Clinical Study Of Toxin Clearing Away And Turbid Descending Method On Treatment Of Anal Sinusitis

Objective: Anal sinusitis is acute or chronic inflammation occurred in analsinus part.Morbidity of anal sinusitis is on rise year by year.The major clinical features of it are shown as pendant expansion discomfort of anal part and dentate line region,stabbing pain,damp and pruritus of anal part,etc.Since incipient symptom of anal sinusitis is latent,anal sinusitis is easily ignored by patient,and clinically does not attaches sufficient attention by physicians of anorectal department,resulting in protracting of the disease and finally developing into chronic disease.Anal sinusitis is prelusion of a lot of diseases in anorectal department,such as perianal abscess,anal fistula,papillary fibroma,etc.,so that it is has significantly significance for improving life quality of patient,reducing morbidity of anorectal diseases and shortening postoperation course of anorectal department diseases by early detection,early diagnosis and early treatment.Methods for clinically treating anal sinusitis are various at present,such as oral administration of antibiotics,TCM(traditional Chinese medicine)enteroclysis,fumigation and washing,topical liniment of various ointments,anus excision and acupuncture,etc.The methods have the deficiencies of poor clinical effect,high recurrence rate and long disease course.With patient suffering from anal sinusitis as research object,following related theory of TCM,in accordance with pathopoiesis characteristics of damp evil and heat evil to anal sinusitis,by combining deep understanding of turbid toxins theory to the disease and diagnosis and treatment of related viscera and by applying the treatment principles of clearing away heat,promoting dieresis,clearing away toxin and descending turbid,the issue observes and evaluates clinical effect of toxin clearing away and turbid descending method on treatment of anal sinusitis to illuminate cause,pathogenesis,progress and treatment of anal sinusitis caused by spleen and stomach injury,movement and transformation failure,endoretention of damp heat,turbid toxin down to anus and qi-blood circulation of anus part influenced by exogenous evil invasion and stagnation of qi activity,so as to achieve the effects of treating disease according to cause,overall dialectic and applying medicine according to symptoms,thereby providing a green,convenient,reasonable,effective and economic treatment path for clinic treatment of anal sinusitis.Methods: The study cases are outpatients from anorectal department of the First Hospital of Hebei Medical University,total 80 cases,in which male 52 cases,female 28 cases,are in accordance with the anal sinusitis diagnosis and inclusive criteria,sign informed consent form and voluntarily take medicine.80 confirmed cases are randomly divided into two groups,treatment group and reference group,and 40 cases in each group.Statistical analysis shows that the two groups have no statistical difference(P>0.05)on aspects of age,sex and disease developing degree and have comparability.The treatment group adopts toxin clearing away and turbid descending method and is treated by orally taking proposed prescription(200 mL each time,2 times/d)and hip bath fuming and washing with traditional Chinese medicine(TCM)(500 mL each time,1 time/d),and the reference group is treated by orally taking diosmin(0.9 g each time,2 times/d)and hip bath fuming and washing with potassium permanganate solution at diluting rate of 1:5,000(1 time/d).Hip bath fuming and washing method includes heating decoction 500 ml before sleep at night by patient,and fuming and washing anus part for about 15-20 min.One treatment course contains two weeks,after completion of treatment course,improvement conditions of clinical symptom and sign of patients of two groups before and after treatment are compared,and treatment safety,total effective rate,cure rate,recurrence rate after post-treatment 3 months and other indices are summarized and analyzed.The data of the study is statistically analyzed by SPSS13.0 software statistical package.Measurement data is shown with average value ± standard deviation(x ± s),data comparison adopts chi-square test,and P<0.05 is adopted as standard for determining significant difference.Recent comprehensive treatment effect is determined by statistical principle analysis.Results:1 The treatment group contains cured 33 cases,improved 6 cases and no effect 1 case,recurrence 3 cases in cured 33 cases.The cure rate is 82.5%,the effective rate is 97.5%,the recurrence rate is 9.1%.The reference group contains cured 23 cases,improved 11 cases and no effect 6 cases,recurrence 6 cases in cured 23 cases.The cure rate is 57.5%,the effective rate is 85%,the recurrence rate is 21.7%.χ~2 test shows cure rate P<0.05.The results show that total treatment effects of two groups have significant difference,and the treatment group has recurrence rate obviously lower than the reference group and has effect obviously better than reference group.2 Improvement condition of clinical symptom: χ~2 test shows improvements of the treated patients of two groups on anus pain,anus heavy swelling and other symptoms have significant difference(P<0.05),and clinical effect of the treatment group is obviously better than that of the reference group.Improvement on the perianal prurit has no significant difference P=0.478(P>0.05).Currently,it is not capable of considering significant difference between two groups on prevention of perianal prurit.3 Improvement condition of clinical sign: χ~2 test shows obvious improvements of the treated patients of two groups on anal sinuses edema,hyperemia,touch pain and other signs have significant difference(P<0.05),the treatment group has effect obviously better than the reference group.Improvement on the anal papilla red and swelling has no significant difference P=0.592(P>0.05).It is not capable of considering significant difference between two groups on improvement of anal papilla red and swelling.4 Recurrence rate reducing condition: χ~2 test shows two groups have significant difference(P=0.037)on recurrence rate.The treatment group has recurrence rate lower than the reference group,the recurrence rate of the treatment group is 9.1%,and the recurrence rate of the reference group is 21.7%.Conclusion: Anal sinusitis can be effectively treated by oral administration of decoction of proposed prescription for treating disease by toxin clearing away and turbid descending method and hip bath fuming and washing,clinical symptom and sign can be obviously improved,the recurrence rate is low,the treatment effect is better than reference group.The method has no toxic and side effects in treatment process,so that application of prescription for treating anal sinusitis by toxin clearing away and turbid descending method is safe and feasible.