益气养阴疏肝法结合微创闭式修补术治疗重度直肠前突20例临床观察

摘要

目的 观察益气养阴疏肝法结合微创闭式修补术对重度直肠前突的影响.方法 将60例重度直肠前突患者随机分为3组,对照1组20例采用经阴道切开修补术,对照2组20例采用微创闭式修补术,治疗组20例在对照2组治疗基础上加益气养阴疏肝中药,连服30 d.观察3组术中出血及术后并发症发生情况；随访3个月,观察临床疗效,统计治疗前及治疗后第7d、3个月症状评分变化情况.结果 治疗组临床痊愈率高于对照1、2组(P＜0.05),3组总有效率比较差异无统计学意义(P＞0.05).治疗组及对照2组术中出血及术后疼痛、坠胀发生例数均少于对照1组(P＜0.05),且治疗组术后坠胀例数少于对照2组(P＜0.05).3组治疗后7d及3个月症状积分与本组治疗前比较均明显下降(P＜0.05),且治疗组治疗后3个月症状积分低于对照1、2组(P＜0.05).结论 益气养阴疏肝法结合微创闭式修补术治疗重度直肠前突操作简便,术中、术后并发症少,可充分发挥中西医结合的优势,标本兼治,值得临床推广.%Objective To observe the clinical efficacy of minimally invasive closed repair combined with Yiqi Yangyin Shugan Decoction for treatment of severe rectal protrusion. Methods 60 Patients with severe rectal protrusion were randomly divided into three groups. Control group one received transvaginal incision repair. Control group Two received a minimally invasive closed repair. Treatment group received oral administration of Yiqi Yangyin Shugan Decoction combined with minimally invasive closed repair. The course was 30 days. Blood loss and postoperative complications were observed in three groups. Clinical efficacy, symptom score changes before and after 7 days and three months of treatment follow - up of 3 months was observed. Results Cure rate in treatment group was higher than that in control group One and Two (P <0. 05). There was no significant difference between three group on the total effective rate (P >0. 05). The number of intraoperative blood loss and postoperative complications in treatment group and control group Two was less than that in control group One (P < 0. 05 ). Symptom score of 7 days and 3 months after treatment were obviously decreased compared with those before treatment in three groups (P <0. 05). Symptom score of 3 months after treatment in treatment group was decreased compared with those in control group One and Two (P<0. 05). Conclusion Yiqi Yangyin Shugan Decoction combined with minimally invasive closed repair is simple, intraoperative, and postoperative fewer complications on the treatment of severe rectal operation can give full play to the advantages of integrated traditional and Western medicine, treating both principal and secondary as-pect of disease and is worthy of clinical.