参苓白术散颗粒联合提肛训练对中低位直肠癌Dixon术后肛门功能障碍的近期疗效评价

doi:10.3969/j.issn.1009-976X.2023.05.007

摘要/Abstract

摘要： 目的探讨参苓白术散颗粒联合提肛训练对中低位直肠癌Dixon术后肛门功能障碍的近期疗效。方法 45例行直肠癌Dixon术的患者,分为对照组（采用蒙脱石散联合提肛训练治疗,n=21）和观察组（在对照组治疗基础上,给予口服参苓白术散颗粒,n=24）。于术后1、3、6个月采用Williams标准、Wexner 评分系统及排粪造影评估术后肛门功能恢复状况。结果 Williams肛门功能评估：观察组患者术后 3 个月的肛门功能良好率均优于对照组,差异有统计学意义（P=0.042）,术后1、6个月时差异无统计学意义（P>0.05）;肛门失禁Wexner评分：观察组患者术后1、3、6个月肛门失禁Wexner评分明显低于对照组,差异有统计学意义（P<0.05）。术后6个月排粪造影观察组20例（20/24）,对照组中15例（15/21）可见直肠充盈良好未见明显狭窄,未见造影剂外漏。结论参苓白术散颗粒联合提肛训练能够加速中低位直肠癌Dixon术后肛门功能障碍的恢复,降低术后肛门失禁发生率。

关键词: 参苓白术散, 提肛训练, 中低位直肠癌Dixon术后, 肛门功能

Abstract: Objective To explore the short-term efficacy of Shenling Baizhu San granules combined with training of lifting the anus for anal dysfunction after Dixon operation for middle and low rectal cancer. Methods Forty-fivepatients with rectal cancer undergoing Dixon'soperation were divided into a control group （treated with Montmorillonite powder combined with levator ani muscle training） of 21 cases, and a study group （treated with oral Shenling Baizhu San granules beside of the same as control group） of 24 cases. The recovery of anal function was evaluated using Williams criteria, Wexner scoring system, and defecography at 1,3,6 months after surgery. Results Williams Anal Function Assessment： The fine anal function rate of in the study group was higher than that in the control group at 3 months after surgery, with a statistically significant difference （P=0.042）, but there was no statistically significant difference at 1 and 6 months after surgery （P>0.05）. Wexner score of anal incontinence： The Wexner score of anal incontinence in the study group was significantly lower than that in the control group at 1,3,6 months after surgery, with a statistically significant difference （P<0.05）. Six months after surgery, defecography in ZD patients at the study group patients （20/24） and 15 patients （15/21） at the control group showed fine rectal filling without significant stenosis and no leakage of contrast media. Conclusion Shenling Baizhu San granules combined with training of lifting the anuscan accelerate the recovery of anal dysfunction after Dixon's operation for middle and low rectal cancer, and reduce the incidence of postoperative anal incontinence.

Key words: Shenling Baizhu San, training of lifting the anus, middle and low rectal cancer patients after Dixon's operation, anal function

中图分类号:

霍景山, 梁立雪, 杨志林, 吴岷翰, 贺友, 黄诚友, 韩新峰. 参苓白术散颗粒联合提肛训练对中低位直肠癌Dixon术后肛门功能障碍的近期疗效评价[J]. 岭南现代临床外科, 2023, 23(05): 410-414.

HUO Jing-shan, LIANG Li-xue, YANG Zhi-lin, WU Min-han, HE You, HUANG Cheng-you, HAN Xin-feng. Short-term efficacy evaluation of Shenling Baizhu San granules combined with training of lifting the anus for anal dysfunction after Dixon's operation for middle and low rectal cancer[J]. Lingnan Modern Clinics In Surgery, 2023, 23(05): 410-414.

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