| High position anal fistula being one of difficult anus intestines section diseases, due to lesion location height, much bending of pipeline complicated,branches,and deep cavities, has great difficulty in treating it. According to the medical literature, the traditional Chinese medicine seton therapy has been the mainstream method in the domestic treatments for high position anal fistula.In order to improve the clinical curative powers of the traditional Chinese medicine diagnosis and treatment of high position anal fistula, we have improved the traditional seton therapy to coordinated the contra-aperture drainage therapy summarizing over 30 years clinical experiences. The therapy that we have used many years clinically have no specific reference data of the reduction of cicatrization time,wound area and pain, as well as to function damage of anus, which make the clinical doctors not sure to popularize it. We have researched the stochastic clinical comparison of the traditional seton therapy and that coordinated the contra-aperture drainage therapy via the anal tube rectum pressure measurement, patients private prosecution of defecation and other means to evaluate the function of anus after operation, as well as through the wound cicatrization time, the degree of postoperative pain, two-month recrudescence situation and other curative effect indicators to reveal that the traditional seton therapy coordinated the contra-aperture drainage therapy have the objective superiority in the respect of shortening cicatrization time and reserving the anus function, in compared with the traditional low-position incision and high-position seton therapy, thereby helping to promote the use of this therapy clinically , furthermore improving the clinical curative powers of the traditional Chinese medicine diagnosis and treatment of the high position anal fistula, reducing complications, shortening courses to display the preeminence of the Chinese medicine treatment of high position anal fistula. The thesis is divided into two parts:Partâ… : Documental summary.1 .The systemic summary of the traditional Chinese medicine on the name,etiology and pathogenesis,classification,treatment and other aspect of anus fistula.2.The systemic summary of the current medicine on the name,etiology and pathogenesis,classification,diagnosis,treatment and other aspect of anus fistula, and furthermore bringing forward the application of the traditional seton therapy coordinated the contra-aperture drainage therapy.3.The systemic summary of the application of the traditional seton therapy in the treatment for high position anal fistula.Partâ…¡: Clinical reseachObject: To research the stochastic clinical comparison of the traditional seton therapy and that coordinated the contra-aperture drainage therapy via the anal tube rectum pressure measurement,patients private prosecution of defecation and other means to evaluate the function of anus after operation, as well as through the wound cicatrization time, the degree of postoperative pain, the recrudescence rate and other curative effect indicators to reveal that the traditional seton therapy coordinated the contra-aperture drainage therapy have the objective superiority in the respect of shortening cicatrization time and reserving the anus function, in compared with the traditional low-position incision and high-position seton therapy, thereby helping to promote the use of this therapy clinically, furthermore improving the clinical curative powers of the traditional Chinese medicine diagnosis and treatment of high position anal fistula, reducing complications, shortening courses,reducing wound areas and postoperative pain to display the preeminence of the Chinese medicine treatment of high position anal fistula.Method: Study 61 examples who are diagnosed as high position anal fistula definitely, dividing into two groups stochastically: the experimental group and the control group. The experimental group of 29 cases adopts the traditional seton therapy coordinated the contra-aperture drainage therapy while 32 cases of the control group adopts the traditional low-position incision and high-position seton therapy. Both postoperative groups use Shengjiyuhong ointment changing fresh dressing for a wound till cicatrisation. And then analyze the total curative effect, two-month recrudescence situation, wound healing time,the function of the anal sphincter, the area of the postoperative wound area and postoperative pain of two groups.Result: Two groups in the aspect of the total curative effect, two-month recrudescence situation and the function of the anal sphincter have no significant difference (P> 0.05), and in the aspect of wound healing time,the area of the postoperative wound area and postoperative pain have significance difference (P<0.05).Conclusion: The traditional seton therapy coordinated the contra-aperture drainage therapy and the traditional low-position incision and high-position seton therapy have no significant different in the aspect of the total curative effect,two-month recrudescence situation and the function of the anal sphincter, and both of them don't lead to encopresis. The total curative effect is 100% and the function of the anal sphincter is 100% to the normal. Compared to the traditional low-position incision and high-position seton therapy, the traditional seton therapy coordinated the contra-aperture drainage therapy which can shorten cicatrization time,reducing wound areas and postoperative pain, is worth promoting in the clinical application. |
