Zergani Farzad Jassemi, Shaiesthe Ali Akbar, Hajiani Eskandar, Hashemi Jalal, Masjedizadeh Rahim, Sebghatollahei Vaheid, Alavinejad Pejman, Kadkhodaei Ahmad, Akhavan Kambeiz, Seyyedian Saeid
Hepatology Department, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.
Prz Gastroenterol. 2017;12(2):128-134. doi: 10.5114/pg.2016.64846. Epub 2016 Dec 29.
Argon plasma coagulation (APC) has been reported to be effective in the treatment of solitary rectal ulcer syndrome (SRUS). However, it has not appeared to be effective in healing ulcers.
This study aimed at assessing the effectiveness of APC in controlling rectal ulcer-induced bleeding, and at examining the ultimate effect of this approach in healing these lesions.
This randomised, controlled trial was conducted on 99 patients with SRUS. Patients were randomly enrolled into two groups of APC therapy (intervention) and conventional therapy (control). The control group ( = 58) received a high-fibre diet, laxatives, behaviour therapy, and sucralfate enemas, and the intervention group ( = 41) were treated with APC plus conventional therapy; in fact they received directed and focused argon gas in addition to a high-fibre diet and laxatives.
Responses to treatment in the control group and in the APC-receiving group were 29.3% and 75.6%, respectively. The continuation of ulcer healing after 3 months in the control group was 10.3%, and it was 70.7% in the APC-treated group. There was a significant statistical difference between the two groups ( < 0.004), i.e. bleeding was controlled more frequently in the group receiving APC plus conventional therapies than in the group receiving only the conventional therapies. However, the results showed no statistically significant difference between the two groups in terms of pain relief ( < 0.36).
Argon plasma coagulation not only controlled bleeding in patients with SRUS, but also, in comparison with the conventional methods of treating SRUS, led to healing and continuation of healing of rectal ulcers.
据报道，氩离子凝固术（APC）在治疗孤立性直肠溃疡综合征（SRUS）方面有效。然而，它似乎对溃疡愈合无效。
本研究旨在评估APC控制直肠溃疡出血的有效性，并检验该方法对这些病变愈合的最终效果。
这项随机对照试验对99例SRUS患者进行。患者被随机分为两组，一组接受APC治疗（干预组），另一组接受传统治疗（对照组）。对照组（n = 58）接受高纤维饮食、泻药、行为疗法和硫糖铝灌肠，干预组（n = 41）接受APC联合传统治疗；实际上，他们除了接受高纤维饮食和泻药外，还接受定向聚焦氩气治疗。
对照组和接受APC治疗组的治疗有效率分别为29.3%和75.6%。对照组3个月后溃疡持续愈合率为10.3%，APC治疗组为70.7%。两组之间存在显著统计学差异（P < 0.004），即接受APC联合传统治疗的组比仅接受传统治疗的组更频繁地控制了出血。然而，结果显示两组在疼痛缓解方面无统计学显著差异（P < 0.36）。
氩离子凝固术不仅能控制SRUS患者的出血，而且与治疗SRUS的传统方法相比，能使直肠溃疡愈合并持续愈合。
