Contents 1 Pinyin 2 English reference 3 Overview 4 Causes and pathogenesis of external hemorrhoids 5 Symptoms of external hemorrhoids 6 Classification of external hemorrhoids 6.1 Varicose external hemorrhoids (gas hemorrhoids) 6.1.1 Causes and pathogenesis of varicose external hemorrhoids 6.1 .2 Diagnosis of varicose external hemorrhoids 6.1.3 Diseases that need to be differentiated from varicose external hemorrhoids 6.1.3.1 Thrombotic external hemorrhoids 6.1.3.2 Connective tissue external hemorrhoids 6.2 Thrombotic external hemorrhoids (grape hemorrhoids) 6.2.1 Causes of thrombotic external hemorrhoids Pathogenesis 6.2.2 Diagnosis of thrombotic external hemorrhoids 6.2.3 Diseases that need to be differentiated from thrombotic external hemorrhoids 6.3 Connective tissue external hemorrhoids (cockscomb hemorrhoids, coral hemorrhoids) 7 Diagnosis of external hemorrhoids 8 Treatment of external hemorrhoids 8.1 Internal treatment 8.1.1 Qi Blood stasis 8.1.2 Damp-heat injection 8.1.3 Spleen deficiency and qi depression 8.2 External treatment methods 8.3 Other therapies 8.4 Treatment of varicose external hemorrhoids (qi hemorrhoids) 8.4.1 Syndrome differentiation treatment 8.4.1.1 Damp-heat injection 8.4.1.1.1 Symptoms 8.4.1.1.2 Syndrome analysis 8.4.1.1.3 Treatment method 8.4.1.1.4 Prescription treatment 8.4.2 External treatment method 8.4.3 Other treatments 8.4.3.1 Indications of external hemorrhoids 8.4.3.2 Operation method 8.5 Thrombotic external hemorrhoids (grape) Treatment of hemorrhoids 8.5.1 Syndrome differentiation treatment 8.5.1.1 Blood heat and blood stasis 8.5.1.1.1 Symptoms 8.5.1.1.2 Syndrome differentiation analysis 8.5.1.1.3 Treatment method 8.5.1.1.4 Prescription treatment 8.5.2 External treatment method 8.5 .3 Other therapies 8.5.3.1 Indications for external hemorrhoids 8.5.3.2 Operation methods 9 About hemorrhoids 10 References attached: 1 Acupoints for treating external hemorrhoids 2 Prescriptions for treating external hemorrhoids 3 Chinese patent medicines for treating external hemorrhoids 4 Drugs related to external hemorrhoids 5 External hemorrhoids in ancient books 1 Pinyin
wài zhì 2 English reference
external hemorrhoid [Traditional Chinese Medicine Terminology Approval Committee. Traditional Chinese Medicine Terminology (2004)]
external hemorrhoids [21st Century English-Chinese-Chinese] English-Chinese Dictionary]
external piles [21st Century English-Chinese Chinese-English Dictionary]
3 Overview
External hemorrhoids (external hemorrhoid[1]) is the name of the disease[2 ]. Volume 23 of "Essential Prescriptions for Emergencies" was published. It refers to hemorrhoids that are born below the tooth line of the anal canal and are mainly characterized by foreign body sensation or swelling and pain [3]. Including connective tissue external hemorrhoids (cockscomb hemorrhoids, coral hemorrhoids), varicose external hemorrhoids (air hemorrhoids) and thrombotic external hemorrhoids (grape hemorrhoids) [3]. Its clinical characteristics are swelling, pain, and foreign body sensation. 4 The etiology and pathogenesis of external hemorrhoids
*** Laceration, external invasion of evil poisons, or hard work in defecation or childbirth, resulting in qi and blood stasis, coupled with the invasion of external evils, which persists for a long time, then Skin hyperplasia forms tags.
5 Symptoms of external hemorrhoids
Generally there is no pain, mostly no bleeding, local swollen nuclei and protrusions, skin flaps growing over time, foreign body sensation in the vagina, and obvious pain during inflammation [2]. 6 Classification of external hemorrhoids
External hemorrhoids are divided into four types: thrombotic external hemorrhoids, epidermal 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 venous plexus outside the hemorrhoids, expanding the varicose veins, and forming a mass.
