CN106421095B - A kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation - Google Patents
A kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation Download PDFInfo
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Abstract
The invention belongs to traditional Chinese medical science fields, and in particular to a kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation, in parts by weight, it is prepared by following Chinese medicine material: 25~30 parts of Radix Astragali, 10~15 parts of Radix Angelicae Sinensis, 6~10 parts of Rhizoma Chuanxiong, 10~15 parts of radix paeoniae rubra, 10~15 parts of Radix Rehmanniae, 10~15 parts of Fructus Aurantii, 10~15 parts of radix saposhnikoviae, 10~15 parts of sophora flower, 10~15 parts of garden burnet, 10~15 parts of radix scutellariae, 25~30 parts of purslane, 6~10 parts of Radix Glycyrrhizae.The advantage of the invention is that used Chinese medicine meets Pharmacopoeia of People's Republic of China regulation, drug is safe and reliable.Have the characteristics that curative for effect, quick, cure rate is high, without side-effects for anal intestine PPH postoperative anal falling inflation.
Description
Technical field
The invention belongs to traditional Chinese medical science fields, and in particular to a kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation.
Background technique
In 1998, report used PPH to treat hemorrhoid to Italian Longo for the first time, and obtained significantly after wide clinical application
Curative effect, be the best approach that current anorectum department handles III, IV phase internal piles, the varication of hemorrhoid and anus pad moved down after operation
It can play a role in improving, postoperative short-term and long-term effect are preferable, but people also gradually have found the art formula there are certain deficiencies
Place.Wherein, rectal tenesmus sense is the postoperative generally existing symptom of PPH, and patient often feels rectal tenesmus unbearably, puts sometimes
Be mapped to waist sacrum, buttocks and thigh, can with diarrhea, tenesmus, awareness of defecation is frequent.Recurrent exerbation, gently then a few days, heavy then several months number
Year, it controls long refractory, has seriously affected the quality of life of patient.Its reason may be related with Shou Shu, inflammatory stimulus defecation receptor.
Patient often has that anus foreign body sensation, tenesmus, awareness of defecation is frequent, from rest and morning after mitigate, patient is very painful, while also influencing
The recovery of disease.How effectively treating and preventing PPH postoperative anal falling inflation is the important topic that current anal intestine interface is faced.
The reason of motherland's medicine thinks rectal tenesmus is damp-heat accumulation anus, leads to large intestine functional activity of QI being not smooth, in addition postoperative arteries and veins
Network is impaired, functional activity of QI being not smooth, stagnation of blood stasis, so as to cause rear double infection.Collapse from qi deficiency, qi depression to blood stasis, humidity hysteresis heat knot are the morbidities of this disease
An important factor for.
Often this disease is treated as local inflammation at present, and mostly using antibiotic or applies glucocorticoid, is often treated
It imitates bad, replaces Multiple Classes of Antibiotics or antibiotic usage overlong time sometimes, side effect is big, and rectal tenesmus is more serious instead, such as
(cyclic annular prolapsus hemorrhoid Clinical analysis [J] large intestine anal disease surgery of the .PPH art such as Zhang Ni, Zhang Zhenyong, Cai Bibo treatment is miscellaneous for document
Will, 2003,9 (supplementary issues): 33-34.) mentioning can delay to after PPH postoperative anal falling inflation patient's intramuscular injection Sauteralgyl 50mg, 30min
Solution；(Yang Congjia, Hu Xuanya dexamethasone add Tinidazole retention enema to prevent and treat hemorrhoid postoperative anal falling inflation [J] China anal intestine to document
Sick magazine, 2015,35 (7): 59.) mentioning and add Tinidazole retention enema to prevent and treat hemorrhoid postoperative anal falling inflation using dexamethasone water needle,
Can substantially reduced rectal tenesmus sense generation and falling inflation degree；(the mixed hemorrhoid such as Zhou Chengzhi, Hu Senmao, Zheng Tao PPH is postoperative for document
Anus pain falling inflation cause initial probe and treatment Countermeasures (the attached 286 analyses) Inner Mongol [J] traditional Chinese medicine, 2014,33 (17): 135-
135.) it mentions using broad-spectrum antibiotic and anaerobe resistant antibiotic treatment PPH postoperative anal falling inflation.Control measure has bed to stop
Breath, external application PuJi BenShi Fang, removal stimulus etc., but rectal tenesmus sense of discomfort cannot all be effectively relieved.
Summary of the invention
According to the above-mentioned deficiencies of the prior art, the present invention provides a kind of Chinese medicine filling for treating anal intestine PPH postoperative anal falling inflation
Intestines agent, it is significant in efficacy, safe and reliable, have no toxic side effect, there is wide potential applicability in clinical practice.
A kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation of the present invention, it is characterised in that according to weight
Number meter is measured, is prepared by following Chinese medicine material: 25~30 parts of Radix Astragali, 10~15 parts of Radix Angelicae Sinensis, 6~10 parts of Rhizoma Chuanxiong, radix paeoniae rubra 10
~15 parts, 10~15 parts of Radix Rehmanniae, 10~15 parts of Fructus Aurantii, 10~15 parts of radix saposhnikoviae, 10~15 parts of sophora flower, 10~15 parts of garden burnet, radix scutellariae
10~15 parts, 25~30 parts of purslane, 6~10 parts of Radix Glycyrrhizae.
Wherein, preferred embodiment is as follows:
It can be prepared in parts by weight by following Chinese medicine material: 25 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, 6 parts of Rhizoma Chuanxiong,
10 parts of radix paeoniae rubra, 15 parts of Radix Rehmanniae, 10 parts of Fructus Aurantii, 15 parts of radix saposhnikoviae is 10 parts of sophora flower, 15 parts of garden burnet, 15 parts of radix scutellariae, 30 parts of purslane, sweet
6 parts of grass.
It can also be prepared in parts by weight by following Chinese medicine material: 30 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, Rhizoma Chuanxiong 10
Part, 10 parts of radix paeoniae rubra, 10 parts of Radix Rehmanniae, 10 parts of Fructus Aurantii, 10 parts of radix saposhnikoviae, 10 parts of sophora flower, 10 parts of garden burnet, 10 parts of radix scutellariae, 30 parts of purslane,
6 parts of Radix Glycyrrhizae.
A kind of preparation method of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation of the present invention, according to
The preparation of lower section method: weighing above-mentioned Chinese medicine, cleans impurity elimination, and the water that 10 times of medicinal material weight amounts are added decocts 15min, and filter is collected by filtration
Liquid, then 10 times of amount water of medicinal material weight are added in the dregs of a decoction and decoct 15min, filtrate is collected in filtering, filtrate will be merged twice, concentration
To the 1/20 of amount of water.
Drug temperature is heated to 37 DEG C or so when bowel lavage, gives patient to enema fluid enema treatment, dose 80ml/ times, in
Preceding retention enema is slept every night, first uses warm saline cleansing enema before bowel lavage, is taken the padded buttocks of lateral position, is delayed after catheter depth about 8cm
It is slow to inject medical fluid, it keeps buttocks to raise about 30min after tube drawing, retains 3~5h/ times.
Pharmacology analysis:
Radix Astragali: sweet, warm.Return lung, the spleen channel.Invigorating qi, consolidating exterior, promoting urination and detoxification, apocenosis, expelling pus and promoting granulation.For deficiency of vital energy and acking in strength, food
Few loose stool, the sinking of qi of middle-jiao, rush down prolapse of the anus for a long time, uterine bleeding of having blood in stool, exterior deficiency spontaneous perspiration, deficiency of vital energy and edema, ulcer is difficult to burst, burst for a long time and does not holds back, flaccidity of limbs due to deficiency of blood
Huang, Heat Diabetes；Chronic rephrilis protinuria, diabetes.
Radix Angelicae Sinensis: sweet, acrid, warm.Return liver, the heart, the spleen channel.Replenishing and activating blood, regulating menstruation and relieving pain, moistening intestines and relaxing bowels.It is dizzy for blood deficiency chlorosis
Dizzy palpitaition, irregular menstruation, amenorrhea and algomenorrhea, asthenia cold abdominalgia, dry constipation of intestines, rheumatic arthralgia, injury from falling down, ulcer sores.Prepared RADIX ANGELICAE SINENSIS with yellow rice wine
Blood circulation.For amenorrhea and algomenorrhea, rheumatic arthralgia, injury from falling down.
Rhizoma Chuanxiong: acrid in flavour and warm in nature.Return liver, gallbladder, pericardium channel.Blood-activating and qi-promoting, wind-expelling pain-stopping.For irregular menstruation, amenorrhea and algomenorrhea, disease
Lump in the abdomen abdominal pain, pricking pain in the chest, tumbling and swelling, headache, rheumatic arthralgia.
Radix paeoniae rubra: it is bitter, it is slightly cold.Return liver warp.Clearing heat and cooling blood, removing blood stasis and acesodyne.For febrile virulent maculae, hematemesis and epistaxis, red eye, swell pain,
Liver-depressed hypochondrium pain, amenorrhea and algomenorrhea, abdominal mass abdominal pain, injury from falling down, carbuncle swells sore.
