Abstract Purpose: To observe the efficacy of the combination of removing dampness and detoxification in the treatment of anal eczema. Methods: 136 cases of this disease were treated by oral administration of Huashijiedu Decoction (Smilax, Curcuma, Chuanxiong, Licorice). Result: The total effective rate is 98.5%. Prompt: This prescription has a significant effect in treating anal eczema, and has the effects of dispelling rheumatism and detoxification.
Subject Headings Eczema/Traditional Chinese Medicine Treatment Anal Diseases
Eczema is a reflection of skin inflammation with obvious exudation tendency caused by a variety of internal and external factors. The rash is diverse, and the chronic phase is limited with infiltration and hypertrophy, severe itching, and easy recurrence. The site of anal eczema is confined to the anus, and a few can involve the nearby skin and perineum, itching is unbearable, often humid, the skin is infiltrated and thick, and chapped may occur. From March 2005 to May 2007, the author used self-made Huashi Jiedu Decoction to treat 136 cases of anal eczema, and achieved satisfactory clinical effects. The clinical observation results are reported as follows.
Clinical data of 136 patients, all cases come from the outpatient department and ward of our hospital, including 64 males and 72 females; age 21-62 years old, with an average of 42.5 years; the shortest course of disease is 7 days, the longest is 11 years, and the average is 6.7 months There were 24 cases of acute eczema, 63 cases of subacute eczema, and 49 cases of chronic eczema.
The diagnostic criteria are drawn up with reference to the "Diagnosis and Efficacy Criteria for Diseases and Syndromes of Traditional Chinese Medicine" formulated by the State Administration of Traditional Chinese Medicine in 1994 . (1) Acute eczema: the onset is rapid and the course of the disease is short. At the beginning, the skin damages include erythema, papules, exudation, erosion, hydration, crusting, desquamation, etc., the symptoms are basically one, and sometimes they occur together; Slight itching, severe itching, severe itching, unbearable, intermittent or paroxysmal seizures, increased at night. (2) Subacute eczema: mostly prolonged from acute eczema, the condition is relatively slow; there are not many blisters, less exudate, erythema, papules, scales, crusts, erosions, etc. are still visible (3) Chronic eczema: often due to acute eczema It does not heal for a long time, or it is chronic at first. The skin on the anal margin is thickened and rough, with lichen-like changes, weakened or disappeared in elasticity; brown-red or gray-white in color, the boundary of the skin lesions is not clear, and itching is intense; it often recurs and persists.
Treatment method use Chushijiedu Decoction to treat with the symptoms. Prescription: Smilax glabra 30g, zedoary turmeric and chuanxiong 10g each, 6g licorice. For those with exudate, add 4g of Coptis and 12g of honeysuckle; for dry, add 10g of Digupi and 15g of comfrey. Decoction in water, 1 dose per day, 200ml in water, divided into morning and evening, and taken after meals. 7 days is a course of treatment.
Curative effect standard: Cure: all the rashes disappear, clinical symptoms disappear, and the skin returns to normal; significant effect: clinical symptoms and skin damage have been improved, and the rash has resolved more than 60%; effective: clinical symptoms and skin damage have been improved, and the rash has resolved more than 30%; Ineffective: Less than 30% of the rash subsided, no improvement in clinical symptoms.
Treatment results In this group of cases, 67 were cured, 35 were markedly effective, 32 were effective, and 2 were ineffective. The total effective rate was 98.5%. The average course of treatment for the above cases was 14 days.
Typical case Zhou, male, 34 years old. Seen a doctor on March 30, 2006. It has been nearly a year for anal pruritus and it has been intensified for a week. It has been treated with various methods and the effect is not good. Check: Body temperature: 39℃, pulse rate, yellow and greasy tongue coating. There are several erosions in the perineum and perianal area, the rash is in pieces, yellow scabs, ulcerated running water, and part of the yellow scabs are coagulated. Diagnosed as anal eczema. Symptoms are dampness and heat, injure the spleen and stomach, bet on the anus, overflow the skin. Cure to clear heat and detoxify, invigorate the spleen and ooze dampness. After 7 doses, 30g of Poria cocos, 10g of Zedoary Turmeric and Ligusticum chuanxiong, 6g of Licorice, 4g of Coptis, 12g of Honeysuckle were used. After 7 doses, the itch and rash disappeared, but there were pigmentation spots. Follow this prescription to continue treatment for two weeks and heal.
Discuss: Anal eczema belongs to the category of "soaking sores" and "rheumatic sores" in Chinese medicine. It is mostly caused by visceral dysfunction, internal dampness and heat, or feeling of exogenous pathogens, invigorating, blocking the circulation of qi and blood, and soaking the skin; it can also be caused by damp heat and camping blood, blood heat generating wind, and overflowing in the skin. According to the "Golden Jian Surgery Heart Techniques of the Medical School": "At first, it is like corn, but itching and painful, and it can grow everywhere. It is caused by dampness and heat of the spleen and stomach, external wind and pathogens, and fighting each other." Zhou skin itching, rash, hydration, erosion, swelling, pain and discomfort. If the condition persists, blood is consumed and body fluid is further consumed, the blood is prone to weathering and dryness, the skin loses its glory, and the skin is hypertrophic, rough, scaly or chapped. Modern medicine believes that this disease is a non-transmissive allergic disease, mostly due to local anal dirty, or drinking disorder, or suffering from anal fistula, hemorrhoids, anal fissure, anal sinusitis, enteritis and pinworm anorectal disease secretions Stimulation and other causes of this disease. As wind, damp-heat are the main causes of this disease, damp-heat and blood dryness are the main pathogenesis, the author used Smilax chinensis, turmeric, Chuanxiong, Coptis, Yinhua, Digu Bark, comfrey, and licorice as the main prescription.Tuckahoe, honeysuckle, and coptis in the recipe have the functions of clearing heat and detoxification, drying dampness and dispelling wind; zedoary turmeric and chuanxiong can invigorate blood and qi; Digu Bark and comfrey have the effects of cooling blood, activating blood, clearing heat and detoxifying, and licorice is used to harmonize the medicinal properties. The medicine is matched to achieve the effects of eliminating rheumatism and detoxification. Modern pharmacological studies have proved that Smilax glabra has no inhibitory effect on humoral immune response, but it can selectively inhibit cellular immune response. The latter mainly affects the inflammatory process after sensitized T lymphocytes release lymphokines. In addition, Smilax glabra has an effect on golden yellow grapes. Bacteria such as Coccus, Streptococcus hemolyticus, Pseudomonas aeruginosa, Escherichia coli, Typhoid bacillus, Shigella flexneri, Diphtheria bacillus, Bacillus anthracis have a certain inhibitory effect . Ligusticum chuanxiong can expand the coronary artery and peripheral blood vessels, shorten the length of thrombus, and reduce the wet and dry weight of thrombus . The curcumin components in Curcuma turmeric are mainly curcumin, demethoxy, base curcumin, and double demethoxy curcumin, which have anti-inflammatory and antibacterial effects . Coptis and honeysuckle have antibacterial, detoxification, antipyretic, anti-inflammatory and improve the body's defense function; comfrey and Digupi also have antibacterial effects. Therefore, the prescription has anti-inflammatory, antibacterial and anti-allergic effects. The clinical treatment of anal eczema is effective without toxic side effects. At the same time during treatment, patients should be warned to avoid mental stimulation and overwork, and avoid spicy stimulants, fish, shrimp and seafood.
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