| Objective: To study the clinical efficacy of methylene blue perianal local closure injection(intraoperative)combined with auricular point pressure bean(postoperative)to relieve the pain of patients after mixed hemorrhoids by Milligan-Morgan surgery.It is hoped that this study can provide needed clinical research support for patients undergoing mixed hemorrhoids by Milligan-Morgan surgery to relieve postoperative pain by applying local closure injection of methylene blue around the anus(intraoperative)combined with auricular point pressure bean(postoperative).Methods: This study used a randomized,controlled,single-blind trial.In this study,105 patients who underwent mixed hemorrhoids by MilliganMorgan surgery in the anorectal Department of the Affiliated Hospital of Shandong University of Chinese Medicine from October 2021 to December2022 were selected.Patients were randomly assigned to combination group,methylene blue group and auricular point group according to SPSS random number table method.The conventional basic treatment of different groups was the same.35 patients in the combined group were given operative methylene blue injection with anal closure injection combined with postoperative ear point pressure bean.Postoperative anal pain,edema and first urine discharge were compared among the three groups.In the methylene blue group,35 patients were injected with methylene blue injection in the anus,and the adhesive tape without the seeds was pasted on the corresponding auricular points after operation.35 cases in auricular acupoint group were sprayed with methylene blue injection into the corresponding parts around the anus and pressed into the auricular acupoint after operation.Postoperative anal pain,edema and first urine discharge were compared among the three groups.Results: In this study,there were shedding cases,including 4 cases in the combination group,2 cases in the auricular point group and 3cases in the methylene blue group,with a shedding rate of 8.57 %.Finally,a total of 96 patients were included in the study.There were no significant differences in gender,age and the classification of internal hemorrhoids among different groups(P>0.05),indicating that the three groups could be compared.After treatment,there were no statistical differences in edema degree,first urination and wound healing time among the three groups(P>0.05),and no patients had anal incontinence.There were significant differences in pain scores at the 1st,3rd,5th and 7th day after surgery(P<0.05).The pain score on the first day after surgery was 4(3,6)in the combined group,6(5,7)in the auricular point group,and 5(4,6)in the methylene blue group.The difference between the combined group and the auricular point group was statistically significant(P<0.05),and the difference between the methylene blue group and the auricular point group was statistically significant(P<0.05).There was no significant difference between methylene blue group and combination group(P>0.05).The pain score on the 3rd day after surgery was 3.58±2.292 in the combined group,4.94±2.249 in the auricular point group,and 3.72±2.218 in the methylene blue group.The difference between the combined group and the auricular point group was statistically significant(P<0.05),and the difference between the methylene blue group and the auricular point group was statistically significant(P<0.05).There was no significant difference between methylene blue group and combination group(P>0.05).The pain score on the 5th day after surgery was 2(0,3)in the combination group,4(4,5)in the auricular point group,and 3(2,4.75)in the methylene blue group,and the difference between the combination group and the auricular point group was statistically significant(P<0.001),and the difference between the methylene blue group and the auricular point group was statistically significant(P<0.05).The difference between methylene blue group and combination group was statistically significant(P<0.05).The pain score on the 7th day after surgery was 1(0,2)in the combination group,3(3,4)in the auricular point group,and 2(1,2)in the methylene blue group,and the difference between the combination group and the auricular point group was statistically significant(P<0.001),and the difference between the methylene blue group and the auricular point group was statistically significant(P<0.05).The difference between methylene blue group and combination group was statistically significant(P<0.05).Conclusion: Methylene blue injection combined with auricular point pressure can significantly reduce the pain of patients with mixed hemorrhoids after external stripping and internal operation,with low pain score,fewer complications and no obvious adverse reactions,which can be widely used in clinical practice. |
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