10.Three recovered Wexner scoring after statistical analysis,comparison between test 1 and test 2 group p=0.00<0.05,statistically significant differences,comparison between test 1 and test 3 group p=0.00<0.05,statistically significant differences. Comparison between test 2 and test 3 group p=1.00>0.05, the difference was not statistically significant.Different rubber band shedding time span associated with healing Wexner scoring, test 2 group recovered Wexner scoring lower than test 1. Recovered Wexner scoring and correlation analysis of anorectal pressure change rate:recovered Wexner resting pressure rate of decline in scoring and the Pearson correlation coefficient for 0.579,P=0.000,healed Wexner scores associated with resting pressure exists between the rate of decline. Shrinkage after squeezing pressure and squeezing pressure rate of change and recovery there linear correlation between the Wexner score.Test l,test 2 group, test group 3,specialist diagnosis and MRI diagnosis and intraoperative diagnosis,diagnosis of MRI in diagnosis and p>0.05,the difference was not statistically significant.Group internal test 3 groups,specialist diagnosis and Surgery specialist diagnosis and MRI diagnosis and diagnosis,MRI diagnosis in intraoperative diagnosis,p<0.05,differences are statistically significant.Conclusion:rubber band off time is hanging loose line and cutting and healing effects of integrated performance.hung high treatment anal fissure fistula in the rubber band off time and after-surgery anal function exists between interrelated,when rubber band off the time between 11 days to 16 days after recovery, scoring,and rectum buggery wexner measured the pressure change significantly lower rates than rubber band off time of less than 10 days.wexner scoring and rectum buggery measure the pressure tube anal function contains a better assessment of the role before and after surgery,through anal intercourse rectum measuring tube pressure change rates compare found rectum buggery assessment test tube Pressure Sensitivity is better.wexner recovered after scoring and rectum anal intercourse between the Pressure measured rate change linear dependence,to assess consistency of anal function.