Department of Surgery, Ajou University School of Medicine, 164 Worldcup-ro, Youngtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA.
Tech Coloproctol. 2019 Feb;23(2):143-149. doi: 10.1007/s10151-019-01934-x. Epub 2019 Feb 7.
While various medical treatments such as topical steroid ointment, antihistamine agent, and sedatives have been used for treating idiopathic intractable pruritus ani, they are not long-term solutions, due to the high recurrence rate. The aim of this study was to determine the effect of methylene-blue intradermal-injection therapy for treating patients with idiopathic intractable pruritus ani. Symptom improvement and recurrence rates were determined with a long-term follow-up.
A retrospective study was conducted from January 2011 to October 2013 on consecutive patients with intractable pruritus ani treated with methylene-blue intradermal injection. The therapy included 5 ml of 1% methylene blue and 15 ml of 1% lidocaine. Follow-up included a physical exam and satisfaction-score survey (1 = much worse, 2 = worse, 3 = no improvement, 4 = much better, 5 = gone completely) before treatment, 6 weeks after treatment, and 3 years after treatment to check patient status and recurrence rate.
Of 103 treated patients, 96 were able to attend the 6-week follow-up visit. There were 58 (60.4%) males and 38 (39.6%) females with a mean age of 48.34 ± 10.21 years. Their mean satisfaction score at 6 weeks was 4.23 ± 0.86. Of the total of 96 patients, 9 (9.4%) patients scored 3 or less in their satisfactions score at 6 weeks. 62 (64.6%) patients were evaluated 3-year post-treatment. The satisfaction score at 3 years after treatment was 4.74 ± 0.57. Besides the 9 patients who initially failed treatment, 4 of the remaining 53 patients scored 3 or less in their satisfaction score surveys. Thus, the recurrence rate at 3 years was 7.5% (4/53).
Methylene-blue intradermal injection can result in a high symptom improvement rate with low recurrence rate for patients with idiopathic pruritus ani.
尽管已经使用了各种医学治疗方法，如局部类固醇软膏、抗组胺药和镇静剂来治疗特发性难治性肛门瘙痒症，但由于复发率高，这些方法都不是长期解决方案。本研究的目的是确定亚甲蓝皮内注射疗法治疗特发性难治性肛门瘙痒症患者的效果。通过长期随访确定症状改善和复发率。
对 2011 年 1 月至 2013 年 10 月连续接受亚甲蓝皮内注射治疗的难治性肛门瘙痒症患者进行回顾性研究。该疗法包括 5ml 1%亚甲蓝和 15ml 1%利多卡因。随访包括治疗前、治疗后 6 周和治疗后 3 年进行体格检查和满意度评分调查（1=差很多，2=差一点，3=无改善，4=好很多，5=完全消失），以检查患者状况和复发率。
在 103 例接受治疗的患者中，96 例能够参加 6 周随访。男性 58 例（60.4%），女性 38 例（39.6%），平均年龄 48.34±10.21 岁。他们在治疗后 6 周的平均满意度评分为 4.23±0.86。在 96 例患者中，9 例（9.4%）患者在治疗后 6 周的满意度评分低于 3 分。62 例（64.6%）患者在治疗后 3 年进行了评估。治疗后 3 年的满意度评分为 4.74±0.57。除了最初治疗失败的 9 例患者外，53 例患者中有 4 例的满意度评分低于 3 分。因此，3 年的复发率为 7.5%（4/53）。
亚甲蓝皮内注射可使特发性肛门瘙痒症患者的症状改善率高，复发率低。
