目的：评价苦参汤熏洗结合八"穴盒灸治疗高位复杂性肛瘘患者术后并发症的临床疗效。方法回顾性选取2010年9月—2015年9月成都中医药大学附属医院肛肠科住院部收治的符合纳入标准的高位复杂性肛瘘患者873例，采用SPSS 20.0的倾向性匹配法成功匹配苦参汤熏洗结合八"穴盒灸组128例（ A组）、苦参汤熏洗组128例（B组）和八"穴盒灸组128例（C组）。A组给予苦参汤熏洗结合八"穴盒灸治疗，B组给予苦参汤熏洗治疗，C组给予八"穴盒灸治疗；3组患者均治疗14 d。术后14 d时评价患者临床疗效，术后第1、7、14天时采用疼痛数字评分法（ NRS）评价术后疼痛程度，术后第1和3天时观察患者尿潴留发生情况。结果术后第14天，3组患者临床疗效比较，差异有统计学意义（p〈0.05）；A组患者的临床疗效优于B组和C组（p〈0.05）；B组和C组临床疗效比较，差异无统计学意义（p〉0.05）。治疗方法与治疗时间在NRS评分上存在交互作用（p〈0.05），治疗时间在NRS评分上主效应不显著（p〉0.05），治疗方法在NRS评分上主效应显著（p〈0.05）。术后第7天，A组患者NRS评分低于B组和C组（p〈0.05），B组患者NRS评分低于C组（p〈0.05）。术后第14天，A组和B组患者NRS评分低于C组（p〈0.05），A组和B组患者NRS评分比较差异无统计学意义（p〉0.05）。术后第1天，3组患者尿潴留发生率比较，差异无统计学意义（p〉0.05）。术后第3天，3组患者尿潴留发生率比较，差异有统计学意义（p〈0.05）。结论苦参汤熏洗结合八"穴盒灸能有效减轻高位复杂性肛瘘患者术后疼痛及降低尿潴留发生率。%Objective To evaluate the clinical effect of sophora flavescens decoction fumigation combined with box moxibustion at Baliao acupoint on treating postoperative complications in patients with high complicated anal fistula. Methods According to the inclusion criteria,873 high complicated anal fistula patients in Inpatient Department of Teaching Hospital of Chengdu University of T. C. M from September 2010 to September 2015 were retrospectively selected. By propensity score matching of SPSS 20. 0 ,128 patients adopted sophora flavescens decoction fumigation combined with box moxibustion at Baliao acupoint (group A),128 used sophora flavescens decoction fumigation alone(group B)and 128 received box moxibustion at Baliao acupoint alone(group C). The patients in the three groups were treated for 14 days. The clinical effects of patients 14 days after operation were evaluated,the postoperative pain degree of patients at the first day,seven days and 14th after operation was evaluated by numeric rating scale( NRS)score,and incidence of urine retention of patients at the first day and the third day after operation was observed. Results At the 14th day after operation,the clinical efficacy of patients in the three groups was significantly different(p〈0. 05). The clinical effect in group A was better than that in group B and C(p 〈0. 05),while there was no significant difference in the clinical effect between group B and C ( p 〉0. 05 ) . The therapeutic method and treatment time had interactive effects on NRS score(p〈0. 05),the treatment time had no significant interactive effects on NRS score(p〉0. 05),while the therapeutic method had significant interactive effects on NRS score(p〈0. 05). The NRS score of patients at the 7th day after operation in group A was lower than that in group B and C(p〈0. 05);the NRS score of patients at the 7th day after operation in group B was lower than that in group C(p〈0. 05). The NRS score of patients at the 14th day after operation in group A and B was lower than that in group C(p〈0. 05),there was no significant difference in the NRS score of patients in group A and B at the 14th day after operation(p〉0. 05). The incidence of urine retention of patients in the three groups at the first day after operation was not significantly different(p〉0. 05). There was significant difference in the incidence of urine retention of patients in the three groups at the third day after operation ( p〈0. 05 ) . Conclusion Sophora flavescens decoction combined with box moxibustion at Baliao acupoint can effectively alleviate the postoperative pain and reduce the occurrence rate of urine retention of patients with high complicated anal fistula.
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