OBSERVATION OF THERAPEUTIC EFFECT療效觀察〕
Current and Further Curative Effects of Herbal Medicine Hongteng Mixture Combined with Traditional Chinese and Western Medicines for Abscess of Appendix

紅藤合劑為主中西醫結合治療闌尾膿腫近期與遠期療效分析

By Huirong Gao

中國•浙江省杭州市第一人民醫院外科  高惠榮


           Huirong Gao:     Abstract:    Traditional Chinese medicine jHong-Teng He-Jik plus antibiotics were applied in the treatment of 101 cases of appendix abscess.  Forty-one cases were cured and fifty four cases were alleviated. The general effect rate was 94.06%. Average hospitalization period was 8.9 days. Six cases failed to respond the treatment and were transferred for surgical treatment. The average hospitalization term for the jHong-Teng He Jik plus antibiotic group was 8.9 days. It was significantly shorter than the only antibiotic group which averaged 20.3 days, and the surgery group which averaged 26.6~29.8 days. Eighty-one patients were followed up from 6 months to 10 years after being discharged from hospitalization. Sixty-three of eighty-one (63.86%) cases had a positive long term recovery. Twenty-six cases accepted surgical treatment due to recurrence at 2~6 months. Eighteen of twenty-six re-occurrences were implicated with their primary pathological changes.

 

    本院採用紅藤合劑治療闌尾膿腫已有三十多年。現將19732月至19814月八年中收治的闌尾膿腫 113例加以分析,並對其近期和遠期療效加以評價

一、臨床資料

    113例中男49例,女64例;年齡886歲。其中41歲以上61例(54%)。發病三天以上111例(98.2%)。入院時右下腹可觸及包塊者87例(77%)。體溫在38℃以上者99例, 白細胞計數1015×109/L 46例,>15.1×109/L22例。

二、治療方法

    本組除6例因特殊情況未服中藥外,101例服用紅藤合劑,該合劑組成為下:

    紅藤30克、赤芍10克、地丁15克、忍冬藤12克、元胡12克、乳香6克、沒藥6克、紫草12克、連翹12克、冬瓜子30克、蒲公英15克、生甘草6克。 入院後一日一劑內服,全部病例都合用抗生素如肌注青、鏈霉素,部分病例靜脈滴注慶大霉素或紅、氯霉素。現將各種療法分組列表如下:

表1. 113例闌尾膿腫不同療法和住院天數關係表

治療方法

病例數

平均住院天數

非手術組                                                                                                                                                                                                                                                                    

紅藤合劑加抗生素

 單用抗生素

 手術組

單純引流

 闌尾切除

101                                                                                                                                          95

6

12(其中6例系保守治療無效,改手術)

4

8

 

8.9

20.3

 

29.8

26.6

 

表2. 83例闌尾膿腫中西醫結合治療後遠期療效分析

遠期療效

例數

良好

尚好

不好

其他

35

18

26

 4

42.17

21.69

31.33

 4.81

三、 療效分析

    1.療效標準參照天津市南開醫院制定的標準加以分類[]

    2.近期療效:本組113例中,6例單用抗生素,未服中藥。 6例入院後就進行手術治療不作療效評價。服中藥組101例,治癒41例,好轉54例(總有效率為94.06%)。無效6例改手術。

    3.遠期療效:經服紅藤合劑治療好轉出院的95例,經過6個月到10年的長期隨訪得83例。 隨訪結果見表2

    從表2可看出, 紅藤合劑治療闌尾膿腫遠期療效良好和尚好者共65例(占隨訪者63.85%)。遠期效果不好的26例,全部在出院後因症狀復發而接受手術治療。復發者大部分在出院後26個月內。復發有原因可查者18例。第一次住院時右下腹腫塊邊界不清者7例,腹腔內粘連3例,腫塊大於8cm3例,闌尾粘液囊腫、闌尾血吸蟲病、壞疽性闌尾炎以及發病時間長達33年者各1例,還有1例第一次發病住院三天就出院,闌尾膿腫治療不充分。

四、結 

    1.中藥紅藤合劑為主的中西醫結合治療闌尾膿腫,近期療效滿意,有效率達94.06%,平均住院日比不用中藥或手術治療組有明顯縮短。從遠期隨訪結果來看, 遠期良好或尚好者仍達60%以上。可見中西醫結合是治療闌尾膿腫的首選療法。

    2.闌尾膿腫在闌尾炎症發展形成膿腫的過程中,病人全身的抵抗力以及闌尾局部的病理變化不是一成不變的,從有原因可查的18例復發者來看,原發的病理基礎對療效有一定影響。因此採用中西醫結合方法治療闌尾膿腫必須結合病人的具體情況,在紅藤合劑主方的基礎上辨證論治,隨證加減,以期收到更好的效果。

    〔注〕:南開醫院  中西醫結合治療急腹症人民衛生出版社  1972.5第一版 54


洽詢地址Add.: 2712 San Gabriel Boulevard
Rosemead, CA 91770 U.S.A.

電話Tel.: (626) 288-1199

傳真Fax: (626) 288-4199

http://www.sotcm.com/Arrow.gifReturn to Journal of SOTCM Professional Edition Page