评估外用硝苯地平和地尔硫䓬治疗慢性肛裂有效性的对比研究。

Comparative Study to Assess the Effectiveness of Topical Nifedipine and Diltiazem in the Treatment of Chronic Anal Fissure.

作者信息

Kujur Archana Dipa Sangita, Paul Ekka Nishith M, Chandra Satish, Lal Shreya, Malua Shital

机构信息

Department of Pharmacology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Department of Surgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

出版信息

J Family Med Prim Care. 2020 Nov 30;9(11):5652-5657. doi: 10.4103/jfmpc.jfmpc_986_20. eCollection 2020 Nov.

DOI:10.4103/jfmpc.jfmpc_986_20

PMID:33532409

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7842453/

Abstract

BACKGROUND

Chronic anal fissure is a common condition which is classically treated by surgery which may lead to incontinence. Recently medical treatment in form of calcium channel blockers (CCB) has gained interest.

AIMS

The aim of this study is to compare the effectiveness of local Nifedipine and Diltiazem with lignocaine as control. We also aimed to observe the clinical pattern of chronic anal fissure.

MATERIAL AND METHOD

Patients of chronic anal fissure were divided into three groups. First group received topical Nifedipine, second received topical Diltiazem, and the control group received only local lignocaine for 1 month. Their clinical data was recorded. The intensity of pain and bleeding was assessed from a visual analogue score (VAS). On the 4 week patients were examined for healing.

STATISTICAL ANALYSIS

Statistical analysis was done by Medcalc statistical software v14. Student's -test and Chi-square test was used accordingly.

RESULTS

Mean age was 35.89 with a male female ratio of 1.7:1. Most common clinical feature was pain (100%), followed by constipation, bleeding, and pruritus. Most common location was posterior. VAS scores for pain of the Nifedipine group and Diltiazem group was significantly better than control group ( < 0.0001). VAS scores for bleeding in the Nifedipine group ( = 0.0091) and Diltiazem group ( = 0.0045) was significantly better than control group. The healing rate for NFD group was 93.33% ( < 0.0001), that of DTZ group was 86.67% ( = 0.0002), which was statistically better than control group (36.67%). There was no significant difference between the two CCBs.

CONCLUSION

Adding topical Nifedipine or Diltiazem in the treatment of anal fissure is far superior to treatment with only topical Lignocaine.

摘要

背景

慢性肛裂是一种常见病症，传统上通过手术治疗，但手术可能导致失禁。最近，钙通道阻滞剂（CCB）形式的药物治疗受到关注。

目的

本研究的目的是比较局部使用硝苯地平和地尔硫䓬与利多卡因作为对照的有效性。我们还旨在观察慢性肛裂的临床模式。

材料与方法

慢性肛裂患者分为三组。第一组接受局部硝苯地平治疗，第二组接受局部地尔硫䓬治疗，对照组仅接受局部利多卡因治疗1个月。记录他们的临床数据。通过视觉模拟评分（VAS）评估疼痛和出血的强度。在第4周时检查患者的愈合情况。

统计分析

使用Medcalc统计软件v14进行统计分析。相应地使用学生t检验和卡方检验。

结果

平均年龄为35.89岁，男女比例为1.7:1。最常见的临床特征是疼痛（100%），其次是便秘、出血和瘙痒。最常见的部位是后部。硝苯地平组和地尔硫䓬组的疼痛VAS评分明显优于对照组（P<0.0001）。硝苯地平组（P = 0.0091）和地尔硫䓬组（P = 0.0045）的出血VAS评分明显优于对照组。硝苯地平组的愈合率为93.33%（P<0.0001），地尔硫䓬组为86.67%（P = 0.0002），在统计学上优于对照组（36.67%）。两种CCB之间没有显著差异。