Varicose external hemorrhoids are varicose veins in the anal canal below the teeth line. They are soft to touch, dark purple in color, and the tumor is oval. When the abdominal pressure increases, the tumor may slightly enlarge and harden, and may become localized. The tumor becomes smaller and softer during ***. 6.1.1 The etiology and pathogenesis of varicose external hemorrhoids
Varicose external hemorrhoids are often caused by repeated prolapse of hemorrhoids in stages II and III, or multipartum, heavy weight-bearing and long-distance travel, resulting in transverse tendons and qi and blood stasis. Become. 6.1.2 Diagnosis of varicose external hemorrhoids
Occurring in the anal canal below the dental line, there is a local oval or elongated tumor that is soft to touch and increases in size during defecation or weight-bearing. , and are dark purple in color, hard to press, and usually have a foreign body sensation. They may become swollen and painful when exposed to poison. 6.1.3 Diseases that need to be differentiated from varicose external hemorrhoids 6.1.3.1 Thrombotic external hemorrhoids
Thrombotic external hemorrhoids mostly occur on the left and right sides of the vagina, swell suddenly, cause severe pain, and are shaped like grapes , the color is blue and purple, and it is hard to press (2-3 days later). 6.1.3.2 Connective tissue external hemorrhoids
The skin tags of connective tissue external hemorrhoids gradually increase in size and become soft when pressed. There is no obvious change in the skin during defecation or weight-bearing for long distances. 6.2 Thrombotic external hemorrhoids (grape hemorrhoids)
Thrombotic external hemorrhoids are caused by the rupture of the external hemorrhoidal veins, blood overflowing outside the veins, blood stasis under the skin, and coagulation into clots. It is characterized by sudden, severe pain at the edge of the penis and a dark purple lump. Thrombotic external hemorrhoids mostly occur on the left and right sides of the penis. First there are varicose external hemorrhoids, which swell suddenly and look like grapes. They appear dark red at first and gradually turn blue and purple. They are hard and smooth when pressed, and the pain is severe. 6.2.1 The etiology and pathogenesis of thrombotic external hemorrhoids
There is blood heat in the internal hemorrhoids, or there are venous external hemorrhoids. In addition, straining during defecation or weight-bearing for long distances may lead to rupture of the external hemorrhoidal veins and hemorrhagic bleeding. Outside the pulse, blood stasis occurs under the skin, condensing into lumps. 6.2.2 Diagnosis of thrombosed external hemorrhoids
It usually occurs in summer, mostly at the anal verge lithotomy position at 3 and 9 o'clock. At onset, there is sudden and severe pain in the vagina, and purple spots can be seen under the anal verge. It is a dark round mass with obvious tenderness and clear boundaries. The pain will be relieved after 3-5 days, and sometimes small blood clots can be absorbed by themselves. 6.2.3 Diseases that need to be differentiated from thrombotic external hemorrhoids
Internal hemorrhoids are incarcerated, internal hemorrhoids are prolapsed and incarcerated on the dental line, the mass is large, and even 3-5 around the anus, the pain gradually increases, and over time Erosion and necrosis, seepage and water accumulation, and restlessness. 6.3 Connective tissue external hemorrhoids (cockscomb hemorrhoids, coral hemorrhoids)
Connective tissue external hemorrhoids refer to the hyperplasia and hypertrophy of connective tissue in the skin (folds) of the vagina. Including sentinel hemorrhoids and external hemorrhoids. Its main clinical manifestation is *** foreign body sensation. 7 Diagnosis of external hemorrhoids
*** Skin tags on the edges gradually enlarge, soft texture, generally painless, no bleeding, only *** foreign body sensation, pain only when swelling due to poisoning. External hemorrhoids occurring at 6 and 12 o'clock of the lithotomy position are often caused by anal fissure. External hemorrhoids that occur at 3, 7, and 11 o'clock are often accompanied by internal hemorrhoids. 8 Treatment of external hemorrhoids 8.1 Internal treatment
External hemorrhoids generally do not require internal treatment. When external hemorrhoids are poisonous, swollen and painful, methods of clearing away heat and diluting dampness can be used, followed by pain relief such as Shen Tang or Wu Shen Tang.
