摘要
目的 研究复方当归注射液联合生物反馈治疗功能性肛门直肠痛的临床疗效。方法 选取2020年6月—2020年11月于湖北省中医院肛肠科门诊治疗的符合纳入标准的功能性肛门直肠痛患者60例作为研究对象,采用随机数表法分为治疗组与对照组,各30例,对照组采用单纯的生物反馈疗法,治疗组在生物反馈疗法的基础上联合复方当归注射长强穴及肛周局部注射治疗,对比2组患者的疼痛视觉模拟评分(VAS)和临床疗效。结果 治疗组治疗后的VAS评分为(2.45±1.88)分,低于对照组的(4.07±2.02)分(t = 3.204,P<0.05);治疗组的总有效率(93.33%)高于对照组(70.00%),χ2=4.01,P<0.05。结论 复方当归注射液联合生物反馈能有效缓解患者疼痛,在治疗功能性肛门直肠痛上明显优于单纯生物反馈疗法,操作简便,价格低廉,微创且又避免了长期使用镇痛药物的毒副作用,有较好的临床实用性。
关键词: 功能性肛门直肠痛;复方当归注射液;穴位注射;生物反馈;视觉模拟评分
Abstract
Objective To study the clinical efficacy of compound Angelica injection combined with biofeedback in the treatment of functional anorectal pain. Methods:A total of 60 patients with functional anorectal pain who were treated in the outpatient department of Proctology, Hubei Hospital of Traditional Chinese Medicine from June 2020 to November 2020 and met the inclusion criteria were selected as the research objects. They were divided into treatment group and control group by random number table method, with 30 patients in each group. The control group received simple biofeedback therapy. On the basis of biofeedback therapy, the treatment group was combined with compound Angelica injection at Changqiang acupoint and local injection around anus. Visual analogue scale (VAS) of pain and clinical efficacy in twogroups were compared. Results: The VAS score of the treatment group was (2.45±1.88), lower than that of the control group (4.07±2.02)(t = 3.204, P < 0.05). The total effective rate in treatment group (93.33%) was higher than that in control group (70.00%), χ2=4.01, P < 0.05. Conclusion : Compound Angelica injection combined with biofeedback can effectively relieve the pain of the patients, and is obviously superior to simple biofeedback therapy in the treatment of functional anorectal pain. It is simple, inexpensive, minimally invasive, and avoids the toxic and side effects of long-term use of analgesics, so it has good clinical practicability.
Key words: Functional Anorectal Pain; Compound Angelica Injection; Acupoint Injection; Biofeedback Therapy; Visual Analogue Scale
参考文献 References
[1] Zhang, Q., et al., Impaired Anorectal Afferents Is a Potential Pathophysiological Factor Associated to Functional Anorectal Pain. Frontiers in neurology, 2020. 11.
[2] 梁勇等, 从“郁”论治功能性肛门直肠痛经验. 中国中医急症, 2021. 30(11): 第2049-2051页.
[3] Simren, M., O.S. Palsson and W.E. Whitehead, Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice. Curr Gastroenterol Rep, 2017. 19(4): p. 15.
[4] Katz J, Melzack R. Measurement of pain[J]. Surgical Clinics of North America, 1999, 79(2): 231-252.
[5] 国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,002:312-314.
[6] Boyce, P.M., et al., Epidemiology of the functional gastrointestinal disorders diagnosed according to Rome II criteria: an Australian population-based study. Intern Med J, 2006. 36(1): p. 28-36.
[7] 袁周萍等, 温针灸长强穴治疗功能性肛门直肠痛40例. 实用中医药杂志, 2016. 32(08): 第818页.
[8] 郭光丽, 钟瑾与王彦峰, 桃红四物汤加味结合保留灌肠治疗肛隐窝炎48例. 环球中医药, 2008(05): 第20-21页.
[9] 李佳楠等, 从瘀论治功能性肛门直肠痛. 中国中医药信息杂志, 2022. 29(01): 第140-142页.
[10] 刘东, 复方当归注射液穴位注射治疗PKP术后疼痛疗效观察, 2020, 云南中医药大学. 第 45页.
[11] 鞠应东, 李强与鞠丽娟, 长强穴给药治疗功能性肛门直肠痛, in 2012医学前沿——中华中医药学会肛肠分会第十四次全国肛肠学术交流大会2012: 中国湖南长沙. 第3页.
[12] 蔡丽群等, 电针治疗功能性肛门直肠痛35例. 中国针灸, 2016. 36(01): 第41-42页.
[13] 韦元成等, 功能性肛门直肠痛的临床诊疗进展. 世界华人消化杂志, 2021. 29(1): 第1-6页.
[14] 钟志凤等, 生物反馈联合舒肛汤中药坐浴治疗功能性肛门直肠痛的效果. 中华全科医学, 2020. 18(01): 第56-58+153页.