Radix Rehmanniae: it is sweet, it trembles with fear.Return heart, liver, kidney channel.Enriching yin, cool blood.Cure mainly fever due to yin deficiency, consumption of YIN caused by febrile disease, polydipsia, hectic fever due to yin, spot
Rash, blood under hematemesis, menoxenia, the diseases such as threatened abortion.
Fructus Aurantii: bitter, pungent, sour, temperature.Returns spleen, stomach meridian.Regulating the flow of QI to ease the stomach, the stagnant dissipate-swelling of row.For the chest side of body stagnation of the circulation of vital energy, turgor pain, food
Product is not changed, and stops in phlegm retention；Gastroptosis, rectal prolapse, sub-official prolapses.
Radix saposhnikoviae: acrid, sweet, warm.Return bladder, liver, the spleen channel.Inducing diaphoresis to dispel wind wins wet, relieving convulsion.For cold headache, rheumatism numbness
Bitterly, rubella itch, tetanus.
Sophora flower: bitter, cold nature.Return liver, large intestine channel.Enter that blood holds back drop, body slightly dissipates, there is cooling blood and hemostasis, clearing liver-fire
Effect.Curing mainly hematochezia, hemorrhoid blood, bloody flux, hematuria, blood strangury, metrorrhagia and metrostaxis spit blood, bleeding from five sense organs or subcutaneous tissue, irascibility headache, red eye, swell pain, sore throat,
Aphonia, ulcer sores.
Garden burnet: it is bitter, sour, puckery, it is slightly cold.Enter liver, large intestine channel.Cooling blood and hemostasis, removing toxic substances sore.For hematochezia, hemorrhoid blood, bloody flux,
Metrorrhagia and metrostaxis, scald, carbuncle sore tumefacting virus.
Radix scutellariae: it is bitter, it trembles with fear.Return lung, gallbladder, spleen, large intestine, small intestinl channel.Heat-clearing and damp-drying drug, purging fire for removing toxin, hemostasis, miscarriage prevention.For wet
Temperature, heat temperature chest tightness and emesis, damp and hot feeling of fullness, dysentery, jaundice, cough with lung heat, hyperpyrexia polydipsia, blood-head tells nosebleed, carbuncle sore tumefacting virus, movement of the foetus is not
Peace.
Purslane: acid is trembled with fear.Enter large intestine, liver, the spleen channel.It is clearing heat and detoxicating, dissipate blood detumescence.Control hot dysentery purulence blood, heat gonorrhea, blood strangury, band
Under, Carbuncle swells dislikes sore, erysipelas, trace scrofula.For damp and hot caused diarrhea, dysentery.It takes or smashes juice external application orally, control carbuncle swells.Also for just
Blood, uterine hemorrhage, there is anastalsis.
Radix Glycyrrhizae: sweet and neutral.Return heart, lung, spleen, stomach meridian.It invigorates the spleen and benefits qi, clearing heat and detoxicating, expelling phlegm and arresting coughing, relieving spasm to stop pain reconciles all
Medicine.For weakness of the spleen and the stomach, fatigue and weakness, shortness of breath and palpitation, coughing with a lot of sputum, stomach duct and abdomen, four limbs contraction, carbuncle sore tumefacting virus, abirritant
It is object toxicity, strong.
The present invention uses enema,retention in treatment, and retention enema category external treatment of traditional Chinese medicine, per rectum administration can be by medical fluid
It is placed directly within affected area, plays drug effect to the greatest extent, and absorption total amount, infiltration rate and the bioavilability of drug are compared with mouth
Clothes administration significantly improves.Modern medicine believes that, rectal wall tissue has the semi-permeable membrane of selective absorbing and excretion and abundant quiet
Arteries and veins clump, medical fluid are sucked by intestinal wall semi-permeable membrane, through veniplex, enter body circulation by portal vein and inferior caval vein, are absorbed into vivo
Lesion, and by enteron aisle osmosis, also can locally it work.Therefore, herbal enema, the effect of can not only playing drug,
And can guide drugs to illness station, meet " sick Yu Jinzhe, closely take it " " the i.e. interior reason controlled of the reason controlled outside, the i.e. interior medicine controlled of the medicine controlled outside, institute
The Chinese medicine of different person's method ear " is cured the disease theory.
