李珏 梁娅

[摘要]目的 評估中药熏蒸联合硝酸甘油软膏对肛裂术后疼痛及睡眠质量的影响。方法 选取2016年1月～2017年6月本院收治的112例慢性肛裂术后患者作为研究对象，按照随机数字表法分为对照组和观察组，各56例。对照组给予单纯中药熏蒸治疗，观察组给予中药熏蒸联合硝酸甘油软膏治疗，分别评定两组术后第1、4、7天的疼痛及睡眠质量情况，比较两组术后不良反应发生情况。结果 两组患者术后第1天的疼痛及睡眠质量评分比较，差异无统计学意义（P>0.05）。两组患者术后第4、7天的疼痛及睡眠质量均有明显改善，且观察组改善更为明显，差异有统计学意义（P<0.05）。两组患者的头痛发生率比较，差异无统计学意义（P>0.05）。观察组的并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。结论 中药熏蒸联合硝酸甘油软膏治疗能有效缓解肛裂患者的术后疼痛及改善夜间睡眠质量，减少并发症的发生。

[关键词]肛裂；肛门疼痛；睡眠质量；中药熏蒸；硝酸甘油软膏

[中图分类号] R657.1 [文献标识码] A [文章编号] 1674-4721（2018）2（b）-0022-04

Influence of traditional Chinese medicine fumigation combined with Nitroglycerin Ointment on postoperative pain and sleep quality in anal fissure patients

LI Jue LIANG Ya

Department of Integrated Chinese and Western Medicine Anorectal，Affiliated Hospital of North Sichuan Medical College，Sichuan Province，Nanchong 637000，China

[Abstract]Objective To evaluate the influence of traditional Chinese medicine fumigation combined with Nitroglycerin Ointment on postoperative pain and sleep quality in anal fissure patients.Methods From January 2016 to June 2017，112 cases of postoperative patient with anal fissure treated in our hospital were selected as the research subjects，and there were divided into the control group （n=56） and the observation group （n=56） by random number table method.The control group was treated with traditional Chinese medicine fumigation treatment，and the observation group was treated with traditional Chinese medicine fumigation combined with Nitroglycerin Ointment treatment，respectively.The pain and sleep quality of the two groups were evaluated at 1st day，4th day，and 7th day after operation.The adverse events were compared between the two groups.Results There was no statistical significance in pain and sleep quality score between the 2 groups at 1st day （P>0.05）.The pain and sleep quality of the two groups were significantly improved at 4th，7th day，and the observation group improved more obviously，with statistical significance （P<0.05）.There was no statistical significance in the incidence of headache between the two groups （P>0.05）.The incidence of complications in the observation group was significantly lower than that in the control group，with statistical significance （P<0.05）.Conclusion Traditional Chinese medicine fumigation combined with Nitroglycerin Ointment treatment can effectively relieve postoperative pain in anal fissure patients and improve the quality of sleep at night，and reduce the incidence of complications.

[Key words]Anal fissure；Anal pain；Sleep quality；Traditional Chinese medicine fumigation；Nitroglycerin Ointment

肛裂是肛肠科的常见疾病，临床上以周期性肛门疼痛、便血及便秘为主要特征。其发病机制尚不十分明确，目前主要认为是局部解剖因素、炎性肠病、肛管受损、感染等原因[1]，引起肛门内括约肌缺血性溃疡、痉挛，并形成缺血-痉挛-缺血的恶性循环。慢性肛裂常经久不愈，绝大部分需手术才能治愈，但术后常常出现疼痛、便秘、尿潴留、出血等并发症。术后疼痛是最常见、最苦恼的并发症，患者往往因剧烈疼痛而不敢排便，每天都生活在痛苦之中，严重影响日常生活及睡眠质量，甚至部分患者产生抑郁、自卑情绪。本研究旨在探讨中药熏蒸联合硝酸甘油软膏对肛裂术后疼痛及睡眠质量的影响，现报道如下。