抄録
【目的】肛門周囲膿瘍(以下本症)に対する十全大補湯投与の効果につき,後方視的に検討した.【方法】2001年11月より2005年12月の間に外来を受診した本症患児に,切開・排膿による局所処置を主とする従来の治療に加えて十全大補湯を投与した(投与群,n=61).これらの症例における治療期間,治癒までの外来受診回数,再発率,手術移行件数について,それ以前の期間(1998年1月から2001年10月)に従来の治療のみを行って治療した症例(非投与群,n=44)とで比較した.【結果】両群間で男女比,初診時月齢に有意差を認めなかった.治療期間は非投与群:投与群=1.4±1.6:2.1±2.2か月と有意に非投与群で短かった(p<0.05).治癒までの外来受診回数(6.76±5.06回:6.51±3.68回),再発率(7/44例(15.9%):7/61例(11.5%))には有意差を認めなかった.一方保存的治療に抵抗し手術を行った件数は,非投与群で9/44例認めたのに対し,投与群では0例であった(p<0.01).また,2か月以上の長期に治療を要した症例(非投与群17例,投与群35例)に限って月平均の外来受診回数をみると,4.4±2.0:2.7±0.8回で有意に投与群が少なかった.【結語】肛門周囲膿瘍に対し,十全大補湯投与による明らかな治療期間の短縮,外来受診回数の減少,再発率の低下は認められなかったが,慢性化症例に関しては,外来受診回数が減少し,手術に至る症例がなくなるなどの効果が期待されることが示唆された.
Purpose: We retrospectively investigated the efficacy of the Japanese herbal medicine "Juzen-taiho-to" in the treatment of infantile perianal abscess. Patients and Methods: Sixty-one infants who presented with perianal abscess between November 2001 and December 2005 were given "Juzen-taiho-to" in addition to the usual local treatment of a small incision and drainage (Juzen-taiho-to group). Another 44 children with perianal abscess were treated by usual local treatment during the former period (no-medication group). The duration of treatment, number of hospital visits, local recurrence rate, and number of patients who finally required surgical drainage were compared between the two groups. Results: There was no difference in age or gender between the two groups. The mean duration of treatment was significantly shorter in the no-medication group than in the Juzen-taiho-to group (1.4+/-1.6 vs. 2.1+/-2.2 months, p<0.05). However, there was no difference in total number of hospital visits (6.8 vs. 6.5 times) or the local recurrence rate (15.9 vs. 11.5%). Nine patients in the no-medication group finally required surgery, while none in the Juzen-taiho-to group did (p<0.01). In the patients who had more than 2 months' treatment length (17 and 35 in each group), the mean number of hospital visit was fewer in the Juzen-taiho-to group compared to the no-medication group (4.4+/-2.0 vs. 2.7+/-0.8 times, p<0.05). Conclusion: "Juzen-taiho-to" did not shorten the duration of treatment or reduce the recurrence rate of infantile perianal abscess. However, in chronic patients, it might be expected to result in avoiding frequent hospital visits and not worsening the disease into surgical treatment.
