长强穴按摩联合手指扩肛预防外剥内扎术后肛门狭窄的临床观察

Clinical Observation of Changqiang Point Massage Combined with Finger Anal Dilation in Preventing Anal Stenosis after Milligan-Morgan Hemorrhoidectomy

摘要: 目的：观察采用长强穴按摩联合手指扩肛治疗40例混合痔外剥内扎术后患者的临床疗效，以及其预防术后肛门狭窄的情况。方法：选取2023年2月至2024年2月黑龙江省中医药科学院收治的80例混合痔患者为研究对象，随机分为对照组及观察组，各40例。对照组采用手指扩肛治疗，观察组采用长强穴按摩联合手指扩肛治疗，治疗时间在术后7天至术后21天。分别于术后6天(治疗前)、术后14天(治疗期间)、术后3个月(治疗后随访)记录并比较两组患者NRS 0-10版疼痛评分、Longo ODS评分和肛门指检情况。结果：治疗前，两组NRS 0-10版疼痛评分、Longo ODS评分和肛门指检情况比较，差异均无统计学意义(P > 0.05)，具有可比性。治疗期间及治疗后随访，观察组NRS 0-10版疼痛评分、Longo ODS评分明显低于对照组，肛门指检显示观察组肛门狭窄和指套染血发生率均低于对照组，差异有统计学意义(P < 0.05)。结论：长强穴按摩联合手指扩肛可有效预防外剥内扎术后肛门狭窄，并减轻患者治疗过程中的疼痛，进而提升患者生活质量，值得临床推广。

Abstract: Objective: To observe the clinical efficacy of Changqiang point massage combined with finger anal dilation in treating 40 patients after Milligan-Morgan hemorrhoidectomy for mixed hemorrhoids, and its effect in preventing postoperative anal stenosis. Methods: A total of 80 patients with mixed hemorrhoids admitted to Heilongjiang Provincial Academy of Chinese Medical Sciences from February 2023 to February 2024 were selected as the study subjects and randomly divided into a control group and an observation group, with 40 cases in each group. The control group received finger anal dilation treatment, while the observation group received Changqiang point massage combined with finger anal dilation treatment, with the treatment period ranging from 7 days to 21 days after surgery. The NRS 0-10 pain score, Longo ODS score, and digital rectal examination results were recorded and compared between the two groups at 6 days after surgery (before treatment), 14 days after surgery (during treatment), and 3 months after surgery (follow-up after treatment). Results: Before treatment, there were no statistically significant differences in the NRS 0-10 pain score, Longo ODS score, and digital rectal examination results between the two groups (P > 0.05), indicating comparability. During treatment and at follow-up after treatment, the observation group showed significantly lower NRS 0-10 pain scores and Longo ODS scores compared to the control group. Digital rectal examination revealed that the incidence of anal stenosis and bloodstained finger cots was lower in the observation group than in the control group, with statistically significant differences (P < 0.05). Conclusion: Changqiang point massage combined with finger anal dilation can effectively prevent anal stenosis after Milligan-Morgan hemorrhoidectomy, alleviate pain during treatment, and thereby improve patients’ quality of life. This treatment is worthy of clinical promotion.