| ObjectWith a rising incidence of diseases in the department of gynecology, such as myoma of uterus, adenomyosis of uterus, endometrial diseases, cervical cancer and so on, operation of hysterectomy has become the most common gynecologic surgery. Poor healing of the vaginal stump after hysterectomy often occur in clinical work, mainly in the performances of postoperative infection, vaginal stump bleeding and the growth of the vaginal stump polyps in, few can cause vaginal stump rectum fistula. If the result of poor healing of the vaginal stump is light, it can only affect the patients’ quality of life, the severe cases may endanger the patients’ lives because of the septicemia caused by the infection diffusion of the vaginal stump. In the aspect of promoting the healing of the vaginal stump after hysterectomy, there is no obvious effective method in western medicine, but the Traditional Chinese medicine can have good curative effect. This study thinks the major pathogenesis of the poor healing of the vaginal stump after hysterectomy are deficiency, cold, blood stasis and Qi stagnation, and the treatment works through the external use of the Traditional Chinese medicine on the vaginal stump to promote the local blood circulation and remove the blood stasis, tonify the deficiency and dispel the cold, suppurate to promote tissue regeneration to help the vaginal stump wound healing. This study is to observe the vaginal stump bleeding postoperative, vaginal stump macroscopic observation, vaginal stump’s ultrasound images and related indicators by external use of the Traditional Chinese medicine on the vaginal stump to explore the effect of The TCM granules "SHENG YU NO.1" on vaginal stump’s healing after hysterectomy.MethodAll the observed cases are from the Gynecology department of the NO.2Affiliated Hospital of Beijing University of Traditional Chinese Medicine between April2013and February2014. The60patients who would take the date-chosen operation of hysterectomy were randomly divided into the treatment group and the control group, with30cases respectively in each group. All the patients meet the Inclusion criteria. The patients’ ages are between the range of42-70years old. The basic information of the patients in the two groups, such as ages, the mainly disease types due to surgery this time, the combined internal basis diseases preoperative, the operation lasting time and the blood loss during the operation and so on distribute samely, there was no stastial-ly significant difference (with P>0.05), they are comparable. The patients in the two groups were treated with the conventional preoperative and postoperative processing methods. On the aspect of the dressing change on the vaginal stump after hysterectomy, The TCM granules "SHENG YU NO.1" is mixed with appropriate amount of normal saline to some kind of evenly thick paste in advance. The TCM granules "SHENG YU NO. l"is mainly composed of rheum officinale, aconite, monkshood, asarum, lithospermum, radix angelicae with the quantity of20g each medicine. After the sewing and washing of the vaginal stump end, paste of "SHENG YU NO.1" will be wrapped in sterile cotton and filled onto the vaginal stump end, and the dressing change will be done once a day from the second till the fourth day after the operation. The specific procedure of dressing change is as follows:①tell the patient to urinate.②take the patient to the examination room, and keep her in lithotomy position.③open the vagina with speculum carefully to expose the sump end fully.④smear the paste of "SHENG YU NO.1" onto the vaginal stump end, if there is much secretion near the vaginal stump end, first take some sterile cotton ball to wipe it away softly. The pat i ents i n control group will be only filled with a sterile cotton into vaginal after the operation is completed, and also dressing change will be done on day2, day3, day4after the operation by cleaning the vaginal stump end with some normal saline. All the patients will be administrated intrave-nously with cefuroxime (0.5g), twice a day after they have safely returned to the wards. At the same time, the patients’postoperative body temperature, the regular blood test on the third day after operation will be recorded, and the vaginal bleeding condition, patients’subjective feeling of pain on the vaginal stump end, the red and swollen condition of the vaginal stump end, the amount of vaginal secretion, the polyps growth on the vaginal stump end will be closely observed. On the seventh day after hysterectomy, all the patients will take B-ultrasound examination to check the condition of the vaginal stump end, finally an overall score will be calculated according to the rating scale (refer to the specific score criteria in the part of clinical observation in Chapter3) to estimate the patients’overall recovery of the vaginal stump, and all the related data will be recorded again on the patient’s30th day reexa-mination to calculate an overall score to estimate the healing condition of the vaginal stump end. The results of the two groups will be compared to evaluate the curing effect of "SHENG YU NO.1". All the data will be stored as database using the software of Excel2003, and be analyzed in the software of Spssl7.0. If P value is no more than0.05, it means the statistical significance.Results1. The overall scores on evaluating the healing condition of the vaginal stump in both the experimental and the control group from the operation day till the seventh day after the operation and the thirtieth day postoperative are compared with statistical method, the results are statistically significant with p<0.05.2. In all the indicators evaluating the healing condition of the vaginal stump end in both group, the scores of body temperature postoperative and the blood routine test on the third day postoperative after statistical treatment, the results show no statistical difference with P>0.05. The scores of the rest indicators (refer to the bleeding of the vaginal stump, the red and swollen of the vaginal stump surface, patients’subjective pain of the vaginal stump, the surface conditions, the amount of secretion of the vaginal stump, ultrasound images of the vaginal stump) after statistical treatment show statistical difference with P<0.05.3. In all the indicators evaluating the healing condition of the vaginal stump end in both groups on the30th day reexamination after surgery, we find that all the patients in both group have no subjective pain or red and swollen condition on the vaginal stump, so we think these two indicators have no meaning of observation. The scores of the amount of vaginal stump secretion of the two group after statistical treatment show statistical difference with P>0.05. The scores of the rest indicators (refer to the bleeding of the vaginal stump, the surface conditions, ultrasound images of the vaginal stump) after stat-istical treatment show statistical difference with P<0.05.Conclusions1. The TCM granules "SHENG YU NO.1" can promote the healing of the vaginal stump after hysterectomy.2. About the observation indicators of this study, a preliminary conclusion can be made. From the operation day and the following seven days, the main indicators on evaluating the healing condition of the vaginal stump can be as follows:the bleeding of the vaginal stump, the red and swollen of the vaginal stump surface, patients’subjective pain of the vaginal stump, the surface conditions, the amount of secretion of the vaginal stump, ultrasound images of the vaginal stump.3. The TCM granules "SHENG YU NO.1" can reduce the bleeding and pain after hysterectomy in short term, and its long term work is better than the short term. It can reduce the incidence of poor healing. It can be beneficial in the clinical work. |
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