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Traditional Chinese medicine has a long history of preventing and treating colorectal diseases. The common treatment methods recorded in many medical books are nothing more than internal treatment and external treatment. The internal treatment method is based on the holistic concept of Chinese medicine for syndrome differentiation, which includes the methods of removing pus, holding toxins, promoting blood circulation and reducing swelling, which are obviously different from the treatment methods of traditional Chinese medicine. The external treatment methods include surgical therapy and the methods of eliminating, decocting, and removing drugs for external use. In clinical treatment, some patients can be cured by external therapy alone, but for most patients, external therapy and internal therapy must be used together to obtain the desired effect. In practice, according to the different pathogenic factors and the difference of the patient's physique, the eight-gang syndrome differentiation method is used to distinguish yin and yang, external and internal, deficiency and excess, cold and heat, and visceral meridians, and carefully understand the nature of the disease according to the progression of the disease, and then Formulate the rules of internal governance and external governance.
In clinical internal treatment, it is mostly applied to the initial anal diseases, such as internal hemorrhoids and external hemorrhoids inflammation
And elderly and infirm patients with other serious diseases (such as liver disease, kidney disease, heart disease, tumors, etc.), or anal fissure, perianal abscess, fistula inflammation period, including all patients at the initial stage of acute anal infection. The treatment rules are summarized into three principles: elimination, care, and supplementation, which can be flexibly grasped according to different conditions of the disease. For example, in the treatment of anorectal abscess, according to the three stages of onset, empyema, and ulceration, three methods of elimination, support and supplementation can be applied respectively.
Elimination method is to use dissipating drugs to dissipate the inflammatory diseases in the anorectal area at the initial stage, and avoid the pain of pus and surgical incision. This method is only suitable for diseases such as perianal carbuncle, inflammatory external hemorrhoids, thrombotic external hemorrhoids and anal fissure without purulent. The treatment method must be different from disease to disease. Comprehensive analysis sums up the treatment rules. For all unpurulent diseases, first adopt internal elimination. If internal elimination is not possible, it must be deep and shallow, so that the larger is smaller, and the heavier is changed to the lighter. . If the pus has been formed, the method of internal elimination cannot be applied, so as to avoid the risk of nourishing pus, the poison will not be collected, and the blood gas will be damaged, and the internal sepsis will turn from mild to severe and become a refractory disease.
Tuofa is a medicine that nourishes qi and blood, supports righteous qi, and prevents poison from leaking out, so as to prevent the poison from sinking. This method is applied to the ulceration of the purulent lesions around the anus, weak righteousness, excessive toxins, impure pus, flattened appearance of carbuncle, loose roots and feet, dark sores, difficult to ulcer and rot, carrion does not fall off, new A false proof that meat does not produce. If the poisonous qi is strong but the righteous qi is not weakened, pus-permeable drugs can be used to promote the excretion of pus, so that the swelling and pain are reduced, and the future troubles are avoided.
3 complementary method
Tonic method is to use tonic drugs to restore righteousness, regenerate the affected area, and make sores and fistulas heal as soon as possible. This method is suitable for elderly patients with weak Qi and blood in the late stage of the sore. For example, after the anorectal disease surgery, the heat toxin has gone, the lesion has been removed, and the spirit is exhausted, the complexion is pale, the tone is low, the pus is clear, the sore is difficult to gather, and the long-term blood in the stool and rectal prolapse, etc., all are weak For those with weakened spleen and stomach, the spleen and stomach should be strengthened; for those with insufficient liver and kidney, the liver and kidney should be nourished. But when the poisonous evil is not exhausted, do not use the tonic method as soon as possible, so as not to help the evil, so that the evil will be embedded and not healed for a long time.
