摘要: 目的：评估苦参汤中药熏蒸联合坐浴对于混合痔术后并发症的临床疗效。方法：选取2024年1月至2024年12月收治的符合纳入标准的混合痔术后患者160例，随机分为观察组和对照组各80例。两组患者均在椎管内麻醉下行混合痔外剥内扎术，术后予以相同的抗感染、止血、换药等常规治疗。在此基础上，观察组采用苦参汤熏蒸坐浴，对照组采用高锰酸钾熏蒸坐浴。对比两组患者术后第1天、3天、5天、一周、二周、三周、一月的肛周疼痛(VAS评分)、肛缘水肿、肛门瘙痒、创面渗血、创面渗液、创面愈合时间、首次排便时间、不良反应(恶心、头昏、刺痛等)等指标，记录数据并分析治疗效果。结果：术后第1天，肛周疼痛、肛缘水肿、肛门瘙痒、创面渗血、创面渗液情况比较，P > 0.05，表明两组无显著性差异。术后第3天，肛缘水肿、肛门瘙痒、创面渗血、创面渗液情况比较，P > 0.05，表明两组无显著性差异，疗效相当，肛周疼痛比较，P < 0.05，表明有显著性差异。术后第5天、一周、二周，肛周疼痛、肛缘水肿、肛门瘙痒、创面渗血、创面渗液情况比较，P < 0.05，说明具有统计学意义的差异，观察组优于对照组。术后三周、一月，肛周疼痛、肛缘水肿、肛门瘙痒、创面渗血、创面渗液症状已基本消退，差异无统计学意义(P > 0.05)。比较两组创面愈合时间、首次排便时间，P < 0.05，显示出显著性差异，提示观察组的平均愈合时间、首次排便时间均短于对照组。术后患者满意度比较，P < 0.05，观察组疗效优于对照组。结论：苦参汤中药熏蒸联合坐浴能明显减轻混合痔患者术后肛周疼痛、肛缘水肿、肛门瘙痒、创面渗血、创面渗液等症状，缩短创面愈合时间，促进创面愈合。中药熏蒸联合坐浴，疗效优势明显，安全性高，值得进一步临床推广和使用。
Abstract: Objective: To evaluate the clinical efficacy of traditional Chinese medicine fumigation and sitting bath with Sophora flavescens decoction in the treatment of postoperative complications of mixed hemorrhoids. Methods: A total of 160 patients who met the inclusion criteria and underwent mixed hemorrhoid surgery from January 2024 to December 2024 were randomly divided into an observation group and a control group, with 80 cases in each group. Both groups underwent external hemorrhoid excision and internal hemorrhoid ligation under spinal anesthesia and received the same routine treatments such as anti-infection, hemostasis, and dressing changes. On this basis, the observation group was treated with Sophora flavescens decoction fumigation and sitting bath, while the control group was treated with potassium permanganate fumigation and sitting bath. The indicators of perianal pain (VAS score), anal margin edema, anal itching, wound bleeding, wound exudation, wound healing time, first defecation time, and adverse reactions (nausea, dizziness, stinging pain, etc.) were compared on the 1st, 3rd, 5th day, one week, two weeks, three weeks, and one month after surgery. Data were recorded and analyzed for therapeutic effects. Results: On the 1st day after surgery, there was no significant difference in perianal pain, anal margin edema, anal itching, wound bleeding, and wound exudation between the two groups (P > 0.05). On the 3rd day after surgery, there was no significant difference in anal margin edema, anal itching, wound bleeding, and wound exudation between the two groups (P > 0.05), indicating comparable efficacy. However, there was a significant difference in perianal pain (P < 0.05). On the 5th day, one week, and two weeks after surgery, there were significant differences in perianal pain, anal margin edema, anal itching, wound bleeding, and wound exudation between the two groups (P < 0.05), with the observation group showing better results. In the 3rd week and one month after surgery, the symptoms of perianal pain, anal margin edema, anal itching, wound bleeding, and wound exudation had basically subsided, and there was no significant difference (P > 0.05). There were significant differences in wound healing time and first defecation time between the two groups (P < 0.05), indicating that the average healing time and first defecation time in the observation group were shorter than those in the control group. There was a significant difference in patient satisfaction after surgery (P < 0.05), suggesting that the therapeutic effect of the observation group was better than that of the control group. Conclusion: The combination of herbal steam inhalation and sitz bath in the Bu Xin Decoction can significantly alleviate the symptoms of postoperative perianal pain, perianal edema, anal itching, bleeding from the wound surface, and exudate from the wound in patients with mixed hemorrhoids. It can shorten the wound healing time and promote wound healing. The therapeutic effect of this combination is remarkable, with high safety. It is worthy of further clinical promotion and application.