The composition of drug used in the present invention is applicant in " fructus-sophorae Radix et Rhizoma sanguisorbae ball " (coming from clear Qi Kun " surgery great achievement ") and " support
In sterilize dissipate " on the basis of (coming from clear Wu Qian " Yizong Jinjian surgery heart method gist "), the clinic in more than 10 years of process is total
Knotization is cut out, and applicant thinks that PPH is postoperative, local chronic inflammatory repetitious stimulation at previous anastomotic, raw in cult poison；In addition postoperative patient
Its gas that gathers of the damage of person's qi and blood, heresy must be empty, simulataneous insufficiency and excessive, therefore shows as the disease of many discomforts, hard to work using well-established law.This
Side takes " Tuoli Xiaodu " support to mend, rise scattered power, the function of swelling and pain relieving clearing heat and detoxicating in conjunction with " fructus-sophorae Radix et Rhizoma sanguisorbae ball ".Reuse Radix Astragali
It being equipped with to work as and is classified as danggui buxue decoction bowl spares and leads to, be monarch drug in a prescription, garden burnet, sophora flower, purslane, radix scutellariae, radix paeoniae rubra, Radix Rehmanniae are clearing heat and detoxicating,
Cool blood yin-nourishing is minister, and the monarch and his subjects match, and eliminating evil is without hurting just, to help cult poison outgoing, windproof wind-dispelling hemostasis, and Fructus Aurantii relieving stagnant Qi disperse accumulation, river
Rhizome of chuanxiong pungent-warm perfume (or spice) is dry, and can dissipate can manage it, but can tying-in, the poison that local chronic inflammatory gathers gradually is discharged, is altogether adjutant, Radix Glycyrrhizae tune
With all medicines, to make.
The advantage of the invention is that used Chinese medicine meets Pharmacopoeia of People's Republic of China regulation, drug is safe and reliable.
Have the characteristics that curative for effect, quick, cure rate is high, without side-effects for anal intestine PPH postoperative anal falling inflation.
Curative effect judgement:
1 data and method
1.1 research objects: affiliated hospital, University Of Qingdao anorectum department inpatient in May, -2015 in May, 2,013 50 is collected
Example, meets ring-shaped mixed hemorrhoids surgical indication, parallel ring-shaped mixed hemorrhoids PPH patient；With rectal tenesmus, it is in great pain based on
Disease, with abdominal distension, desiring defecation constantly, informing patient treatment protocol simultaneously sign informed consent form.
1.2 treatment methods: all patients i.e. medication after there is rectal tenesmus.Treatment group is retained using above-mentioned enema fluid to be filled
Intestines.Control group uses Metronidazule injection 100ml retention enema.
1.3 clinical indexes: two groups of pretherapy and post-treatment symptom integrals of patient are observed and recorded.Ranking criterion is according to " Chinese medicine
Clinical Researches of New Drugs guideline (tentative) " in related content work out.It is pressed within the 1st, 3,5,7 day after 1d and treatment before treating
Patient anus falling inflation degree scores.
The scoring of 1.4 rectal tenesmus: 1. without rectal tenesmus, remember 0 point；2. even have or relatively spend falling inflation, 2 points are remembered；3. take place frequently or compared with
Weight falling inflation, notably tenesmus sense is anxious just to feel, and influences work, but rests or alleviate after treating, and remembers 4 points；4. the anus that takes place frequently is fallen
It is swollen, work is influenced, unobvious, 6 points of note is alleviated in treatment or rest.
1.5 curative effect determinate standards: referring to Standards for Diagnosis and Curative Effect of Chinese Medical Symptom, the symptom integral before and after combined treatment is evaluated
Curative effect.Total mark × 100% before therapeutic index (%)=(pre-treatment score-post treatment integral)/treatment.1. recovery from illness: clinical condition
Shape completely disappears, therapeutic index 100%；2. effective: clinical symptoms are substantially reduced, and therapeutic index is > 70%；3. effectively: facing
Bed symptom mitigates, 40% < therapeutic index≤70%；4. invalid: clinical symptoms are without significant change or exacerbation.
1.6 statistical methods: measurement data uses mean ± standard deviationIt indicates, contrast before and after treatment, using t
It examines；Enumeration data is indicated using rate or composition ratio, using χ2It examines.All data operations use SPSSl3.0 statistical software into
Row.
2 results
The scoring of 2.1 two groups of different time rectal tenesmus is compared: the 1st after treatment, rectal tenesmus scoring in 3,5,7 days is below pair
According to group, wherein rectal tenesmus scoring in the 3rd, 5,7 day is compared with the control group, difference it is statistically significant (t value is respectively 4.23,
4.42,5.41), it is shown in Table 1.
Different time rectal tenesmus scoring (dividing) after 1 two groups of treatments of table
Note: compared with the control group, * P < 0.01.
2.2 two groups of Clinical efficacy comparisons: treatment group's total effective rate is 96%, and control group 64%, 2 groups of comparing differences have system
Meter learns meaning (χ2=8.00, * P < 0.01), it is shown in Table 2.