The external treatment of colorectal and anal diseases is to use surgery, certain instruments, and drugs to directly act on the lesions on the body surface to achieve the purpose of curing the disease. Compared with internal treatment, external treatment is the main treatment method in colorectal diseases. Not only can this method be combined with internal treatment to improve the treatment effect and shorten the course of treatment, but also many external treatments for colorectal diseases can only be effective. Such as severe perianal carbuncle and complex anal fistula. The application of external treatment method must be the same as internal treatment method. Different treatment methods should be used according to the different development process and nature of the disease. It can be roughly summarized as: drug therapy, surgical methods, including washing method, embolization method , Enema, etc.
1 drug therapy
It is to use drugs to make different dosage forms, which are directly or indirectly applied to the affected area of the patient. Through the action of the drug, the drug reaches the diseased place, thereby achieving the purpose of treatment. In use, in view of the differences in the severity and nature of various diseases of the anus, the composition of the ointment used is also different.
The ligation method, also known as the "twisting method", has been widely used in the field of surgery very early. Modern medicine generally uses silk ligation. After ligation, the blood vessels in the affected area are blocked and the diseased tissue is gradually necrosis and fall off, so as to achieve the purpose of healing. Generally used for internal hemorrhoids, polyps, anal skin warts, etc.
3 washing method
The washing method is to use Chinese medicine to decoct the soup and fumigate and soak the affected part while it is hot. It is also known as "staining method" and "fumigation washing method". In ancient literature, it is divided into dipping, bathing, showering and wet bathing methods. It is widely used in the treatment of colorectal and anal diseases. For patients with internal and external hemorrhoids, abscesses, anal fistulas, and perianal skin diseases, the symptoms can be relieved by medication. For some initial patients, the use of traditional Chinese medicine can be cured. After abscess ulceration, inflammation and edema of internal and external hemorrhoids, perianal soft tissue cellulitis, and anal eczema, washing method can be used to clean the wound, so that toxins can be removed, and it is beneficial to the growth of granulation. Different prescriptions are selected according to different conditions. For example, Qudu Decoction has the effects of reducing swelling and pain, astringent and hemostasis, and is suitable for inflammation of hemorrhoids, anal incarceration, edema and anal cancer;
Ginseng has the functions of dispelling wind, moisturizing, killing insects and relieving itching, and is suitable for anal eczema and anal pruritus. Sit bath with salt, prickly nitrate, and pepper decoction can achieve the purpose of reducing swelling, pain, itching and convergence. The medicine can be decocted and put into the bidet for first fumigation and then washing.
The enema method is to decoct the medicine and put it into an enema or syringe, connect the anal tube or urinary catheter, apply liquid paraffin oil or glycerin lubricant, and then put it into the anus, and slowly inject the medicine into the rectum. Commonly used medicinal liquids such as Sanhuang Decoction, Chengqi Decoction, soapy water and physiological saline, etc., this method is mostly used to treat non-specific ulcerative colitis, atrophic proctitis, chronic proctitis, as well as preoperative bowel preparation and postoperative constipation Wait. There are many types of infusion drugs, and the quantity and frequency also depend on the condition. For patients with constipation, 200 ml of glycerin and Chengqi decoction are commonly used, and they can defecate after 10 to 15 minutes after being injected into the rectum. For proctitis, according to the condition, choose 50-200 ml of medicine decoction enema, 1 to 2 times a day, and retain the enema. It is used for preoperative bowel preparation, mostly in the morning of surgery, enema with soapy water or saline, 600 to 1,000 ml each time. Normally, normal saline is usually used for cleaning enema, 2 to 3 times, until the water is discharged to meet the requirements of the operation.
Embolization method is to make the medicine into suppository, put it into the patient's anus, make it dissolve and absorb by itself, and directly act on the wound of intestinal wall. It is generally used for internal hemorrhoids, anorectal diseases, anal fissure, anal fistula, abscess and other diseases. Commonly used suppositories include Puji Hemorrhoids Suppository, Kangtai Hemorrhoids Suppository, Indomethacin Suppository and so on. After the patient has a bowel movement, he should clean the anus. After taking a bath, gently push the round head of the drug plug into the anus toward the anus. Do not let it slip out. One capsule each time, 1-2 times a day. The purpose of using suppositories is to further reduce inflammation and build muscle and accelerate wound healing.