A randomised study comparing systemic transdermal treatment and local application of glyceryl trinitrate ointment in the management of chronic anal fissure.

Tahsin Colak, Turgut Ipek, Namik Urkaya, Arzu Kanik, Musa Dirlik
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Abstract

Objective: To compare a systemic transdermal therapeutic system with local application of glyceryl trinitrate ointment in the treatment of anal fissure.

Design: Prospective, multicentre, randomised trial.

Setting: Three teaching hospitals, Turkey.

Subjects: 89 outpatients with chronic anal fissure were randomly assigned to be treated with either transdermal (n = 52) or 0.2% glyceryl trinitrate ointment (n = 37).

Interventions: The patients were assessed at the sixth and the twelfth week after initial evaluation by physical examination, anoscopy, and anal manometry.

Main outcome measures: Changes in the maximal anal resting pressure, healing rate.

Results: Anal fissure was completely healed in 38 (73%) and 24 (64%) of the patients after 6 weeks and 48 (81%) and 27 (79%) of the patients in transdermal group and ointment group, respectively. Maximal anal resting pressure was reduced by 24% and 21% in transdermal and ointment groups, respectively.

Conclusion: Systemic transdermal application of glyceryl trinitrate gave a satisfactory healing rate, which was comparable to that of local application of ointment.

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一项比较全身经皮治疗和局部应用三硝酸甘油软膏治疗慢性肛裂的随机研究。
目的:比较全身经皮治疗与局部应用三硝酸甘油软膏治疗肛裂的疗效。设计:前瞻性、多中心、随机试验。环境:土耳其三所教学医院。研究对象:89例慢性肛裂门诊患者随机分为透皮治疗组(n = 52)和0.2%三硝酸甘油软膏组(n = 37)。干预措施:在初步评估后的第6周和第12周,通过体格检查、肛门镜检查和肛门测压对患者进行评估。主要观察指标:肛门最大静息压变化、治愈率。结果:6周后肛裂完全愈合38例(73%)、24例(64%),透皮组48例(81%)、软膏组27例(79%)。透皮组和软膏组最大静息肛压分别降低24%和21%。结论:全身经皮应用三硝酸甘油具有满意的治愈率,与局部应用软膏的治愈率相当。
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