摘要
目的:研究针刺联合吴茱萸热奄包对痔病患者术后尿潴留相关指标及血清T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)表达的影响。方法:随机选取2020年1月-2021年6月进行手术、术式均为经肛门直肠黏膜环切并外痔切除术的92例患者为研究对象,分为对照组和观察组,每组46例。对照组术后行针刺治疗;观察组术后同时进行针刺治疗和吴茱萸热奄包外敷治疗,两组患者均连续治疗7 d。采用流式细胞仪双标法进行T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)表达的检测。观察术后两组患者首次自主排尿时间、排尿量及小腹胀满症状、小便通畅度、总有效率、导尿率、术后不同时间(首次自主排尿后及6、24、48 h)的膀胱残余尿量。结果:(1)与对照组比较,观察组首次自主排尿时间更短,首次自主排尿量更多,小腹胀满症状评分、小便通畅度评分更低,均差异有统计学意义(P<0.05);(2)观察组在首次自主排尿后及术后6、24、48 h所测膀胱残余尿量明显少于对照组,均差异有统计学意义(P<0.05);(3)观察组的总有效率为91.30%,高于对照组的76.09%,差异有统计学意义(P<0.05);观察组的导尿率明显低于对照组(8.70%vs.23.91%),差异有统计学意义(P<0.05);(4)术前两组患者的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);术后7 d,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高,CD8^(+)降低,观察组优于对照组,均差异有统计学意义(P<0.05)。结论:混合痔术后采用针刺联合吴茱萸热奄包治疗,可提高患者的免疫力,降低尿潴留的发生率,且疗效优于单独采用针刺治疗,为预防和治疗痔病术后尿潴留提供了一种安全、简单、有效的新方法。
Objective:To study the indexes related to urinary retention after operation of hemorrhoids by acupuncture combined with hot package,and to detect the expression of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in serum T lymphocyte subsets.Methods:A total of 92 patients who underwent surgery in our hospital from January 2020 to June 2021 were randomly divided into the control group and the observation group,with 46 patients in each group.The control group was treated with acupuncture after surgery.The observation group was treated with hot package.After 7 days of continuous treatment,expression of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in T lymphocyte subsets was detected by flow cytometry double-label method.The time of first spontaneous urination,volume of first spontaneous urination,symptoms of abdominal distention,patency of urine,effective rate,catheterization rate,and residual urine volume of bladder at different times(6 h,24 h,48 h after first spontaneous urination)were observed in 2 groups.Results:(1)Compared with the control group,the first spontaneous urination time in the observation group was shorter,the first spontaneous urination volume was more,the lower abdominal distention symptom score and the urinary patency score were lower,with statistical significance(P<0.05);(2)After the first spontaneous urination,6,24 and 48 hours after the operation,the residual urine volume of the bladder in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05);(3)The total effective rate of the observation group was 91.30%,higher than 76.09%of the control group,the difference was statistically significant(P<0.05);the catheterization rate was significantly lower than the control group(8.70%vs.23.91%),the difference was statistically significant(P<0.05);(4)Before surgery,the CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),there was no significant difference(P>0.05);7 days after operation,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)of the two groups increased,CD8^(+)decreased,the observation group was better than the control group(P<0.05).Conclusion:Acupuncture combined with hot package for postoperative mixed hemorrhoids can improve the patient’s immunity,reduce the incidence of urinary retention,and the curative effect is better than that of acupuncture alone.
作者
代立霞
王芳
赵志强
赵婉琳
DAI Lixia;WANG Fang;ZHAO Zhiqiang;ZHAO Wanlin(Department of Anorectal,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,050051,China)
出处
《中国中西医结合消化杂志》
CAS
2022年第10期685-689,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
吴茱萸热奄包
针刺
尿潴留
痔病
免疫因子
T淋巴细胞
hot package
acupuncture
urinary retention
postoperative hemorrhoids
immune factors
T lymphocytes
