为明确痔上黏膜环切术（PPH）联合补中益气汤治疗重度混合痔的疗效及预后，通过前瞻性平行对照临床研究，将2019年2月至2021年1月于北京中医医院顺义医院诊断为重度混合痔的患者纳入对照组（PPH）和联合组（PPH+补中益气汤）。采用视觉模拟评分量表（VAS）评价伤口的疼痛程度，记录住院期间并发症、1年随访期间的远期并发症、复发情况，采用肛门坠胀评分评价肛门功能。结果显示，联合组术后VAS显著低于对照组（P<0.001），1年随访时肛门坠胀评分、远期并发症发生率、痔核脱出复发率均显著低于对照组（P=0.002）（P=0.014）（P=0.009）；说明PPH联合补中益气汤治疗重度混合痔的疗效及预后均优于单纯PPH，可有效降低术后伤口疼痛、提高患者预后的肛门功能，减少远期并发症及痔核脱出复发率。
In order to determine the efficacy and prognosis of procedure for prolapse and hemorrhoids (PPH) combined with Buzhong Yiqi Decoction in the treatment of severe mixed hemorrhoids, a prospective parallel controlled clinical study was conducted. Patients with severe mixed hemorrhoids diagnosed and treated in our hospital from Feb 2019 to Jan 2021 were taken as the research objects, and they were successively included in the control group (PPH) and the combined group (PPH + Buzhong Yiqi Decoction). Visual analog scale (VAS) was used to evaluate the pain degree of postoperative wound, record the short-term complications during hospitalization, record the long-term complications and recurrence of hemorrhoid prolapse during one-year follow-up after operation, and evaluate the anal function of patients' prognosis by anal distension score. The results found that postoperative VAS of the combined group was significantly lower than that of the control group (P<0.001). The one-year follow-up results showed that the anal distension score, long-term complication rate, and recurrence rate of hemorrhoid prolapse of the combined group were significantly lower than those of the control group (P=0.002) (P=0.014) (P=0.009). This study suggests that the curative effect and prognosis of PPH combined with Buzhong Yiqi Decoction in the treatment of severe mixed hemorrhoids are better than those of PPH alone. The combined treatment can effectively reduce the postoperative wound pain, improve the anal function of patients' prognosis, and reduce the incidence of long-term complications and the recurrence rate of hemorrhoid prolapse.
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