2020年12月22日星期二

what does a hemorrhoids look like,Blood in the stool

    [concept]

    According to clinical findings, blood in the stool is called blood in the stool regardless of whether it is blood in the stool, blood in the stool after blood, or blood in the stool, or simple blood in the stool.

    Blood in the stool has a different name in the medical literature of the past. "Lingshu. "Hundred Diseases Beginning" is called "Later Blood"; "Su Wen. "Yin and Yang" called "Blood in the stool"; "Treatise on Febrile Diseases" called "Blood"; "Synopsis of the Golden Chamber" called "Xia Xue", and according to the difference between the order of blood and defecation, "distant blood" and "near blood" were proposed Name. Later "Introduction to Medicine" is also known as "blood arrow", "because of its blood in the stool, it will be as powerful as an arrow shot." "Shou Shi Bao Yuan" will blood in the stool, the blood before the stool, the blood is like Those who are splashed, bloody and fresh are called "intestinal wind." "Introduction to Medicine" and "Blood Syndrome" etc. will have blood in the stool, turbid and unclear, dull, and anal swelling and pain, called "dirty poison" ".

    This syndrome should be differentiated from dysentery with pus and blood. The syndrome of dysentery with pus and blood is mostly mixed with pus and blood, with prominent abdominal pain, tenesmus and other manifestations. This disease is manifested by blood falling during stool without pus. And there is no prominent abdominal pain and tenesmus.

    Blood in the stool is often a common symptom of many anal diseases. Blood in the stool caused by diseases such as anal fissure, hemorrhoids, anal leak, and anal carbuncle are not discussed within the scope of this article.

    [Identification]

    Common syndromes

    Intestinal bleeding caused by wind and fire: blood in the stool, dry lips, cold thirst, swollen gums, bitter mouth and bad breath, sores on the mouth and tongue, constipation, burning anus, red tongue, yellow coating, strong pulse Etc.

    Damp-heat in the large intestine contains poisonous blood in the stool: blood in the stool, yellowing of the face, dry and bitter mouth, unwilling to eat, chest tightness, nausea and vomiting, eating less, abdominal distension, uncomfortable stool, foul smell, or anal swelling and pain , Short red urine, or turbidity, yellow and greasy tongue coating, slippery pulse and other symptoms.

    Liver and kidney yin deficiency and blood in the stool: blood in the stool, symptom and dizziness, red and red cheeks, five upset and hot, restless sleep sound at night, bone steaming and night sweats, loss of sperm in dreams, backache and limb fatigue, body weight loss, red tongue, pulse condition Count down.

    Spleen and kidney Yang deficiency and blood in the stool: blood in the stool, dull pain in the abdominal abdomen, dull complexion, tired limbs, lazy speech, loose stools, even chills, cold limbs, long urine, pale tongue, thin and weak pulse.

    Discriminant analysis

    Wind and fire forced large intestine blood in the stool and large intestine damp-heat accumulation of poisonous blood in the stool: both of them belong to heat syndrome, empirical evidence, and are easily confused. Wind and fire force the large intestine to have blood in the stool, usually due to wind evil invading the Yangming meridian, which is depressed to reduce heat, or because the liver meridian wind and wood evil is multiplied in the intestines and stomach, the wind and fire are forced, the yin collateral is injured, the blood is not hidden, and blood in the stool occurs. . This is why the "Zhongzang Wind" says: "The heat of the large intestine is extremely hot and the stool will be bloody, and the large intestine will be blood in the wind." This type of blood in the stool generally belongs to the so-called "intestinal wind" in later generations. Therefore, clinical symptoms often include thirst and cold, swollen gums, bitter mouth and bad breath, dry stool, yellow moss and pulses, and it is due to wind and fire. The disease occurs randomly, and the course of the disease is short. Therefore, it is characterized by blood in the stool, blood before the stool, blood spattering, clear and fresh, and even pure blood. The method of treatment is always to cool the blood to relieve heat, and to relieve wind and calm blood. Huaihua powder is a commonly used prescription. If the symptoms of the liver meridian wind-heat are both incited (such as fullness of the flanks, irritability, pulse number, etc.), the treatment is to clear the liver and calm the blood, and use Huangqin Decoction plus Bupleurum, Danpi, etc.; if you also see Yang For those who are violent with heat and toxins and urge blood to go wrong (the lower blood is thick, the mouth is dry, the lips are burnt, the tongue is red, the coating is yellow, the pulse is strong, etc.), the treatment can be used to cool the blood to relieve the fire.

    Damp-heat in the large intestine accumulates poison and blood in the stool, mostly caused by drinking and eating pungent, overeating fat and sweet, dampness from endogenous, or due to prolonged lying on the wet ground, repeated exposure to fog and dew, dampness from the outside, will cause dampness to accumulate in the body. Heat accumulates poison, burns the yin collaterals, thirst for qi and blood, and causes blood in the stool. According to clinical findings, this type of blood in the stool is mostly classified as "dirty poison", because it has accumulated poison for a long time, so the blood is purple and black and dirty, and it is not as dark as black bean juice, and it is even in pieces. Heat and dampness are blocked, so clinical symptoms such as fullness of chest and stomach, nausea and low food, abdominal distension, and slippery pulse are often seen. Damp heat stays away, accumulates toxins, and causes anal swelling and pain. The main treatment is to detoxify damp-heat, Heying and detoxification, and use red bean Angelica powder and Diyu San to clear away heat and dampness, and Heying to stop bleeding; if the blood is very dirty, Huanglian Decoction can be used to detoxify.