External hemorrhoids can be divided into syndrome types such as qi stagnation and blood stasis, damp-heat depression, spleen deficiency and qi depression.
8.1.1 Qi stagnation and blood stasis
External hemorrhoids with pattern of qi stagnation and blood stasis refers to qi stagnation and blood stasis, with protruding masses at the anal margin, which may increase during defecation. Symptoms of common external hemorrhoids include large, distended or falling pain, foreign body sensation, local palpable hard nodules, dark purple tongue, yellowish tongue coating, stringy and astringent pulse [3]. 8.1.2 Dampness and heat diffusing downward
External hemorrhoids with pattern of dampnessheat diffusing downward refers to the symptoms of dampness and heat diffusing downward, with swelling at the anal verge, burning pain or hydration, and dry stools. Or loose water, red tongue, yellow and greasy tongue coating, slippery and rapid pulse are common symptoms of external hemorrhoids [3]. 8.1.3 Spleen deficiency and qi sinking
External hemorrhoids with pattern of spleen ?deficiency and qi sinking (external hemorrhoids with pattern of spleen ?deficiency and qi sinking), spleen deficiency and qi sinking, manifested by bulging masses at the anal margin, and swollen and swollen vaginal hemorrhoids. Symptoms of external hemorrhoids include the urge to defecate, fatigue, poor appetite and loose stools, pale and fat tongue, thin and white tongue coating, and thready and weak pulse [3]. 8.2 External treatment methods
External treatment methods for external hemorrhoids mainly include fumigation, acupuncture, ligation, hemorrhoid picking, surgery, etc. [2]. If there is redness, swelling and pain, it can still be combined with oral administration of heat-clearing, detoxifying, blood-stasis-removing and pain-relieving drugs [2].
(1) It can be washed with Sophora flavescens decoction to prevent infection.
(2) When external hemorrhoids are swollen and painful, apply hemorrhoid ointment or coptis ointment externally. 8.3 Other treatments
External hemorrhoids can be surgically removed if they are large and frequently swollen and painful. The specific method is to make a radial fusiform incision to remove external hemorrhoids under local anesthesia, paying attention to protecting the anal canal skin as much as possible. 8.4 Treatment of varicose external hemorrhoids (gas hemorrhoids) 8.4.1 Syndrome differentiation treatment
Varicose external hemorrhoids generally do not require internal treatment. If they are poisoned, they can be treated according to the following syndrome types. 8.4.1.1 Damp-heat diffusing downward
External hemorrhoids with pattern of dampnessheat diffusing downward refers to the symptoms of damp-heat diffusing downward, with swelling at the anal verge, burning pain or water retention, and dry stools. Or loose water, red tongue, yellow and greasy tongue coating, slippery and rapid pulse are common symptoms of external hemorrhoids [3]. 8.4.1.1.1 Symptoms
The swelling at the anal edge is bulging, painful, or even oozing with water; red tongue, yellow and greasy coating, slippery and rapid pulse. 8.4.1.1.2 Syndrome analysis
If you travel long distances with heavy weight, struggle to defecate, transverse meridians, and qi and blood stasis, the swelling will rise; if you are infected with damp-heat poisonous evil, and the qi and blood stasis becomes aggravated, there will be swelling and pain. ; Damp-heat disease will result in oozing of water; a red tongue, yellow and greasy coating, and a slippery and rapid pulse are signs of internal heat invasion. 8.4.1.1.3 Treatment method
Clear away heat and dampness, regulate qi and activate blood circulation. 8.4.1.1.4 Prescription treatment
Modifications of Wushen Decoction and Huoxue Sanyu Decoction. 8.4.2 External treatment method
When the swelling is obvious, first use Sophora flavescens decoction to fumigate and wash, and then apply Xiaozhi ointment or Coptis chinensis ointment externally. 8.4.3 Other treatments
For complete cure, external hemorrhoidal vein dissection should be performed. 8.4.3.1 Indications
Simple varicose external hemorrhoids, external hemorrhoids of mixed hemorrhoids.
