Experience of systematic treatment of perianal eczema.
Abstract: Perianal eczema is a common and multifocal non-infectious skin disease that can occur at any age and gender, with lesions mostly confined to the perianal skin, or occasionally spreading to the buttocks, perineum and scrotum. Localized rash, erythema, papules, blisters, crusting, flaking and erosion may occur. If the disease is prolonged, the perianal skin becomes thickened, grayish or dark red, rough, resulting in chapping, exudation, itching, and recurrent attacks.
Key words: Anal sinusitis. Physical therapy instrument. Chinese medicine fumigation. Efficacy
Clinical data: From March 2012 to March 2013, our department observed and treated 120 patients with perianal eczema, 84 cases of sex and 36 cases of women; age 20-62 years, duration 1-3 months, 46 cases of simple itching and 74 cases of perianal moist itching with painful chapping.
Treatment methods.
1.Physical therapy: Our department used LG2000 infrared low-frequency comprehensive treatment instrument to carry out physical therapy on patients, firstly, give the patients 10g of anal anal anal ointment, then put the rotating magnetic infrared treatment probe on the safety cover and massage the probe gently around the patient’s anus for 1min. after the patients adapt to it, then slowly place the treatment head into the anus about 125px, turn on the rotating magnetic vibration button and gradually increase it until the patient can tolerate it, then put the heat treatment head into the anus about 125px, turn on the rotating magnetic vibration button and gradually increase it until the patient can tolerate it. Then adjust the heat therapy knob to medium heat (39 degrees Celsius), through the combined effect of electric heat, vibration massage and magnetic therapy to improve blood circulation and make anal ointment work better. Each treatment 20min, 2 times a day, 7 consecutive days for a course of treatment.
2.Chinese medicine fumigation treatment: After the physiotherapy is finished, the patient immediately carries on the Chinese medicine fumigation treatment stage, the patient sits on the fumigation treatment instrument of our department and starts the fumigation treatment, the fumigation preparation is the decoction of our department, the medicine is: 15g of Jing scabies, 15g of Fangfeng, 30g of Serpentine, 30g of Dioscorea, 15g of Sichuan pepper, 10g of rhubarb, 10g of wild chrysanthemum, after each physiotherapy starts the fumigation sitting bath for 20 After each physical treatment, start to fumigate the sitz bath for 20 min, twice a day, for 7 consecutive days as a course of treatment.
3.Topical drugs: After each fumigation bath, immediately apply topical drugs on the perianal area.
1. Furnaceolite lotion. First shake the glycolite lotion well, then use a cotton swab dipped in the original solution to apply to the affected area twice a day.
2.Apply dexamethasone tablets 0.75mg10 tablets crushed into powder and added into lincomycin lidocaine gel 10g, mix well and then apply to the affected area with cotton swab twice a day. The above 2 topical drugs should be used alternately on alternate days, both need to be applied to the affected area after the herbal fumigation treatment.
3. 2 anal plugs of taining before bedtime every night.
4.Anal subcutaneous tissue Melanocyte nerve block: chronic eczema intractable pruritus, available methylene blue 2ml plus 2% lidocaine 5ml dotted subcutaneous injection.
5. During the treatment period, patients were asked to prohibit spicy and stimulating diet, alcohol, and to ensure sufficient sleep, and patients with insomnia could be given alprazolam 0.8mg once a night.
Results: 120 cases of perianal eczema, 116 cases were cured, 4 cases of recurrence, the average treatment time was 2 weeks and 2 courses of treatment.
Discussion: The etiology of perianal eczema is mainly due to the following factors.
1, allergic reaction
2, neurological dysfunction and endocrine disorders
3, chronic disease factors
4.Local lesion infection
5, blood circulation disorders, etc.
After 1 year of clinical observation, most of the patients with perianal eczema are caused by long-term chronic sinusitis, mostly accompanied by a sense of unclean bowel movements, long-term inflammatory stimulation of the anal sinus area, resulting in inflammatory overflow in the anus, slow infiltration of mucus into the perianal skin, resulting in the appearance of eczema, erosion and fissures. Patients with perianal eczema are especially prone to perianal itching at night, and most patients suffer from mental anxiety, depression, long-term insomnia, and fatigue. The author believes that systematic treatment of perianal eczema should regulate the patient’s mental state, or give drugs to maintain adequate sleep is very important. Combined with systematic and standardized physical therapy, herbal fumigation treatment, and topical medication, we can obtain better clinical results.