2 English reference harmony [Chinese medicine terminology examination Committee. Terminology of Traditional Chinese Medicine (2004)]
External Harmony [2 1 Century English-Chinese-English Bidirectional Dictionary]
Waizhuang [2 1 Century English-Chinese-English Bidirectional Dictionary]
3 Overview External hemorrhoid (1) is the name of the disease [2]. From Volume 23 of Emergency Preparedness. Refers to hemorrhoids born below the anal canal tooth line, with foreign body sensation or swelling and pain as the main performance [3]. Including connective tissue external hemorrhoids (cockscomb hemorrhoids, coral hemorrhoids), varicose external hemorrhoids (gas hemorrhoids), thrombotic external hemorrhoids (grape hemorrhoids) [3]. Its clinical features are bloating, pain and foreign body sensation.
4 Etiology and pathogenesis of external hemorrhoids * * * laceration, invasion of pathogenic toxin, or excessive exertion of defecation and childbirth, which leads to stagnation of qi and blood, coupled with invasion of external pathogens, the skin will proliferate and form redundant skin.
5 The symptoms of external hemorrhoids are generally painless, mostly bleeding, local swelling, swelling, over time skin flap overgrowth, foreign body sensation in the * * * part, and obvious pain in inflammation [2].
6 Classification of external hemorrhoids External hemorrhoids can be divided into four types: thrombotic external hemorrhoids, redundant external hemorrhoids, varicose external hemorrhoids and inflammatory external hemorrhoids [2].
6. 1 Varicose external hemorrhoids (gas hemorrhoids) Varicose external hemorrhoids refer to round or oval tumors formed by blood stasis in the external venous plexus.
Varicose anal canal under dental floss for varicose external hemorrhoids is soft to the touch, purple-black, and the tumor is oval. When the abdominal pressure is increased, the tumor can be slightly enlarged and hardened, and the tumor can be small and soft locally.
6. 1. 1 Etiology and pathogenesis of varicose external hemorrhoids Most varicose external hemorrhoids are caused by the repeated prolapse of internal hemorrhoids in stage II and III, or the long journey and heavy load after childbirth, which leads to the lateral disintegration of the tendons and veins and the stagnation of qi and blood.
6. 1.2 The diagnosis of varicose external hemorrhoids occurred in the anal canal below the tooth line, and there were oval or long tumors in some areas, which were soft to the touch. When defecating or traveling with heavy load, the tumor is enlarged and purple-black, which is difficult to press. Generally, there will be foreign body sensation, and it can be swollen and painful when poisoned.
6. 1.3 Diseases that need to be differentiated from varicose external hemorrhoids 6. 1.3. 1 Thrombotic external hemorrhoids are mostly born in * * *, with sudden swelling and severe pain, like grapes, blue in color and difficult to press (2-3 days later).
6. 1.3.2 connective tissue external hemorrhoid vegetation gradually increased, and the skin flap did not change significantly when defecating or walking with load.
6.2 Thrombotic external hemorrhoid (grape hemorrhoid) Thrombotic external hemorrhoid is caused by the rupture of external hemorrhoid vein, extravasation of blood, stagnation under the skin and solidification into pieces. It is characterized by sudden and severe pain at the edge of * *, and a dark purple lump appears. Thrombotic external hemorrhoids mostly occur on the left and right sides of * * *. First, varicose external hemorrhoids suddenly swell up, like grapes, starting with dark red, gradually turning into blue-purple, hard, slippery and painful.
6.2. 1 The etiology and pathogenesis of thrombotic external hemorrhoid is blood heat, or venous external hemorrhoid, which causes external hemorrhoid vein rupture, blood extravasation, subcutaneous stagnation and coagulation.
6.2.2 The diagnosis of thrombotic external hemorrhoids generally occurs in summer, mostly at 3 o'clock or 9 o'clock in the anal margin lithotomy position. At the onset, there was sudden and severe pain in the * * * part, and a dark purple lump was visible under the anal margin, with obvious tenderness and clear boundary. After 3-5 days, the pain will be relieved, and sometimes small blood clots can be absorbed by themselves.
