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1、中醫(yī)治療直腸脫垂介紹北京長(zhǎng)青肛腸醫(yī)院100195韓寶(河-南安陽(yáng)學(xué)術(shù)交流會(huì)20()9-3-30)摘要：脫肛病是指肛管、直腸粘膜、直腸全層和部分乙狀結(jié)腸向下移位，脫出或不脫出肛門外的一種疾病。相當(dāng)于現(xiàn)代醫(yī)學(xué)之“直腸脫垂”。中醫(yī)藥治療直腸脫垂具有顯著優(yōu)勢(shì)，治療方法主要有辨證論治、注射療法與手術(shù)治療三種方法。特別是采用中藥制劑消痔靈注射固脫治療直腸脫垂，具有操作簡(jiǎn)便、經(jīng)濟(jì)、安全、痛苦小、療效好的優(yōu)點(diǎn)，其缺點(diǎn)是仍存在著一定的復(fù)發(fā)率。分型分期論治是提高直腸脫垂治療效果的重要途徑，一型直腸粘膜脫垂可采取直腸
2、粘膜下注射法、直腸粘膜結(jié)扎法與直腸粘膜環(huán)切術(shù)。二型I度、II度直腸全層脫垂可采取直腸內(nèi)外雙層注射療法，療效都很滿意，是中醫(yī)治療優(yōu)勢(shì)所在。對(duì)于二型III度直腸脫垂單純行消痔靈雙層注射法，近期療效較好，但遠(yuǎn)期復(fù)發(fā)率仍有30%左右，如果加做直腸粘膜緊縮術(shù)和肛門環(huán)縮術(shù)可顯著降低遠(yuǎn)期復(fù)發(fā)率，總之，不管是何種類型的直腸脫垂，消痔靈注射治療均可以作為本病的首選治療方法，西醫(yī)手術(shù)是中醫(yī)治療的有效補(bǔ)充。作為中醫(yī)藥治療本病的難點(diǎn)在于消痔靈注射在遠(yuǎn)期療效上存在著一定的復(fù)發(fā)率。要降低復(fù)發(fā)率，提高中醫(yī)藥療效，就必須探索直
3、腸脫垂的發(fā)病機(jī)理，以尋找更佳治療方法，或優(yōu)化現(xiàn)有中醫(yī)治療方案，開展中西醫(yī)治療方法的隊(duì)列研究，研究新藥物、新劑型等等都是當(dāng)今需要迫切解決的問題。關(guān)鍵字：直腸脫垂；注射；治療IntroductionofDepletion?RelievingInjectionforTreatmentonRectalProlapseHanbao,BeijingChangqingAnorectalHospitalAbstractTaoGangBing,aterminTraditionalChineseMedicineco
4、rrespondingtotherectalprolapseinterminologyofthemodernmedicine,referstotheinferiortranslocationofproctodaeum,rectalmucosa,thefull-thicknessrectum,andpartialsigmoidcolon,withorwithouttheprolapseoutoftheanus.Withsignificantadvantagesinthetreatmentonrec
5、talprolapse,traditionalChineseMedicineprovidesthreemaintherapiesincludingSymptomDifferentiationandTreatmentAdministration,injection,andsurgery,especiallyXiaoZhiLingasthepreparationofTraditionalChineseMedicineappliedtorectalprolapse,whichischaracteriz
6、edintheadvantagesofsimplifiedadministration,lowcost,safety,lesssufferingsandbettereffects,inspiteofacertainrecurrencerateasitsshortcoming?TheTreatmentAdministrationbasedonstagesandtypesoftherectalprolopseisthekeytoimprovethetherapeuticeffect.Rectalsu
7、bmucosalinjection,rectalmucosaligation,orrectalcircumferentialmucosectomycanbeadoptedfortype1rectalprolapse,whilegradeIorII(thefullthicknessrectalprolapse)intypeIIcanbetreatedwithdoubleinjectionintoboththeexteriorandinteriorlayersoftherectum.Satisfac
8、toryeffectshavebeenobservedinallofthetherapiesasabove,demonstratingtheadvantagesofTraditionalChineseMedicine.Agoodearlytherapeuticresulthasbeenobservedinthesingletreatmentwithdouble-layerinjectionwithXiaoZhiLingfortypeIIgradeIIIrectalprolapse,despite