8.4.3.2 Operation method
Take the lithotomy position or lateral decubitus position, sterilize with 19Lo Xinjiazuride***, use local anesthesia or lumbar anesthesia, lift the top of the external hemorrhoids with tissue forceps, and use scissors to make a radial pattern around the external hemorrhoids. A fusiform incision is made, and then the subcutaneous varicose venous plexus is separated, and the skin and subcutaneous tissue are removed together. After the operation, use Vaseline gauze, Xiaozhi ointment or Coptis chinensis ointment gauze to compress the wound. Take a sitz bath with Glauber's salt solution every day, and apply anti-hemorrhoid ointment externally on the wound until it heals. 8.5 Treatment of thrombotic external hemorrhoids (grape hemorrhoids) 8.5.1 Syndrome differentiation treatment 8.5.1.1 Blood heat and blood stasis
External hemorrhoids with pattern of qi stagnation and blood stasis refers to the syndrome of qi stagnation and blood stasis. Stagnation of blood and blood stasis, manifested by protruding masses at the anal margin, which may enlarge during defecation, may cause distended or falling pain, may have foreign body sensation, may be hard nodules that can be touched locally, dark purple tongue, yellowish tongue coating, and stringy and astringent pulse are common The symptoms of external hemorrhoids [3]. 8.5.1.1.1 Symptoms
Anal verge swelling, severe pain, anal verge round purple mass, hard texture, obvious tenderness; dry mouth, desire to drink, constipation; red tongue, Yellow coating and stringy pulse. 8.5.1.1.2 Syndrome analysis
There is heat in the blood, coupled with struggling during defecation or carrying weight for a long distance, qi and blood stasis, blood heat indiscriminately, venation rupture, blood overflowing outside the veins, and blood stasis under the skin If there is a swelling at the anal margin, the color is purple and dark; if the blood is hot, the mouth will be dry and you want to drink; if the blood is hot and the internal dryness is dry, then you will have constipation; a red tongue and yellow coating indicate heat, and a stringy pulse indicates pain. 8.5.1.1.3 Treatment method
Clear heat, cool blood, reduce swelling and relieve pain. 8.5.1.1.4 Prescription treatment
Modification and subtraction of Liangxue Dihuang Decoction. 8.5.2 External treatment method
First use Sophora flavescens decoction and water to fumigate and wash the penis, and then apply hemorrhoid ointment externally, once a day. 8.5.3 Other treatments
If necessary, perform surgery to remove the thrombus. 8.5.3.1 Indications of external hemorrhoids
Those with large thrombosed external hemorrhoids that cannot be absorbed within 3 days. 8.5.3.2 Operation method
The patient is placed in the lateral decubitus position. *** After routine disinfection and local anesthesia, a radial incision is made in the center of the mass. Hemostatic forceps are used to separate the bleeding clot, trim excess skin, and then Use coptis ointment and gauze to compress the wound, and change the dressing once a day until it heals. 9 About hemorrhoids
Hemorrhoid[1] is the name of the disease[4]. Also known as hemorrhoids and hemorrhoids [5]. According to the "Huangdi Nei Jing Su Wen·Qi Tongtian Lun": "As a result, after a full meal, the tendons and veins will be released horizontally, and the intestinal habit will become hemorrhoids.". It refers to the collective name of internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids [1]. That is, the soft venous mass formed by the expansion and varicose of the venous plexus under the submucosal membrane of the rectum and the subcutaneous anal canal [4], or the formation of thrombosis and hyperplasia of connective tissue under the anal canal [3]. Men, women, old and young can suffer from it. Therefore, there is a saying that "nine out of ten people have hemorrhoids", among which young adults account for the majority. Depending on the location of the disease, hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids.
Traditional Chinese medicine has long understood hemorrhoids. The ancients said that "hemorrhoids are those that stick out." Born on the side of vagina, such as nose hemorrhoids, eye hemorrhoids, tooth hemorrhoids, etc. But now hemorrhoids refer to *** hemorrhoids.
See Hemorrhoids for details. 10