Mixed hemorrhoids occur on the same tooth line up and down, forming a unified mass of varicose veins.
1. Hematochezia and anal swelling, there may be anal swelling, foreign body sensation or pain.
2. May be accompanied by local secretions or itching.
3. There is a swelling in the same position above and below the tooth line (the epidermis may also be under the tooth line).
1. Anorectal prolapse, 2. Rectal cancer, 3. Low rectal polyps, 4. Anal papillary fibroids, 5. Anal condyloma acuminatum, 6. Inflammatory bowel disease
1. Required items: inspection, digital diagnosis, anoscope, etc.
2. Items for reference: anorectal pressure measurement, pathology, etc.
(1) Traditional Chinese Medicine:
1. Internal governance
If the syndrome is wind-injured intestinal collaterals, the treatment is to clear heat and cool blood, dispel wind and stop bleeding. Fang chooses Liangxue Dihuang Decoction or Huaijiao Pills.
If the card is damp-heat betting, the treatment is to clear heat and eliminate dampness. Fang chooses pain-relieving Rushen Tang, Zanglian Pill, or Sanmiao Pill and Huaijiao Pill.
If the syndrome is qi stagnation and blood stasis, the treatment is to promote qi, promote blood circulation and remove blood stasis, reduce swelling and stop bleeding. Fang chooses Honghua Taoren Decoction or Xuefu Zhuyu Decoction.
If the syndrome is spleen deficiency and qi depression, the treatment is to invigorate the spleen, invigorate the qi and raise the qi. Fang choose Huangtu Tang or Buzhong Yiqi Tang or Guipi Pills.
2. External treatment
(1) Fumigation and washing: fumigation and washing with Chinese medicine decoction for external hemorrhoids.
(2) Suppository medicine: hemorrhoid ointment or hemorrhoid embolization of the anus, 2 times a day.
(3) Medication: External hemorrhoids can be treated with general Xiaozhong San Tiaohuanglian ointment for external hemorrhoids, partial swelling, pain, and incarcerated hemorrhoids, and Kuzhisan can be used for external application when conditions permit.
(2) Western medicine:
Treatment principle: hemostasis, anti-inflammatory, eliminate prolapse. Its purpose is: 1. Control bleeding symptoms; 2. Eliminate inflammation, reduce or eliminate swelling and pain; eliminate symptoms of prolapse.
1. Medicine: Xiaotuozhi 4 tablets, 3 times a day.
When internal hemorrhoids are incarcerated, inflammatory external hemorrhoids, and thrombotic external hemorrhoids, sensitive antibiotics can be used orally, and sensitive antibiotics can be injected intramuscularly or intravenously if necessary.
2. Injection: The internal hemorrhoids of mixed hemorrhoids can be treated with "603 Xiaozhiye" injection, and "Xiaozhiling" hardened injection. Varicose external hemorrhoids can be treated with "603 Xiaozhiye" as "four-point injection of external muscle".
3. Surgical treatment: suitable for prolapsed internal hemorrhoids, large external hemorrhoids, frequent swelling and pain or obvious swelling and pain. Commonly used surgical procedures such as external stripping and internal ligation of mixed hemorrhoids.
4. Other treatments
The internal hemorrhoids of mixed hemorrhoids can be treated with anal expansion therapy, hemorrhoid treatment machine, microwave cauterization, and infrared coagulation therapy. These therapies are mainly used for patients with internal hemorrhoids in the first or second stage. Laser can be used for external hemorrhoid resection and PPH treatment of prolapsed third and fourth stage circular internal hemorrhoids.