| Objective:Hemorrhoids is one of the most common anorectal disorders. We have accumulated rich experience and summaried many effective therapyes in the management of haemorrhoids ever since. Surgery had been shown to be one of major therapies. Many Hemorrhoidectomy techniques have been proposed, but Milligan-Morgan hemorrhoidectomy, as described originally in 1937, has remained the most popular. Operation is inevitable to result in corresponding postoperative complications, because it is a traumatic therapy. It carries risks of postoperative pain , hematochezia, urinary retention and straining of anorectum, etc. . These postoperative complications affect directly quality of life and stage of recovery and decide on the effect of hemorrhoidectomy.On the basis of clinical practice in this study, we use the special traditional Chinese decoction named "Zhitong Rushen Decoction" from Golden Mirror of Medicine in Qing Dynasty. It contacts directly or indirectly local affection of anorectal locus by sitz bath. By heating and drug power, it has the effect of clearing away heat evil and promoting diuresis, activating blood circulation to dissipate blood stasis, redgeing meridian, dispelling windevil and moisturizing dryness-syndrome. It aims at the effect of improving local hemodynamics and microcirculation, promoting lymphatic return, plerosising trauma, cleaning stagnated blood of in operative zone, ameliorating hypoxia of local tissue, relieving the recurrence of postoperative complications in haemorrhoidal zone. Significance :In traditional Chinese medicine' s standpoint, the principl of endotherapy and external treatment is identical. In this study , we altered the usage of "Zhitong Rushen Decoction" from taking orally to sitz bath. Because the therapy of sitz bath can contact directly local affection of anorectal locus, It has an directly effect of drug and reduce deficiency of taking orally. We investigated the effect and principl of treating postoperative complications. Methods:In this case-control study, we assigned randomly patients of Milligan-Morgan haemorrhoidectomy to the treatment group or the control group. In the treatment group, "Zhitong Rushen Decoction" by sitz bath was used, while in the control group, potassium permanganate solution(1:5000) by sitz bath was used. To compare the short-term effect between the two groups, data of postoperatic pain index, times of using analgesic, postoperative bleeding, urinary disturbance, disturbance of control feces, dysporia , etc. were analyzed. Results: l.Compareing results of general condition for balance between two groups:Sex: P=0.796, Staging: P=0.767, Pattern of syndrome: P=0.690, Course: P=0.566 ,Age: P=0.465, Operative time: p=0.598, A11>0.05. There was no statistical difference. It hinted that the two groups possess comparability in general condition.2.Compareing results of post-treatment in complication between two groups.-2.1.Compareing postoperatic anus pain between two groups:Pd1=0.000, Pd2=0.004, Pd3=0. 006, Pd4=0.015, Pd5=0. 000, Pd6=0. 000, Pd7=0.000, all<0.05。 This difference was statistically significant. Comparing frequency of analgesic drug of Tramadol pellet, Tramadol ampule and Sauteralgyl ampule between two groups P = 0. 021 < 0. 05 , This difference was statistically significant. It hinted that the treatment group was superior to the control group in the effect of postoperative analgesic effect and frequency of analgesic drug. 2.2.Compareing postoperative bleeding in two groups:Pd2=0. 024, Pd3=0.038, Pd4=0.022, Pd5=0.036, Pd6=0.035, Pd7=0.048, all< 0.05, This difference was statistically significant. It hinted that the treatment group was superior to the control group in the effect of treating postoperative hematochezia. 2.3.Compareing straining of anorectum between two groups:Pd1=O. 044, Pd2=0. 046, Pd3=0.028, Pd4=0.001, Pd5=0. 001, Pd6=0. 001, Pd7=0.009. all <0. 05, This difference was statistically significant. It hinted that the treatment group was superior to the control group in the effect of treating postoperative straining of anorectum. 2. 4. Compareing urinary disturbance between two groups:Pd1=0. 013, Pd2=0. 004, Pd3=0. 357, Pd4=0. 471, Pd5=0. 647, Pd6=0. 647, Pd7=0. 647, Pd1-Pd2<0. 05, This difference was statistically significant. Pd4-Pd7, >0. 05, There was no statistical difference. It hinted that the treatment group were superior to the control group in the effect of treating postoperative urinary disturbance.2. 5.Compareing the ability of control feces between two groups: Pd2=0. 527, Pd3=0.273, Pd4=0.157, Pd5=0.136, Pd6=0.221, Pd7=0. 512,all>0.05 There was no statistical difference. It hinted that the two groups were no differnce in the effect of treating postoperative disturbance of control feces.2. 6.Compareing faecal function between two groups:Pd2=0.710, Pd3=0.615, Pd4=0. 074, Pd5=0.36, Pd6=0.26, Pd7=0. 249, all>0.05, There was no statistical difference. It hinted that the two groups are no differnce in the effect of treating postoperative disturbance of faecal.3. Compareing results of post-treatment in other condition between two groups: Anus pain of first uresis: P=0.021<0.05, Anus pain of first defecation:P=0.022<0.05,Time of first uresis: P=0. 017,Time and course of first uresis: p=0.027, Time and course of first faecal: p=0.031, Hospitalization time: P=0. 000, Recovering time: P=0. 000, The degree of satisfaction: P=0. 036, all <0. 05. This difference was statistically significant.time of first faecal P = 0.215, P>0. 05.There was no statistical difference. It hinted that the treatment group was superior to the control group in the effect of anus pain of first uresis, anus pain of first defecation, time and course of first uresis and time and course of first faecal after operation. It hinted that the two groups were no differnce in the effect of treating time of first defecation after operation. Conclusions:1.In short-term, the group of "Zhitong Rushen Decoction" by sitz bath is better than potassium permanganate solution(1:5000) by sitz bath in terms of data of postoperative complications, such as postoperatic pain index,...
|
PDF Full Text Request