The Clinical Research Of Catgut Implantation To Control The Postoperative Pain In Mixed Hemorrhoids Patients

Background:Hemorrhoid is the most common clinical disease of the anus. According to the census data show that, the accidence of anorectal diseases is59.1%, in which hemorrhoids is87.25%of all.while mixed hemorrhoids account for80.98%of the number of hemorrhoids. In recent years, as the understanding to mechanism and the anatomy, physiology and pathology of hemorrhoids has been reached further and further, treatment of hemorrhoids has been thorough, Ⅲ,Ⅵ of hemorrhoids in principle be on. operated.There are many ways to hemorrhoid surgery,1937, Milligan and Morgan founded the stripping of Internal Ligation, which is still one of the most useful and classical treatments of III, VI mixed hemorrhoids in recent years. A long-term clinical practice has proved that this operation a good long-term efficacy and relatively low prices, outside strip internal ligation has been used to date, But postoperative pain is the most mixed hemorrhoid patients worried about, and his pain nearly usually last for5-7days then begin gradually reduce, the daily life of patients with psychological and Greatly influenced by, seriously affecting the rehabilitation of patients, while increasing the length of stay and costs. At present, there are many different ways of analgesia, such as taking medicine, applying, hip baths, anal suppositories, local injection of sclerosing agents, Patient-controlled Analgesia, Balanced Anaksia, but each way has its own advantages and shortcomings. How to sustained pain relief effectively, is an important issue to improve the patients quality of life. exploring a way which effective and durable, less side effect and non-addictive pain relief hemorrhoids surgery is the currently important assignment in clinical research.Objective:Based on the theory of Traditional Chinese medicinal meridian, use Evidence-Based Medicine to approch the influence and cecurity of the technique of Catgut implantation and western medicine that can deal with the pain after the bundle of mixed hemorrhoids by chosing scientific research and design, and to find a new and effective clinical options for the clinical treatment of mixed hemorrhoids anal pain.Methods:From December2008to November2011, in Anorectal of Zhujiang Hospital of Southern Medical University, Suffered with mixed hemorrhoid,60patients undergoing with the operation of Hemorrhoids-Morgan Hemorrhoedectomy were divided into Treatment Group (30cases) and Control Group (30cases) randomly. In the Treatment Group,30patients are treated with Catgut Implantation at the implementation and have100mg Tramadol hydrochloride after operation:Use sterile forceps to take in a section of inactive catgut, put it into the front of the needle, and then followed by needle acupunctures. After Patient’s anus is exposed in lateral position, mark Chang qiang Acupoint with gentian violet, conventional iodine disinfection with75%alcohol deiodinase, insert into the anus with left hand index finger as guidance to prevent the needle from broking the bowel, stick the needle with the right hand and quickly pierce through the skin and put into the muscle slowly about3cm deep, and the core-needle is moved forward. Then push the core-needle simultaneously retreat the needle tube. Use Cotton to push needle holes with a while, and check, then paste band-aid to prevent pinhole infection. Then have100mg Tramadol hydrochloride. Control In Group,30patients only have100mg Tramadol hydrochloride. After operation completed, observe the hours of pain evaluation12,24,48,72,96,120,144,168. The main Observation indicators are:visual analogue score (VAS), oral portray score method (VRS score 4),24hours pain duration scores(24hPDS).The adverse effect and the Use of analgesic drugs were recorded simultaneously. Then all data were analyzed with SPSS.13.0.Results:The main evaluation index:(1) two groups of postoperative anal pain VAS scores comparison, according to a=0.05level,12h,24h,144h,168h after surgery two groups VAS score, P>0.05, have no statistical significance; after48h,72h,96h,120h two groups of VAS score comparison, the treatment group and the control group with different distribution, it have statistical significance by statistical analysis (P<0.05), the treatment group was superior than control group.(2) two groups of postoperative anal pain score comparison, according to VRS, a=0.05level, at each time point after operation of two groups of VRS score, P>0.05, two groups have the same distribution, without statistical significance.(3) two groups within24h duration of pain score comparison, according to a=0.05inspection level, after1st,2nd,7th days in two groups of24h within the duration of pain score, P>0.05, two groups of the same distribution, without statistical significance; after3rd,4th,5th,6th days of24h of two groups within the duration of pain score comparison, the treatment group and the control group with different distribution, the statistical analysis, the difference was significant (P <0.05), have statistical significance, the treatment group was superior to control group.(4) in two groups of patients after12h,24h,48h,72h,96h,120h,144h,168h of wound edema score comparison, through statistical analysis, P>0.05, two groups have the same distribution, have no statistical significance.2secondary indicators:the two groups after the pain medication use per capita quantity comparison, according to a=0.05inspection level, postoperative time of analgesics use quantity of average per capita, P>0.05, two groups of the same distribution, without statistical significance.3, security evaluation index:the treatment group and the control group patients have no discomfort. it show a higher safety. Conclusions:1. The technique of catgut implantation at acupoint can reduce the mixed hemorrhoid postoperative pain with a certain curative effect, it can reduce the pain intensity,improve the daily life of patients.2. The technique of catgut implantation at acupoint has so many adventages such as safe, effect, cheeper, durable, easy to master and implement, that is a good treatment to deal with the pain after operation of Hemorrhoids-Morgan Hemorrhoedectomy.3. In the most painful stage of the development of disease, it can reduce the pain intensity and shorten the time of pain with a good analgesic effect and provide a new clinical choice that worth generalizing extensively.