Clinical Observation Of White And Wound Pain And Healing After Mixed Hemorrhoids

Objective:Surgical treatment is the common curative intervention for severe mixed hemorrhoids,and the Milligan-Morgan hemorrhoidectomy is the major method.Complications,as pain and edema of the anus,hemorrhage,and the slow wound healing in the postoperative period,frequently lead to a decrease of efficacy,prolonged hospitalization,an increase of expense,as well as a waste of limited medical resources.Undoubtedly,an effective management of postoperative complications can promote surgical efficacy and patients' satisfaction.Therefore,to reduce incidence rate and severity of the complications after Milligan-Morgan hemorrhoidectomy is a critical issue in clinic.This paper explored the effect of bletilla(Baiji)preparation for these postoperative complications by observing the two main symptoms of anal pain and wound healing.Methods:A total of 80 subjects,who met the diagnostic criteria of mixed hemorrhoids and was prepared to undergo Milligan-Morgan hemorrhoidectomy,were admitted in the Anorectal Department at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 1,2010 to February 28,2017.In this double-blind study,subjects were randomly assigned to one of the four groups including 2 experiment groups and 2 control groups.The experiment groups(totally 40 cases)include Bletilla powder group(20 cases)and Bletilla mannan group(20 cases).On the other side,A vaseline gauze group(20 cases)and a Yunnan Baiyao Medicine group(20 cases)are involved in control group(totally 40 cases).It is no obvious statistic differences in age and gender(P>0.05)in the four groups,so they are comparable in measurement data.Except the medications for external application were different,They had got the same treatment and nursing care since the first application of dressing according to the project.After changing dressing,vaseline gauze and dry gauze applied and strapped up with adhesive tape.Dressing change once a day,21 days as a course.We evaluated numerical rating scale of pain by VAS,3 times a day(before,immediately after,and 2 hours after dressing change).It was recorded from Day 1 to Day 7,and at the Day 14 and the Day 21 after the operation.At the recording time,evaluated and recorded the wound healing condition before dressing change.At the Day 14,and Day 21,the discharged patients were arranged to go to the hospital for dressing changes and recording the pain grading and healing condition by appointment.The data processed with Stata 12.0.Results:The total subjects participated all along are 76.In experiment groups,there were 18 male patients and 19 female patients,while 23 male patients and 16 female patients in the control groups.The average age of bletilla power group was 44.26±14.11,the age of which was from 18 to 63 years old.In using Bletilla mannan group,it was 42.5±12.47 and from 24 to 64 years old.The statistical data showed that all the 4 groups relieved the pain after Milligan-Morgan hemorrhoidectomy.The group with Bletilla mannan application was significant different in immediately relieving pain after dressing change compared with the other groups(P<0.05)by VAS evaluation.The bletilla powder group was significant different in relieving pain 2 hours after dressing change,compared with the other groups(P<0.05)by VAS evaluation.The lasting effect of killing pain of the bletilla powder group is as equally as the Yunnan Baiyao group does,but it has the strongest irritating-effect on wound among the groups.In wound healing aspect,the bletilla powder group was better than the Bletilla mannan group,the vaseline gauze group worked best,while there was no difference in statistics(P>0.05).Conclusion:Both Bletilla mannan and bletilla powder have an effect on relieving pain after Milligan-Morgan hemorrhoidectomy.The Bletilla mannan is better than bletilla powder in immediate relieving pain,while bletilla powder is better than Bletilla mannan in lasting effect of relieving pain.Neither Bletilla mannan nor bletilla powder has showed obvious wound healing ability.No significant adverse reactions and skin allergy occur during this clinical research.