Pruritus is a common neurological dermatosis, usually limited to the perianal area but often spreading to the perineum or scrotum. The disease is most commonly seen in young adults aged 20-40 years. These receptors are stimulated by chemical media such as histamine, kinins and proteolytic enzymes, or by physical factors acting on nerve endings, thus causing impulses that travel through the nerve conduction to the brain via the crestal medulla and finally to the cerebral cortex to produce itchiness. According to Chinese medicine, the cause of anal pruritus is mainly due to the loss of spleen health, loss of qi and blood, blood deficiency and wind, wind winds holding dampness, damp heat blockage, and phlegm flowing into the anus. What are the systemic factors of anal pruritus? 1, allergic reactions Due to the differences in allergic constitution, the reaction to allergenic substances is also different. Although there is a wide variety of allergenic substances, but not every substance has a sensitizing effect on all people. The common allergic substances are specific proteins and certain drugs, such as crabs, fish and shrimp, sulfonamides, antibiotics, anesthetic drugs, etc. 2, disease factors chronic indigestion, diabetes, urticaria, uremia, jaundice, senile skin atrophy, endocrine disorders, menopausal syndrome, etc., can cause anal itching. 3, mental factors such as hysteria, mental tension, excitement, etc. 4, genetic factors abnormal perceptual sensitivity, often prone to anal pruritus, may be related to genetics. It is believed that pruritus has a family heritage of up to 60% or so. What are the local factors of anal pruritus? 1, stimulation factors perianal and perineal, easy to store dirt, a variety of stored substances on the perianal skin have stimulating effects. Such as intestinal mucus overflow, leucorrhea, sweat and sebaceous gland secretions, foreign bodies and fecal residue and other material stimulation, can cause anal pruritus. 2, skin diseases such as anal eczema, ringworm, warts, neurodermatitis, folliculitis, etc., can cause perianal skin itching. 3, parasitic diseases such as pinworm disease, vaginal trichomonas, vaginal mycobacteria, pubic lice, scabies, etc. can cause anal itching. 4, anorectal disorders such as hemorrhoids, anal fissures, anal fistula, polyps, anal papillae hypertrophy, rectal prolapse, enteritis, etc., due to the stimulation of secretions resulting in perianal itching. How to prevent anal itching? Forbid eating spicy and irritating food and specific protein food, such as wine, mustard, fish, crab, shrimp, etc.; avoid contact with chemicals, pollen, raw paint, etc. The underwear worn should not be too tight or too hard, and do not wipe the anus with chemical dyes and paper with ink and plant leaves. Keep the anal area clean and hygienic, change underwear regularly, and do not use alkaline detergent. Avoid emotional anxiety and excessive tension, and do not scratch the perianal skin with your hands to avoid infection. How to treat anal itching in western medicine? 1.Etiological treatment: treat primary and secondary diseases, such as anal fistula, anal fissure, prolapse, hemorrhoids, warts, diabetes, jaundice. 2, drug treatment: when itching is intense, intravenous injection of 5% calcium bromide, 10% calcium gluconate or oral antihistamines, such as Benadryl, paracetamol, etc.. Hormonal drugs such as prednisone, flumethasone, ethinyl estradiol, or vitamin B 6, vitamin B 12, etc. 3.Closure therapy: inject drugs into the itchy area subcutaneously or intradermally to regulate the nerve function and achieve anti-itch effect, commonly used drugs are 0. 2% methylene blue, as dotted intradermal closure therapy; or 1% lidocaine 5 ml, 0. 2% methylene blue 1 ml, flumethasone 1 ml mixed for intradermal or subcutaneous closure; or chlorpromazine 1 ml, 1% procaine 5 ml for subcutaneous injection within the lesion. 4.Physical therapy: local irradiation treatment with carbon dioxide laser, or superficial X-ray therapy, freezing method, etc. 5, topical drug treatment: available 2% camphor cream or 5% sulfur coal tar ointment, or 1% peppermint glyburide lotion and other local rubbing. How to treat anal itching in Chinese medicine? The Chinese medicine treatment of anal itching focuses on the identification and treatment of evidence. 1, blood deficiency wind type: itching recurrent episodes, the duration of the disease is longer, the lesions are dark, infiltrated thick, moss-like changes, pigmentation, dry mouth, dry tongue, sleepless nights. It is advisable to nourish blood and moisten dryness, dispel wind and relieve itching, with 15 g of Radix Rehmanniae, 12 g of Radix Paeoniae Alba, 12 g of Radix Angelicae Sinensis, 12 g of Radix Paeoniae Alba, 19 g of Radix Bupleurum, 9 g of Rhizoma Polygonatum, 6 g of Peppermint, 3 g of Cicada, and 6 g of Glycyrrhiza Uralensis. 2. Wind-heat stagnation type: itching in the anus, burning and swelling, irritability, restlessness at night, bitterness in the mouth and dryness in the throat, constipation in the stool, yellow and red urine, and mental discomfort. It is advisable to dredge wind and clear heat, and to remove fire and relax the stool, using gentian grass 9 g, zedoary 12 g, mouton 9 g, carpenter’s seed (decoction) 15 g, gardenia 12 g, scutellaria 12 g, raw groundnut 12 g, bitter ginseng 12 g, wuzhang snake 9 g, rhubarb (later) 3 g. 3, wind-damp heat type: anal itching, with ooze, itching pain intensifies when moving, anal drop, gastric distension, poor appetite, body heavy and sleepy, restless sleep at night. The symptoms of anal itching are It is advisable to clear heat and dampness, dispel wind and relieve itching, using raw gypsum (first decoction) 30 g, Zhi Mu 12 g, Di Shen Zi 12 g, Tu Fu Ling 12 g, Bai Xian Pi 12 g, Serpentine 12 g, Sheng Di Huang 15 g, Bitter Ginseng 12 g, Thornbush 9 g, Cicada 3 g.