童蕾 祝震亚

[摘要] 目的 探讨止痛如神汤坐浴联合痔点挑治用于内痔的疗效。 方法 选取2017年5月至2018年8月我院收治的内痔患者104例，采用随机字母表法分为观察组与对照组，对照组采用痔点挑治，观察组给予止痛如神汤坐浴联合痔点挑治，对比两组患者临床疗效、临床症状积分、生化指标、不良反应发生情况及复发率。 结果 治疗后，兩组患者临床症状积分均较治疗前下降，观察组与对照组相比明显较低（P<0.05）;观察组治疗总有效率为94.23%，高于对照组的78.85%，差异有统计学意义（P<0.05）;治疗后两组患者血小板计数均较治疗前升高，观察组高于对照组（P<0.05），TT、PT较治疗前降低，观察组低于对照组（P<0.05）;两组患者治疗过程均无明显不良反应发生;两组复发率比较，差异无统计学意义（P>0.05）。 结论 止痛如神汤坐浴联合痔点挑治治疗内痔效果确切，可有效缓解临床症状，改善凝血功能，且安全性较高。

[关键词] 止痛如神汤;痔点挑治;内痔;复发

[Abstract] Objective To explore the efficacy of Zhitong Rushen Decoction sitting bath combined with pickoff therapy of hemorrhoids in the treatment of internal hemorrhoids. Methods A total of 104 patients with internal hemorrhoids treated in our hospital from May 2017 to August 2018 were selected and divided into observation group and control group by random alphabet method. The control group was treated with pickoff therapy of hemorrhoids. The observation group was given Zhitong Rushen Decoction sitting bath combined with pickoff therapy of hemorrhoids. The clinical efficacy， clinical symptom score， biochemical indicators， occurrence of adverse reactions， and recurrence rate between the two groups were compared. Results The clinical symptom scores of the two groups after treatment were lower than those before treatment. And the clinical symptom scores of observation group was significantly lower than those of the control group（P<0.05）. The total effective rate of treatment in the observation group was 94.23%， higher than that in the control group（78.85%）， and the difference was statistically significant（P<0.05）. The platelet counts of the two groups after treatment were higher than those before treatment， and the platelet counts of the observation group were higher than those of the control group（P<0.05）. TT and PT in two groups after treatment were lower than before treatment， and TT and PT in the observation group were lower than those of the control group（P<0.05）. No significant adverse reactions occurred during the treatment of the two groups. There was no significant difference in the recurrence rate between the two groups（P>0.05）. Conclusion Zhitong Rushen Decoction sitting bath combined with pickoff therapy of hemorrhoids are effective in treating internal hemorrhoids， which can effectively relieve clinical symptoms， improve coagulation function， and has high safety.

[Key words] Zhitong Rushen Decoction; Pickoff therapy of hemorrhoids; Internal hemorrhoids; Recurrence

内痔为痔疮的一种，属于肛肠疾病，具有较高的发病率。相关数据显示[1]，内痔占肛肠疾病的71.99%。内痔是由于肛垫组织出现异常移位和（或）病理改变所致，临床主要表现为肛垫组织疼痛、出血、瘙痒、血液淤滞等，伴或不伴排便困难、血栓，对患者日常生活与工作产生影响。内痔的诱发因素较多，便秘、长期饮酒、久站久坐、进食刺激性食物为高危因素。临床治疗的目的在于解除症状，而非消除痔体，因此多主张采用保守治疗以缓解病情，改善生活质量。痔点挑治是治疗内痔的常用疗法，止血效果好，能够在一定程度上缓解疼痛，但复发率较高，长期效果不理想。有研究指出[2-3]，中药药浴治疗内痔起效快，能促进内痔区止血、萎缩，缓解临床症状。止痛如神汤有活血化瘀、消肿止痛之效，临床主要用于痔疮术后，可发挥缓解疼痛、促进术后创面愈合的作用[4-6]，在内痔保守治疗中的应用较少。……