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Combination therapy with traditional medicines for perianal abscess in children
Author(s) -
Sueyoshi Ryo,
Lane Geoffrey J.,
Kusafuka Junichi,
Yamataka Atsuyuki,
Doi Takashi
Publication year - 2019
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13988
Subject(s) - medicine , fistulotomy , abscess , fistulectomy , surgery , gastroenterology , fistula , anal fistula
Background Combination therapy with two different traditional medicine formulations called hainosankyuto and juzentaihoto ( TJ ‐122 and TJ ‐48; Tsumura & Co, Tokyo, Japan) may be effective for perianal abscess ( PA ), but their effectiveness has not been established. The present study investigated the effectiveness of combination therapy with TJ ‐122 and TJ ‐48 as the most effective conservative treatment for PA . Methods We identified 69 patients with PA under 2 years of age and divided them into four groups according to the formulations used: group 1, TJ ‐122 ( n = 17); group 2, TJ ‐48 ( n = 14); group 3, TJ ‐122 and TJ ‐48 ( n = 19); and group 4, no traditional medicines ( n = 19). Treatment was continued for 3–6 months after resolution of the PA in groups 1 and 2, and for 1 year in group 3. Age at presentation, duration of purulent discharge ( PD ), frequency of surgical intervention (incision and drainage [ ID ]; fistulotomy/fistulectomy), and recurrence rates were statistically analyzed. Results Mean age (months) was 8.6 ± 9.2, 6.9 ± 7.3, 5.2 ± 4.7, and 3.8 ± 3.1 in groups 1, 2, 3, and 4, respectively ( P = n.s.). Mean PD (weeks) was 2.5 ± 2.2, 7.1 ± 10.8, 2.0 ± 0.0, and 2.7 ± 1.0, respectively. Duration of PD was significantly longer in group 2 than in groups 1 and 3 ( P < 0.05). Mean number of ID procedures was 1.0 ± 0.2, 2.3 ± 0.5, 0, and 1.6 ± 0.2, respectively. Group 1 had significantly less ID than group 2 ( P < 0.01). Recurrence rates were 6%, 36%, 0%, and 32%, respectively. Groups 1 and 3 had significantly less recurrence than group 2 ( P < 0.05), and group 3 had significantly less recurrence than group 4 ( P < 0.01). Conclusions Combination therapy with TJ ‐122 and TJ ‐48 decreased recurrence and surgical intervention to zero in this study, demonstrating high effectiveness for treating PA in children.