Anorectal neurosis refers to a group of symptoms that occur due to autonomic dysfunction and anorectal nerve disorders. It is often caused by psychological and social factors. It can be manifested as a variety of symptoms, but no corresponding positive signs can be found during examination. The patient has clear consciousness, no behavior disorder, consciously discomfort and requires treatment, and the course of the disease is longer. From March to September 2008, the author has used Qinjiao tablets combined with Deanxit to treat 15 cases, and the effect is remarkable. The report is as follows.
1 Clinical data
The 15 cases in this group are outpatients, including 11 females and 4 males. The oldest is 75 years old, the youngest is 27 years old, and the average age is 52 years old. The shortest course is 15 days and the longest is 9 months. The chief complaint was anal and rectal pain and discomfort, 6 cases of irregular intermittent episodes with foreign body sensation, 5 cases of numbness with walking sensation of small insects and ants, 3 cases of discomfort of falling and sacral pain, uncleanness of the anus and unpleasant smell 2 cases. Patients are all accompanied by varying degrees of lack of energy, loss of appetite, fatigue, and insomnia.
2 Diagnosis basis
The patient reported serious anal symptoms, but no positive signs in anorectal examination. Suggestive therapy can reduce or eliminate symptoms. The main complaint can change with mood swings.
3.1 Gentiana tablets
This product is self-made by the First Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Its main ingredients include Gentiana, Atractylodes, Alisma, Fangfeng, Peach Kernel, Saponaria, Cork, Angelica, Betel Nut, Rhubarb, etc. The specification is 0.3g/tablet. 100 tablets/bottle.
Flupenthixol and Meritroxine Tablets This product is a compound preparation, and its ingredients are: each sugar-coated tablet contains flupentixol dihydrochloride equivalent to 0.5mg flupentixol and hydrochloric acid equivalent to 10mg melitroxine Meritrazine.
Gentiana tablets 3g orally, three times a day. Deanxit initial dose: 10.5mg in the morning and noon, 21mg in the morning for severe symptoms, and 10.5mg in the morning for elderly patients. The maintenance dose is 10.5 mg per day, orally in the morning. 30 days is a course of treatment.
4 Treatment results
14 of 15 patients were cured, 6 were cured with one course of treatment, 7 were cured with two courses, and 1 was cured with three courses. The above patients were followed up for 3 months without recurrence. One patient was lost during follow-up.
5 Examples of medical records
Li, female, 48 years old, came to the clinic on June 16, 2008. The chief complaint was anal numbness accompanied by small insects and ants, aggravated at night, accompanied by fatigue, anorexia, and insomnia. Self-use Diazepam, Mayinglong hemorrhoid ointment and other drugs, the above symptoms did not alleviate. Physical examination: The patient is sluggish, lack of gas, lazy speech, sad and crying, red tongue, yellow greasy coating, slippery pulse. Specialist examination: riding in a prone position, outside the anus is generally normal, no chapped perianal skin, no rash, no hypertrophy, no abnormal discharge. Digital examination: the middle and lower rectum did not reach a hard mass, and the dentinal line did not reach the hypertrophic anal papilla. Anoroscope: The middle and lower rectum mucosa is roughly normal, and the mucosa in the hemorrhoid area is slightly congested and raised. Diagnosed as anal neurosis. The treatment was given to Dianax 10.5 mg orally, once in the morning and once in the middle of the day; Gentiana tablets 3 g orally, three times a day; the treatment was cured after 1 course of treatment, and there was no recurrence after 3 months of follow-up.
This disease is more common in women and belongs to the category of "stagnation syndrome" in traditional Chinese medicine. Its causes are mainly injured by seven emotions, unsuccessful emotions, or liver injury caused by depression and anger, leading to stagnation of liver qi and become the disease. It involves the heart, spleen, and kidneys. Since the disease starts with the liver failure, the dysfunction of dredging, so stagnation of Qi is the first. Qi stagnation results in dampness, and damp stagnation produces phlegm, which results in stagnation of phlegm and qi. As stagnation of qi persists, the stagnation of qi and blood leads to stagnation of blood, which can then turn into fire, but all are based on stagnation of qi. For example, "Like Syndrome Treatment. Depression Syndrome" says: "The depression that arises within the seven emotions will hurt the qi at the beginning, and will eventually reach the blood, and eventually become labor." Therefore, the traditional Chinese medicine treatment of this disease is mostly by soothing the liver and regulating the qi, and smoothing the qi. Opportunity, pleasure and ease are the mainstay. The author believes that the etiology and pathogenesis are mostly emotional disorder, which causes liver qi to invade the spleen, spleen loss of health, dampness and phlegm, stagnation and heat, and damp-heat bets on the anus and rectum to cause the disease. Gentiana tablets have the effects of clearing heat and dampness, promoting qi and blood circulation, and can dispel dampness and heat, reduce swelling, and relieve the discomfort of anal swelling and pain.
Modern medicine believes that its onset is mostly affected by adverse factors, causing persistent mental stress, causing disorders of the excitation and inhibition process of the high-level central nervous system, and autonomic nervous system disorders. Deanxit is a compound preparation composed of two very effective compounds. Among them, flupentixol is a nerve blocker with anti-anxiety and anti-depressant effects in small doses, and Melitrazin is a two-way antidepressant It has excitatory properties when applied in low doses. The two-component compound preparation has antidepressant, anti-anxiety and excitement properties. Apply Deanxit to regulate the central nervous system to achieve the purpose of treatment. It can be seen that the combination of traditional Chinese and western medicine has a good effect in treating this disease, which is worth learning.