6.2.3 Diseases that need to be differentiated from thrombotic external hemorrhoids: internal hemorrhoid incarceration, internal hemorrhoid incarceration on the tooth line, large lump, even 3-5 around anus, and the pain is getting worse gradually. After a long time, it will be eroded and necrotic, exuding nourishing water and restless.
6.3 Connective external hemorrhoid (comb hemorrhoid, coral hemorrhoid) Connective external hemorrhoid refers to connective tissue hyperplasia and hypertrophy of skin (folds) around * * *. Include sentinel hemorrhoid and external hemorrhoid. Its main clinical manifestation is * * * foreign body sensation.
7 diagnosis of external hemorrhoids * * * There is skin on the edge, which gradually increases and the texture is soft. Generally no pain, no bleeding. It only feels * * * foreign body sensation, and only when it is poisoned and swollen will it feel pain. External hemorrhoids at lithotomy position 6, 12 are often caused by anal fissure. External hemorrhoids occur at 3, 7, 1 1 point, and most of them are accompanied by internal hemorrhoids.
8 treatment of external hemorrhoids 8. 1 internal treatment External hemorrhoids generally do not need internal treatment. When there is toxic swelling and pain in external hemorrhoid infection, you can use heat-clearing and dampness-removing methods to relieve pain, such as Shentang or Wushen Decoction.
External hemorrhoids can be divided into syndrome types such as qi stagnation and blood stasis, damp-heat down, spleen deficiency and qi stagnation.
8. 1. 1 Qi stagnation and blood stasis type external hemorrhoid refers to qi stagnation and blood stasis, with a lump protruding from the edge of the anus, which can increase when defecating, and may cause swelling or falling pain, foreign body sensation, local hard nodules, dark purple tongue, yellowish tongue coating and unsmooth pulse.
8. 1.2 External hemorrhoid with downward flow of damp heat refers to external hemorrhoid with swollen anal margin, burning pain or watery stool, red tongue, yellow greasy tongue coating and slippery pulse as common symptoms [3].
8. 1.3 external hemorrhoids with spleen deficiency? Deficiency and qi stagnation), spleen deficiency and qi stagnation, manifested as swelling of anal margin, * * * swelling, feeling like defecation, fatigue, loss of appetite, thin stool, light and fat tongue, thin and white tongue coating and weak pulse are common symptoms of external hemorrhoids [3].
8.2 External treatment of external hemorrhoids is mainly external treatment, and fumigation, acupuncture, ligation, hemorrhoid picking and surgery can be selected [2]. If it is red, swollen and painful, it can be combined with oral medicine for clearing away heat and toxic materials, removing blood stasis and relieving pain [2].
(a) can be washed with Sophora Flavescentis decoction to prevent infection.
(2) External hemorrhoid ointment or coptis ointment should be used when external hemorrhoid is swollen and painful.
8.3 Other therapies External hemorrhoids can be surgically removed when they are large and often swollen and painful. The specific method is to make a radial spindle incision to remove external hemorrhoids under local anesthesia, and pay attention to protecting the skin of anal canal as much as possible.
8.4 Treatment of varicose external hemorrhoids (gas hemorrhoids) 8.4. 1 Treatment of varicose external hemorrhoids based on syndrome differentiation generally does not require internal treatment. If it is poisoning, it can be treated according to the following syndromes.
8.4. 1. 1 External hemorrhoid with downward flow of damp-heat refers to external hemorrhoid with swollen anal margin, burning pain or watery stool, red tongue, yellow greasy tongue coating and slippery pulse as common symptoms.
8.4. 1. 1. 1 Symptoms: the tumor at the anal margin is swollen, painful and even oozes nourishing water; Red tongue, yellow greasy fur and slippery pulse.
8.4. 1. 1.2 Dialectical analysis: When the weight is remote, the stool fails, the meridians cross and the qi and blood stagnate, the tumor will swell; Damp-heat toxin infection will aggravate qi stagnation and blood stasis, which will cause swelling and pain; Damp heat causes infiltration and nourishes water; Red tongue, yellow greasy fur and slippery pulse are obvious signs of heat invasion.
8.4. 1. 1.3 treatment: clearing heat and promoting diuresis, regulating qi and promoting blood circulation.
8.4. 1. 1.4 Prescription treatment of Wushen decoction and Huoxue Sanyu decoction.