    Liver and kidney yin deficiency, blood in the stool and spleen and kidney yang deficiency: both are deficiency syndromes, and have the characteristics of frequent labor. However, liver and kidney yin deficiency has blood in the stool, usually due to chronic illness, internal consumption of yin, or drunk and full housework, loss of kidney yin, or melancholy, depression, anger, five senses of fire, loss of yin and blood and other factors, resulting in liver and kidney yin Blood loss, water loss and fire prosperous, disturbing the yin collaterals and causing blood in the stool, the syndrome is deficiency-heat, which is different from the deficiency-cold syndrome of spleen and kidney deficiency. In clinical cases, it is common to have blood in the stool after the stool, the blood is dark red, dripping, the blood volume is not much, and after the blood in the stool, the physical fatigue is difficult to support, and the mouth is dry and the throat is dry, upset and hot, insomnia, dreams, etc. Yin deficiency and fire, etc. which performed. Treatment should focus on nourishing yin and lowering fire, nourishing and relieving blood. The commonly used prescription is Sanjia Fumai Decoction. For those who are upset and sleepless, use Huanglian Ejiao Decoction.Deficiency of spleen and kidney yang and blood in the stool are mostly caused by factors such as yang deficiency of the body, excessive fatigue, and no more serious illness, which damage the spleen and stomach yang. Loss of spleen qi will lose the power of control, lack of kidney qi will lose the essence of sealing, blood overflow in the yin and collaterals, and blood in the stool. This type of blood in the stool is more common in the "distant blood", which is bloody after the bowel movement, and is thin in quality and dim in color. Or as dark as tar. This syndrome is also often seen in the pathological changes in which the yin damages the yang and the yang deficiency cannot absorb the yin. Therefore, clinical symptoms are often seen as pale and dull, short breath, lazy speech, cold limbs, dull abdominal pain, loose stools, weak tongue and slight pulse. Treatment should focus on strengthening the spleen, warming the kidney, replenishing qi and ingesting blood, using Huangtu Decoction; if the qi sinks over time and the anus falls off, you can use the Buzhong Yiqi Decoction; Hemostasis, to slip off.

    In short, to identify a syndrome of blood in the stool, in addition to examining its etiology, pathogenesis, and main concurrent symptoms, special attention should be paid to the characteristics of the main symptoms (such as the distance, color, texture, etc.) of the blood in the stool. Sex, the establishment of governance, etc. are crucial. "Zhengzhihuibu" said: "Pure blood is pure, the wind is also. The color is like smoke and dust, and it is wet. The dark color is also cold. The red color is also hot." The bloody color is fresh and thick for the actual heat. An injection ‥...‥The light color is the deficiency and coldness of the spleen and stomach. Therefore, where the blood is first and then the stool, the blood is fresh and the "near blood", the disease is in the wide intestine and anus, mostly due to wind, fire, dampness and heat. , It belongs to heat, and the disease is mild and shallow, so the treatment should be mainly to eliminate evil. The disease is in the small intestine and stomach, and the disease is in the small intestine and stomach. As a result, the condition is serious and the deficiency syndrome is mostly, so the treatment should be based on strengthening the body. For another example, if the blood is splashed and the color is clear, it is caused by external wind entering the guest, or internal wind under the large intestine; if the blood is dirty, the anus is swollen, hard and painful, it is dampening. Poison is a "dirty poison" disease caused by pressing the large intestine and anus and damaging the collaterals.

    [Documentation]

    "Jing Yue Quanshu. "Miscellaneous Syndrome Mo": "Patients who condense blood in the stool with the evil of wind and cold are caused by the yin. This is not comparable to typhoid. It is covered in the five internal organs and is not removed. It is called yin. If the yin is not an outsider, the disease belongs to the yin. Therefore, it is blood in the stool. According to the classics, the blood in the stool is one liter, then two liters, and three liters. This is what it means. This is suitable for external moxibustion of Zhongwan, Qihai, and Sanli to dissipate wind evil, and to calm the stomach inside. Yutang Wen San is the main agent."

    "Blood Syndrome. "Blood in stool": "According to this card, it is no different from a woman's uterine bleeding, ... the same is the blood from the menstruation, which leaks out, so the condition is similar. But the orifices that come out are different, and the uterine bleeding is the anterior yin. Therefore, the liver is used to treat the blood chamber. The blood in the stool flows out of the back yin, so the lungs and kidneys are used to consolidate the intestinal qi. The kidneys control the lower Jiao and the rise of Qi, while the kidney feet do not sink. The intestinal qi is self-consolidating. Doctors can understand this principle and use the method of female collapse to treat it as much as possible."

    Quoted from "Differential Diagnosis of TCM Symptoms".

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