| 摘要: |
| 目的：探讨祛痰化瘀方联合多烯磷脂酰胆碱治疗痰瘀互结型非酒精性脂肪性肝炎的疗效。方法：将痰瘀互结型非酒精性脂肪性肝炎患者80 例随机分为治疗组与对照组，每组各40 例。对照组采用多烯磷脂酰胆碱治疗，治疗组在对照组基础上联合祛痰化瘀方治疗。观察2组的中医证候疗效，肝功能［丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、谷氨酰转肽酶（GGT）、总胆汁酸（TBA）］和血脂［三酰甘油（TC）、总胆固醇（TG）］，受控衰减指数（CAP）及肝脏超声疗效。结果：中医证候疗效总有效率治疗组为82.5%（33/40），对照组为72.5%（29/40），2组比较，差异有统计学意义（P＜0.05）。治疗后2组ALT、AST、GGT、TBA、TC、TG、CAP均较治疗前改善，且治疗组AST、TBA、TC、TG、CAP的改善幅度大于对照组（P＜0.05）。肝脏超声疗效总有效率治疗组为77.5%（31/40），对照组为40.0%（16/40），组间比较，差异有统计学意义（P＜0.05）。结论：祛痰化瘀方联合多烯磷脂酰胆碱治疗痰瘀互结型非酒精性脂肪性肝炎疗效确切，值得临床推广应用。 |
| 关键词: 混合痔 RPH 简化外切内扎术 卫生经济学 |
| DOI： |
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| Clinical effect of automatic ligation of hemorrhoids combined with simplified Milligan-Morgan hemorrhoidectomy in treatment of mild-to-moderate mixed hemorrhoids: An analysis of 98 cases |
| ZHANG Yijing,YAO Yanru,LIU Haochen |
| (Hunan University of Chinese Medicine，Changsha 410208，Hunan，China;The First Affiliated Hospital of Hunan University of Chinese Medicine，Changsha 410007，Hunan，China) |
| Abstract: |
| Objective: To investigate the clinical effect of automatic ligation of hemorrhoids (RPH) combined with simplified Milligan-Morgan hemorrhoidectomy in the treatment of mild-to-moderate mixed hemorrhoids and its health economics indicators.Methods: A total of 196 patients with mild-to-moderate mixed hemorrhoids were randomly divided into treatment group and control group，with 98 patients in each group.The patients in the treatment group were given RPH combined with simplified Milligan-Morgan hemorrhoidectomy，and those in the control group were given procedure for prolapse and hemorrhoids (PPH) combined with simplified Milligan-Morgan hemorrhoidectomy.The two groups were compared in terms of intraoperative blood loss，time of operation，wound healing time，pain on days 1，3，5，and 7 after surgery，complications at 1 month after surgery，and health economics indicators (including length of hospital stay，drug costs during hospitalization，total hospital costs，and proportion of drug costs during hospitalization)，and overall response was evaluated at 1 and 3 months after surgery.Results: There was a significant difference in overall response rate between the treatment group and the control group at 1 and 3 months after surgery ［1 month: 96.94% (95/98) vs 87.76% (86/98)，P＜0.05；3 months: 98.98% (97/98) vs 92.86% (91/98)，P＜0.05］.Compared with the control group，the treatment group had a significantly lower intraoperative blood loss and significantly shorter time of operation and wound healing time (all P＜0.01).There was no significant difference in Visual Analogue Scale (VAS) score of pain between the two groups on days 1 and 3 after surgery (P>0.05)，and the treatment group had a significantly lower VAS score of pain than the control group at 5 and 7 days after surgery (P＜0.05).Compared with the control group，the treatment group had a significantly lower incidence rate of complications at 1 month after surgery ［11.22% (11/98) vs 24.49% (24/98)，P＜0.05］.Compared with the control group，the treatment group had a significantly shorter length of hospital stay and significantly lower drug costs during hospitalization and total hospital costs (P＜0.01)，but there was no significant difference in the proportion of drug costs during hospitalization between the two groups (P>0.05).Conclusion: Compared with PPH combined with simplified Milligan-Morgan hemorrhoidectomy，RPH combined with simplified Milligan-Morgan hemorrhoidectomy has a better clinical effect in the treatment of mild-to-moderate mixed hemorrhoids and can reduce the economic burden of patients，and therefore，it holds promise for clinical application. |
| Key words: mixed hemorrhoids automatic ligation of hemorrhoids simplified Milligan-Morgan hemorrhoidectomy health economics |
