Discussion
bleeding, diarrhea, tenesmus, hemorrhoids, postoperative urinary retention, Acupuncture, postoperative urination disorder, ’ anal pain, pain, postoperative infection, postoperative bleeding, chronic anal pain, constipation, PPH, urinary retention
BLEEDING, HEMORRHOIDS, POSTOPERATIVE COMPLICATION, POSTOPERATIVE BLEEDING, POSTOPERATIVE INFECTION, SURGICAL COMPLICATIONS, SECONDARY, COMPLICATIONS
PPH surgery is a good choice for the treatment of hemorrhoids, which has the advantages of short operation time, low incidence of surgical complications, rapid postoperative recovery, and reliable surgical effect [Acupuncture and moxibustion is a kind of treatment in traditional Chinese medicine, which has been increasingly used for perioperative treatment in recent years [A total of 124 patients with hemorrhoids who underwent PPH at Shanghai Fifth People’s Hospital were included in our study. The results showed that EA at Baliao could significantly relieve patients’ anal pain, anal distension, and postoperative urination disorder within 3 days after operation, which was consistent with the previous clinical results on EA at Baliao point. This intervention could have significant clinical relevance since post-operative pain and anal distension are common complications after PPH and can negatively impact patient recovery and quality of life. By providing a non-pharmacological alternative for pain relief, EA at Baliao point may offer a valuable addition to the current standard of care for patients undergoing PPH. It is worth mentioning that the acupoints selected in our study are secondary liao and middle liao, which are different from those reported previously. In addition to PPH, spinal anesthesia will also lead to short-term complications such as local pain and urinary retention; our EA treatment may also has therapeutic effect on local pain and postoperative urinary retention caused by spinal anesthesia and promotes the overall recovery of patients after PPH. Interestingly, there was no statistically significant difference in stool frequency and stool characteristics between the EA group and the control group within 3 days after the operation, suggesting that the effect of EA at Baliao point on defecation function and stool formation needs further research and exploration.Postoperative complications such as postoperative infection and urinary retention occurred in both groups of patients. There was no significant difference in the incidence of postoperative infection between the two groups. While the incidence of urinary retention in the control group was significantly higher than that in the EA group, indicating that EA at Baliao point can promote the recovery of bladder function in patients, promote urine excretion, and avoid the use of catheters after PPH surgery. In addition, one patient in the control group developed severe postoperative bleeding and underwent a second operation to stop the bleeding. In the EA group, there was no postoperative bleeding or reoperation patients in the EA group. We believe that this difference may be caused by accidental factors and is not related to the EA at Baliao point.One-month follow-up results showed that some patients in both groups had symptoms of chronic anal pain, anal bulge, tenesmus, constipation, or diarrhea, but there was no significant difference between the two groups. In both groups, some patients complained that they could not completely empty the feces during defecation, which is a common problem after PPH. The number of patients in the EA group suffering from this problem was slightly less than that in the control group, but the difference was not statistically significant. And this study also has some limitations. Firstly, whether EA at Baliao point can improve the problem of inability to completely empty feces in patients after PPH requires further research. Secondly, there is no objective laboratory index for the patients’ subjective feeling of heaving and pain. How to avoid strong subjectivity and objectively and correctly evaluate the degree of anal distension and pain after PPH needs further research and demonstration. Thirdly, although some studies have shown that the physiological mechanism of acupuncture is related to purinergic signaling, the endorphins theory [