| Hemorrhoids are a very common anorectal condition,while surgery is considered as the most common therapies used to treat hemorrhoids.In1975,Thomson first proposed "anal cushions moving down theory" in1975regarded hemorrhoids as the "normal anatomy of the human body", and defined that "the pathological hypertrophy of normal anal cushions result in hemorrhoids".Based on this theory,the Italian surgeon Longo first described using PPH to treat hemorrhoids in1998. In June2000,Professor Yao Liqing completed the first case of PPH procedure in China. Since then,PPH procedure has been widely developed and applied in our country. After years of clinical experience,PPH procedure has showed the advantages of less trauma,quicker recovery time,less pain,fewer complications,and no damage to the normal physiological function of the anal cushions.PPH procedure can shorten the operation time,hospital stay and postoperative recovery period for the patients,and the postoperative pain is significantly reduced compared with conventional hemorrhoidectomy. However,urinary disorders are common complications after PPH,which have troubled both the patients and the doctors.Acupoint application therapy belongs to scope of external treatment in traditional Chinese medicine,which plays an important role in TCM therapeutics.Based on TCM theories,it is guided by the principles of the holism concept and treatment based on pattern differentiation,with channel and collateral theory as the theoretical foundation. It is a noninvasive acupoint therapy that treats disease by using herbs to directly stimulate acupoints and through percutaneous absorption of the herbs.Acupoint application therapy can not only reduce the incidence of the diseases,alleviate the suffering of patients,but also can improve human body’s resistance. As it is safe and effective,and easy to operate,it has been widely used in clinical practice.Acupoint application of Wulingsan (Five-Ingredient Powder with Poria) is one of the effective external treatment methods to prevent and cure postoperative urinary retention that has been determined by long-term clinical practice in our department.This research was conducted to further evaluate the clinical efficacy of Wulingsan acupoint application in prevention and treatment of PPH postoperative urinary retention as compared to the placebo,in order to find out a more ideal and effective method to prevent and treat PPH postoperative urinary retention.Objectives:To evaluate the clinical efficacy of Wulingsan acupoint application in prevention and treatment of PPH postoperative urinary retention, to provide a safe and effective method for the prevention and treatment of urinary retention after PPH,and to further provide the basis for research on this non-invasive,easy,convenient,safe and effective method for prevention and treatment of urinary retention after PPH.Methods:A randomized,parallel-group clinical trial was conducted. Patients who were hospitalized in the Anorectal Department of Dongfang Hospital affiliated to Beijing University of Chinese Medicine during May2010to March2011were selected.60patients who met the inclusion criteria of hemorrhoids were randomly divided into the control group and the treatment group,with30patients in each group. In the treatment group,Wulingsan acupoint application therapy was used;the five herbs—zhu ling (Polyporus),ze xie (Alisma), fu ling (Poria), bai zhu (white atractylodes rhizome) and gui zhi (Cinnamon Twig) were ground into powder and made into a paste,then the paste was made into medicinal cakes and applied on the acupoints including RN4(guan yuan),RN3(zhong ji) and RN6(qi hai) once daily,starting from the day before the surgery to one week after the surgery. In the control group,the placebo acupoint application therapy was used. The starch paste was made into medicine cakes and applied on the above there acupoints once daily,from the day before the surgery to one week after the surgery. The length of time to the first postoperative voiding, the status of the first postoperative voiding and abdominal symptoms,the incidence of postoperative indwelling catheter use,and the time period for recovery of the normal voiding function after the surgery were observed as the main indicators,and the relevant indicators were quantified and scored,and relevant scores were collected and analyzed using SPSS17.0statistical software.Results:There was no significant difference between the two groups in the age,sex,duration of disease,severity,voiding scores before treatment,etc. of the selected cases,which were comparable. After treatment,the treatment group was showed superior to the control group in the total effective rate in prevention and treatment of PPH postoperative urinary retention,with a statistically significant difference (P<0.05).After comparing the scores oneach observational indicator,it also showed that the treatment group was superior to the control group in the incidence of postoperative indwelling catheter use,the length of time to the first postoperative voiding,and the time period for recovery of the normal voiding function after the surgery,the status of the first voiding and abdominal symptoms,with a statistically significant difference (P<0.05) Conclusion:Wulingsan acupoint application can significantly prevent and improve the incidence of PPH postoperative urinary retention. It is easy to operate and spread,thus being considered as an effective method of TCM external treatment in prevention and treatment of postoperative urinary retention. |
PDF Full Text Request