2 two groups of Clinical efficacy comparisons of table
| Group | Number of cases | Recovery from illness | It is effective | Effectively | In vain | Total effective rate (%) |
| Control group | 25 | 2 | 2 | 12 | 9 | 64 |
| Treatment group | 25 | 16 | 5 | 3 | 1 | *96 |
Note: compared with the control group, P < 0.01 *.
Specific embodiment
The present invention will be further described by the following examples.
Embodiment 1:
A kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation, in parts by weight, by following Chinese medicine material
It is prepared: 25 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, 6 parts of Rhizoma Chuanxiong, 10 parts of radix paeoniae rubra, 15 parts of Radix Rehmanniae, 10 parts of Fructus Aurantii, 15 parts of radix saposhnikoviae, sophora flower 10
Part, 15 parts of garden burnet, 15 parts of radix scutellariae, 30 parts of purslane, 6 parts of Radix Glycyrrhizae.
Embodiment 2:
A kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation, in parts by weight, by following Chinese medicine material
It is prepared: 30 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, 10 parts of Rhizoma Chuanxiong, 10 parts of radix paeoniae rubra, 10 parts of Radix Rehmanniae, 10 parts of Fructus Aurantii, 10 parts of radix saposhnikoviae, sophora flower
10 parts, 10 parts of garden burnet, 10 parts of radix scutellariae, 30 parts of purslane, 6 parts of Radix Glycyrrhizae.
Embodiment 3:
Examples 1 to 2 is prepared in accordance with the following methods: being weighed above-mentioned Chinese medicine, is cleaned impurity elimination, 10 times of medicinal material weight amounts are added
Water decocts 15min, and filtrate is collected by filtration, then 10 times of amount water of medicinal material weight are added in the dregs of a decoction and decoct 15min, and filter is collected in filtering
Liquid filtrate will merge twice, it is concentrated into the 1/20 of amount of water.
Drug temperature is heated to 37 DEG C or so when bowel lavage, gives patient to enema fluid enema treatment, dose 80ml/ times, in
Preceding retention enema is slept every night, first uses warm saline cleansing enema before bowel lavage, is taken the padded buttocks of lateral position, is delayed after catheter depth about 8cm
It is slow to inject medical fluid, it keeps buttocks to raise about 30min after tube drawing, retains 3~5h/ times.
Claims (3)
1. a kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation, it is characterised in that in parts by weight, by following
Chinese medicine material is prepared: 25~30 parts of Radix Astragali, 10~15 parts of Radix Angelicae Sinensis, and 6~10 parts of Rhizoma Chuanxiong, 10~15 parts of radix paeoniae rubra, Radix Rehmanniae 10~
15 parts, 10~15 parts of Fructus Aurantii, 10~15 parts of radix saposhnikoviae, 10~15 parts of sophora flower, 10~15 parts of garden burnet, 10~15 parts of radix scutellariae, purslane
25~30 parts, 6~10 parts of Radix Glycyrrhizae；
Preparation method is prepared in accordance with the following methods: being weighed above-mentioned Chinese medicine, is cleaned impurity elimination, the water that 10 times of medicinal material weight amounts are added decocts
Filtrate is collected by filtration in 15min, then 10 times of amount water of medicinal material weight are added in the dregs of a decoction and decoct 15min, and filtering collects filtrate, by two
Secondary filtrate merges, and is concentrated into the 1/20 of amount of water.
2. a kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation according to claim 1, it is characterised in that press
According to parts by weight meter, it is prepared by following Chinese medicine material: 25 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, 6 parts of Rhizoma Chuanxiong, 10 parts of radix paeoniae rubra, Radix Rehmanniae 15
Part, 10 parts of Fructus Aurantii, 15 parts, 10 parts of sophora flower, 15 parts of garden burnet, 15 parts of radix scutellariae, 30 parts of purslane, 6 parts of Radix Glycyrrhizae of radix saposhnikoviae.
3. a kind of Chinese medicinal enema for treating anal intestine PPH postoperative anal falling inflation according to claim 1, it is characterised in that press
According to parts by weight meter, it is prepared by following Chinese medicine material: 30 parts of Radix Astragali, 10 parts of Radix Angelicae Sinensis, 10 parts of Rhizoma Chuanxiong, 10 parts of radix paeoniae rubra, Radix Rehmanniae
10 parts, 10 parts of Fructus Aurantii, 10 parts, 10 parts of sophora flower, 10 parts of garden burnet, 10 parts of radix scutellariae, 30 parts of purslane, 6 parts of Radix Glycyrrhizae of radix saposhnikoviae.
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