8.4.2 When the swelling is obvious after external treatment, first fumigate and wash with Radix Sophorae Flavescentis decoction, and then externally apply Xiaozhi ointment or Huanglian ointment.
8.4.3 Other therapies and surgical treatments should be completely cured, and external hemorrhoid vein stripping should be performed simultaneously.
8.4.3. 1 indications: simple varicose external hemorrhoids and mixed external hemorrhoids.
8.4.3.2's operation method is to take the lithotomy position or lateral position, use 19Lo bromogeramine to perform local anesthesia or Shu Yao anesthesia, lift the top of the external hemorrhoid with tissue forceps, make a radial spindle-shaped incision around the external hemorrhoid with scissors, then separate the subcutaneous varicose veins and take out the skin together with the subcutaneous tissue. After operation, vaseline gauze or Xiaozhi ointment or Huanglian ointment gauze was used to compress the wound. Take a sitz bath with mirabilite solution every day and apply Xiaozhi ointment to the wound until it is healed.
8.5 Treatment of Thrombotic External Hemorrhoids (Grape Hemorrhoids) 8.5. 1 Syndrome Differentiation and Treatment 8.5. 1. 1 External Hemorrhoids with Qi Stagnation and Blood Stasis refer to Qi Stagnation and Blood Stasis. Blood stasis, manifested as swelling or falling pain, foreign body sensation, local hard nodules, dark purple tongue, yellow tongue coating and astringent pulse, are common symptoms of external hemorrhoids [3].
8.5. 1. 1. 1 Symptoms: the tumor on the anal margin is prominent, with severe pain, round and purplish red anal margin, hard texture and obvious tenderness; Dry mouth and thirst, constipation; Red tongue, yellow fur and thready pulse.
8.5. 1. 1.2 Dialectical analysis shows that blood heat, it is difficult to move or carry a load when defecating, blood and blood are stagnant, blood heat is rushing wildly, and pulse is broken. When the blood overflows the pulse, the tumor on the anal margin is seen under the skin, and the color is purple and dark; When blood is hot, you are thirsty; If the blood is hot and dry, constipation will occur; Red tongue with yellow coating dominates heat, and pulse string dominates pain.
8.5. 1. 1.3 Treatment of clearing away heat and cooling blood, reducing swelling and relieving pain.
8.5. 1. 1.4 Liangxue decoction and Dihuang decoction.
8.5.2 External treatment: first fumigate and wash with Sophora Flavescentis decoction, and then apply hemorrhoid ointment, 1 time, daily 1 time.
8.5.3 Other therapies: remove the thrombus by surgery if necessary.
8.5.3. 1 Indications for external hemorrhoids Patients with large thrombotic external hemorrhoids cannot absorb it within 3 days.
8.5.3.2's operation method: Take the patient to the lateral position, after routine disinfection and local anesthesia, make a radial incision in the center of the mass, separate the bleeding mass with hemostatic forceps, trim the excess skin, and then compress the wound with Huanglian ointment gauze, changing the dressing/kloc-0 times a day until it heals.
9 About hemorrhoids (hemorrhoids [1]) is the name of the disease [4]. Also known as hemorrhoids, hemorrhoids [5]. "Huangdi Neijing Su Jingwen Qi Tian Tong Lun": "Make the foot, tendons and veins transverse, and intestinal addiction is hemorrhoids." . Refers to internal hemorrhoids, external hemorrhoids and mixed hemorrhoids [1]. That is, the soft venous plexus [4] formed by the expansion of rectal terminal and subcutaneous anal submucosa and varicose veins, or the connective tissue [3] formed by thrombosis and proliferation under anus. Men, women and children will be affected. Therefore, there is a saying that "ten people have nine hemorrhoids", among which young people account for the majority. Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the different parts of the disease.
Chinese medicine has long known about hemorrhoids. The ancients said that "hemorrhoids are the origin of hemorrhoids". In ancient times, hemorrhoids meant protrusion. People with small flesh protruding from the nine orifices are called hemorrhoids, and they are not born on the side of * * * *, such as nasal hemorrhoids, eye hemorrhoids and tooth hemorrhoids. But now hemorrhoids refer to hemorrhoids.
See hemorrhoid strip for details.
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