OBJECTIVETo compare the differences in the clinical therapeutic effects on reflux esophagitis among the combined therapy ofdecoction (the decoction for resolving the turbid, detoxification and reducing the pathologic upwardin short) and acupuncture, omeprazole and Chinese herbal medicine.

METHODSNinety patients were randomized into 3 groups, 4 cases of them were dropped off. Finally, there were 29 cases in the combined therapy group with acupuncture and the decoction, 29 cases in the western medication group and 28 cases in the Chinese herbal medicine group in the statistical analysis. In the combined therapy group with acupuncture and the decoction, the decoction was prescribed recurrence rate. The therapeutic effects are better than the simple application of either Chinese herbal medicine or omeprazole. for oral administration. Additionally, acupuncture was applied to Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Ganshu (BL 18), Danshu (BL 19) and Taichong (LR 3). The decoction was applied one dose a day and acupuncture was once a day. In the western medication group, omeprazole capsules, 20 mg were prescribed for oral administration, twice a day. In the Chinese herbal medicine group, the decoction was simply applied. The treatment was 8 weeks in the 3 groups and the follow-up visit was 6 months. The score of reflux disorder questionnaire (RDQ) and the changes in esophageal mucosa under gastroscope were observed before and after treatment; the clinical therapeutic effects and recurrence rate were evaluated in the 3 groups.

RESULTSIn 4 and 8 weeks of treatment, RDQ scores in the 3 groups were all reduced as compared with those before treatment (all<0.05). In 4 weeks of treatment, RDQ score in the combined therapy group with acupuncture and Chinese herbal medicine was lower than that in the western medication group (<0.05). In 8 weeks of treatment, RDQ score in the combined therapy group with acupuncture and Chinese herbal medicine was lower than those in the western medication group and the Chinese herbal medicine group (both<0.05). In follow-up visit for 6 months, the recurrence rate in the combined therapy group with acupuncture and the decoction was lower than those in the other two groups (both<0.05). In 8 weeks of treatment, the total effective rate for clinical symptoms and that observed under gastroscope in the combined therapy group with acupuncture and the decoction were all better than those in the western medication group and the Chinese herbal medicine group (all<0.05).

CONCLUSIONSThe combined therapy ofdecoction and acupuncture achieve the definite therapeutic effects on reflux esophagitis, relieve the symptoms, protect gastric mucosa and reduce the.

OBJECTIVETo evaluate the efficacy of ligation of intersphincteric fistula tract (LIFT) in the treatment of complex fistula-in-ano.

METHODSClinical data of 24 patients with complex fistula-in-ano who treated with LIFT in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2009 to February 2012 were analyzed retrospectively. The operative efficacy and postoperative continence were evaluated.

RESULTSThe prime success rate of fistula healing was 66.7% (16/24) after the LIFT procedure. Two patients presented with intersphincteric incision infection which was successfully treated with topical of silver nitrate. Four patients had intersphincteric fistula with infection and managed with the complete laying open approach. The total clinical healing rate was 91.7% (22/24). Another 2 patients had persistent external opening with discharge. During follow-up of 6 to 44 (median 16) months, The Cleveland Clinic Florida Fecal Incontinence score revealed that no patient developed decreased continence.

CONCLUSIONLIFT is a safe and effective sphincter-preserve procedure for complex fistula-in-ano.

Anus Diseases ; surgery ; Fecal Incontinence ; Humans ; Ligation ; Rectal Fistula ; surgery ; Retrospective Studies ; Wound Healing