胡建文 梁小霞 文桂香

摘要：目的 观察痔瘘洗剂联合加味四黄膏对肛窦炎患者的临床疗效及安全性。方法 将100例肛窦炎患者随机分为观察组和对照组各50例。对照组给予口服头孢丙烯分散片及局部化痔栓塞肛治疗，观察组给予中药痔瘘洗剂局部熏蒸及坐浴患处同时联合加味四黄膏局部外敷治疗。7 d为1个疗程，2组均治疗2个疗程。观察患者治疗前后中医症候积分，评价2组临床疗效，观察2组患者各项症状缓解时间、住院时间、6个月内的复发率及不良反应。结果 2组治疗后中医证候积分均较治疗前明显改善（P<0.01），且观察组低于对照组（P<0.01）。观察组总有效率为96.0%（48/50），对照组为80.0%（40/50），差异有统计学意义（P<0.01）。观察组肛门水肿、肛门潮湿、肛门疼痛、肛门坠胀症状缓解时间均明显短于对照组（P<0.01）。观察组患者平均住院时间为（15.25±2.78）d，对照组为（18.46±3.41）d，2组比较差异有统计学意义（P<0.01）。观察组随访2、4、6个月复发率分别为0、0、2.0%，对照组分别为4.0%、12.0%、16.0%，对照组4、6个月复发率均明显高于观察组（P<0.05）。2组均未出现明显不良反应。结论 痔瘘洗剂联合加味四黄膏治疗肛窦炎临床疗效好，复发率低，安全性高。

关键词：痔瘘洗剂；加味四黄膏；肛窦炎；湿热下注

DOI：10.3969/j.issn.1005-5304.2016.07.006

中图分类号：R269.571 文献标识码：A 文章编号：1005-5304（2016）07-0022-04

Clinical Study on Zhilou Lotion Combined with Modified Sihuang Ointment in Treatment of Anal Cryptitis HU Jian-wen， LIANG Xiao-xia， WEN Gui-xiang （Department of Proctology， Shenzhen Baoan Hospital of Traditional Chinese Medicine， Shenzhen 518100， China）

Abstract： Objective To observe the clinical efficacy and safety of Zhilou Lotion combined with modified Sihuang Ointment in treatment of anal cryptitis. Methods One hundred patients with anal cryptitis were randomly divided into observation group and control group， with 50 cases in each group. The control group was given propylene dispersible tablets oral and topical Huazhi embolism. The observation group received steaming and hip bath with Zhilou Lotion combined with modified Sihuang Ointment topical external application treatment， 7 days as a course of treatment and 2 courses successive. The TCM syndrome scores of two groups were compared before and after treatment to evaluate the clinical efficacy. The remission time of symptoms， hospitalization time， recurrence rate in 6 months and adverse reactions were observed. Results After treatment， the TCM syndrome scores of two groups were improved （P<0.01）， and the scores in the observation group was lower than those in the control group （P<0.01）. The total effective rate was 96.0% （48/50） in the observation group， and 80.0% （40/50） in the control group， with statistical significance （P<0.01）. The remission time of anal edema， anal dampness， anal pain and anal fall-swell in observation group was obviously shorter than that in the control group， with statistical significance （P<0.01）. The average hospitalization time was （15.25±2.78） days in the observation group and （18.46±3.41） days in the control group， the difference was significant （P<0.01）. In the observation group， the recurrence rate was 0， 0 and 2.0% in 2， 4， 6 months follow-up， while that was 4.0%， 12.0% and 16.0% in the control group， respectively. The recurrence rates of the control group in 4 months and 6 months were higher than those of the observation group （P<0.05）. No significant adverse reactions occurred in the two groups. Conclusion Zhilou Lotion combined with modified Sihuang Ointment has good clinical efficacy in treatment of anal cryptitis， with low recurrence rate and high safety.

Key words： Zhilou Lotion； modified Sihuang Ointment； anal cryptitis； downward flow of dampness-heat

基金项目：深圳市宝安区科技计划社会公益（医疗卫生）项目（2014094）

肛窦炎又称肛隐窝炎，是指肛门齿线部的肛隐窝炎症性病变。解剖学中肛窦位于齿线黏膜与肛管皮肤的交界处，呈倒置的漏斗状“囊袋”。腹泻时，稀便常易积存在肛隐窝处，导致肛窦炎。西医疗法常采用抗生素及药物局部塞肛治疗，临床疗效不一，且复发率较高。本病属中医学“脏毒”范畴，基本病机为湿热下注、肠燥热结，治疗以清热解毒、消肿排脓为主[1-2]。笔者辨证应用自制中药洗剂与膏剂对肛窦炎进行针对性局部治疗，观察其疗效及安全性，为中医药治疗肛窦炎、降低复发率提供新的思路与方案。

1 资料与方法

1.1 一般资料

选取本院2014年5月-2015年1月收治住院的肛窦炎患者100例，采用SAS9.1统计软件进行随机数字编程，形成100个区组随机数字，列出流水号为001～100，按照1∶1比例下达该入选受试者应进入观察组或对照组。……