"Walking on the street, I always want to scratch my butt and pick it, so shameful!"
Xiaoxue is 23 years old this year and is a young and beautiful female college student. Just last month, she felt a sudden violent itching around her anus, as if someone had been tickling it with a dog's tail grass.
This itching sensation is not a burst, it is a continuous, long-term itching, as if the itch can only be relieved by reaching out and scratching it fiercely. This feeling makes her sleepless and sleepy, and can't even sleep well at night!
Xiaoxue was ashamed to go to the hospital to find a doctor, so she found Miss Miao, and she privately wrote about her situation: she bought some ointments when she first noticed the itching, although she could Slightly relieved the itching sensation in the anus, but the symptoms have been repeatedly no better. As soon as she stopped the medication, the itching increased again.
Sister Miao persuades her to let go of her shame, and seek medical attention as soon as possible if she is sick, or she will get serious problems if she drags her out. In the end, Xiaoxue was tortured so much that she was diagnosed with perianal eczema after asked a doctor for help, so she had such severe itching.
1. Who can experience the pain of itching but not scratching?
Anal itching is called "itch wind" and "gudao itch" in Chinese medicine, and later doctors called it "anal itching". What is the eczema that causes anal itching?
Anal eczema is a common non-infectious skin disease in the anorectal department. belongs to the categories of TCM sore sores, blood rheumatism, rheumatism, and persistent dampness. Traditional Chinese medicine believes that perianal eczema is more common in the skin with wind, dampness, and heat retention. The acute is the cohesion of damp and heat, the external feeling of wind and evil, which infiltrate the skin. Chronic disease is chronic disease and blood consumption, blood deficiency produces wind and dryness, wind-dryness stagnation, skin loss; or visceral organs accumulate toxins, and turbid qi decreases; or eating disorder, spleen failure, and internal damp heat.
"Yi Zong Jin Jian" said: "This symptom is like corn at first, but itching and pain, breaking the flow of yellow water, soaking into tablets. It is caused by dampness and heat in the spleen and stomach, external exposure to wind, and fighting each other."
Acute anal eczema has a rapid onset and a short course, usually several days or 2 to 3 weeks. It can be cured, but it is easy to relapse. Chronic anal eczema can be caused by acute and subacute anal eczema that does not heal for a long time, and it also becomes chronic at first. The course of the disease is long, does not heal in a constant number of years, and is prone to repeated attacks.
Eczema has rashes, papules, erosions, exudations, crusting and scaling, mild itching, severe itching, intermittent seizures, sudden increase at night, affecting sleep, so dehumidification and antipruritic treatment is the treatment of the anus The focus of eczema.
2. In addition to eczema, what other culprits cause anal itching?
The causes of anal itching are more complicated. Diseases of the rectum, anal canal, colon, and small intestine cause excessive moisture in the anus, a large amount of secretion, and cause greater irritation to the anus. This is a common cause of itching in the anus. In addition to , other pathogenic factors include:
Skin diseases: For example, fungal infections, neurodermatitis, folliculitis, excessive sebum secretion can cause seborrheic dermatitis, etc. Anal itching occurs.
Parasitic disease : For example, pinworm disease, pubic lice disease and so on.
Poor hygiene: The patient’s local hygiene is poor, and carelessly cleaned, causing serious irritation to the skin caused by feces.
Clothes are not suitable: wears tight underwear, rubbing the skin.
Drug factor: Anal topical steroid treatment, or taking antibiotics for too long can cause flora imbalance, and it will also cause itching around the anus.
Three. To treat anal itching, traditional Chinese and Western medicine "see tricks"
For patients with anal pruritus, doctors should diagnose and treat them in time. To make a clear diagnosis, it is necessary to synthesize the patient's various examination results, and diagnose according to the patient's actual clinical manifestations, and then implement effective treatment for the patient. Western medicine mainly focuses on symptomatic treatment, while Chinese medicine mostly treats it from the perspective of dispelling wind and relieving itching. Both have their own advantages. Whether to use Western medicine or traditional Chinese medicine depends on the severity of the disease.
Western medicine treatment
The current Western medicine treatment for anal pruritus is based on topical drugs, such as various lotions, emulsions, pastes, oils, etc.; while oral medications are mainly anti-inflammatory Histamine drugs, combined with central sedative drugs. However, most topical drugs contain hormones or antifungal drugs, while central sedative drugs have no obvious antipruritic effect on anal pruritus. Long-term use can cause many adverse reactions, so use caution.
Closed injection therapy is also a common clinical method to treat anal itching. It refers to a treatment method of injecting hormone drugs or nerve blocking drugs into the subcutaneous or intradermal local lesions. It can play an anti-inflammatory and anti-allergic effect, and can destroy the conduction of sensory nerve endings, block the itching stimulation of the central nervous system from the skin of the diseased area, and play an anti-itching effect. Commonly used drugs include methylene blue and compound betamethasone.
If the refractory anal pruritus does not get better or recurs after conservative treatment, surgery can be considered. The operation mainly uses two methods: cutting the perianal subcutaneous nerve endings and removing the skin of the perianal lesions to block the conduction of itching stimulation to the central nerve. Clinical practice has proved that surgery is effective in treating anal itching, and the operation is simple, and the effect is worthy of recognition.
Traditional Chinese Medicine
The ancient people said: "Itching comes from the wind, and itching must be relieved first." Therefore, the ultimate goal of oral Chinese medicine is to dispel wind and stop itching. Commonly used clinical programs include Jiawei Siwu Xiaofeng Decoction, Gegen Jiashu Decoction, Buzhong Yiqi Decoction, etc., which can effectively dredge the skin and collaterals of the anus, expel wind, dehumidify, dispel cold, replenish qi and raise yang, and induce qi Blood nourishes the skin. Generally it is not itchy.
Chinese medicine sitz bath is also a more effective method. In ancient times, fumigation was called "fumigation", "leaching", etc. It was first recorded in "Fifty-two Prescriptions". is to smoke the transpiration gas of the decoction on the affected area, or heat the medicine to the affected area, with the help of the power of the decoction Directly acting on the lesion with heat, so as to achieve the effects of clearing away heat and dampness, promoting blood circulation and removing blood stasis, reducing swelling and pain, astringent and relieving itching.
Acupuncture and moxibustion has the functions of dredging channels and collaterals, regulating qi and blood, can increase the body's righteousness and help regulate the body's immune function. Use acupuncture to treat primary mild to moderate anal pruritus, select acupoints: Ashi point, Changqiang, Shuangzusanli, Shuangquchi, Shuangxuehai. The control group was given oral drugs and treated with external rubbing ointment.
With the continuous deepening of research, anal pruritus has continuously transitioned from a single treatment to a diversified treatment, and has developed from a single treatment of Western medicine or Chinese medicine to a comprehensive treatment of integrated Chinese and Western medicine, and has achieved good results. In the future, a better combination of Chinese and Western medicine, reduction of toxic and side effects of treatment, simultaneous treatment of symptoms and root causes, and improvement of cure rate will be the future development direction of clinical treatment of anal itching.
References
[1] Huang Yebao, Liu Chunqiang. Research progress in the treatment of anal pruritus with traditional Chinese and western medicine[J]. Hunan Journal of Traditional Chinese Medicine, 2020 (03).
[2] Zhu Ze. Anal Eczema Analysis of Traditional Chinese Medicine Treatment[J]. Modern Chinese Medicine Application, 2015 (05)
[3] Chen Mengting, Cai Erwei. Application progress of traditional Chinese medicine in the treatment of anal pruritus[J]. Electronic Journal of Clinical Medicine Literature, 2019 (94) ).
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