Orthoplan to Screen the Optimum Scheme of Retention Enema in Treatment of Hepatic Encephalopathy with Rhubarb Decoction

Objective To screen the optimum scheme of retention enema with Rhubarb decoction for hepatic encephalopathy,to form the standard manipulation process,to strengthen the effect and its stability.Methods The subjects were those 54 cases of hepatic encephalopathy in grade Ⅲ. Four factors and three levels in the treatment including inserting depth (15cm,20cm,30cm),retention time (30min,60min,120min),decoction temperature (36℃,40℃,45℃),position after retention enema (left side-lying,supine,right side-lying) were scheduled in accordance with the L9 (34) orthogonal table. Patients were randomized into 9 groups. The optimum scheme was screened according to the average recovery time (hour) of patients.Results The orthoplan makes the optimum scheme screened out. The retention enema with Rhubarb decoction (vinegar processed Rhubarb 30g,Ebony 30g) for hepatic encephalopathy at the temperature 40℃,left side-lying position with the hips raised,gentle insertion of anal tube to a depth of over 30cm,slow injection of the decoction,pressing the hips to the anal direction after the tube removed to make the sphincter ani pressed for 5min,changing to the right side-lying position,and maintaining the decoction in the intestine for over 120min.Conclusion The optimum scheme was:retention time over 120min,insertion depth over 30cm,decoction temperature at 40℃,and right side-lying after retention enema. The retention time was the most important factor affecting the effect.