I. Chinese medicine fumigation hemorrhoid lotion composition: fishy grass 100g alum 20g mannitol 30g earth poria 30g ice chips 2g operation method: 250ml lotion add boiling water to 1000ml, first fumigate and then wash Function: detoxification, remove dampness, reduce swelling and pain Caution: 1, first fumigate and then wash, sitz bath, time 10-15 minutes 2, allergic people contraindicated 2, Chinese medicine decoction retained enema 1, identification of the selected formula (1) Damp-heat infusion type: the formula should be added and reduced with gentian diarrhea liver soup. (2) Anal heat toxicity type: formula with Nei Shu Huang Lian Tang plus or minus. (3) Dampness and turbidity infiltration type: formula with Dioscorea Z Infiltration Dampness Tang plus or minus. 2. Decoct the herbal formula twice per payment, thicken the decoction into a volume of about 200ml and reserve the enema twice in the morning and evening. (1) Pay attention to the temperature of the enema solution and insert the anal tube gently. (2) Try to keep the medicine for more than 1 hour after the tube is removed. (3) Chinese herbal medicine: 0,3-0,5% white descending dan gauze change Drug configuration: 0,3-0,5% white descending dan gauze Method: Configure low concentration white descending dan gauze gauze for complex anal fistula postoperative drug change, once a day, first with 0,5% gauze, and after a week change to 0,3% gauze. Functions and Indications: To remove decay and regenerate muscle, used for deep abscess and post-operative complex anal fistula. Precautions: Forbidden for those who are allergic to mercury. Four, the dressing method is to apply Fu Huang cream on the affected area treatment method, when using the ointment will be applied to the affected area. It has the function of clearing heat and detoxification, reducing swelling and relieving pain. It is suitable for anal canker sores in anorectology. Preparation of materials Treatment tray, saline cotton ball, drugs, sterile cotton pad or gauze, cotton paper, adhesive tape or bandage; other drugs for dressing: golden ointment, anti-inflammatory and pain-relieving ointment, etc. Operation procedure 1. Prepare all the materials and bring them to the bedside. Explain well and get the patient’s cooperation. 2. Assist to take appropriate position, expose the affected area, pay attention to keep warm, and cover by screen if necessary. 3. According to the area of dressing, take suitable size of cotton paper or thin adhesive paper and spread the required medicine evenly on the cotton paper with appropriate thickness. 4. If it is a swollen ulcer, the area of dressing should exceed the swelling potential, one is to prevent the spread of poisonous evil and play the role of hoarding poison; the other is to bundle the poisonous evil through the action of medicine, to lift the pus and pluck the poison. 5.After applying the medicine, pay attention to the local situation, if there is red rash, itching, blisters and other allergic phenomena, the use should be suspended and dealt with. Precautions 1. Forbidden for those with skin allergy. 2. For the swelling ulcers with initial head or pus-forming stage, it is appropriate to leave a gap in the middle and dress around, and should not be completely coated. V. Injection at the lumbar point 1. Drug of choice: 20~30ml of 1% lidocaine, or 10~15ml of 0.25%~0.5% bupivacaine for longer operations. 2. Search for the sacral fissure: find the left and right sacral angles, and the depression between the two sacral angles is the sacral fissure. 3.Operating steps: take the lateral position, make a sign after searching the sacral fissure, disinfect routinely, use a syringe equipped with a No.7 needle to aspirate the drug, inject a mound at the sign first, inject the needle by vertical infiltration, when there is obvious resistance at the tip of the needle that is to reach the sacrococcygeal ligament, march the needle in the direction of the umbilicus at an angle of about 45 degrees, when there is a sudden feeling of falling, that is to enter the sacral canal, aspirate no blood and cerebral crest fluid, that is to say, the needle hole facing the The tailbone is slowly injected with 1/5 of the total amount of anesthetic, observe for 5 minutes, and if the patient has no adverse reaction, all the anesthetic is slowly pushed in and the needle is withdrawn, and the anesthesia is successful if the contraction reaction is not seen after 20~25 minutes, when the anal canal is stimulated by the needle tip. 4.Caution: For sacral fissure deformity, variation, irregularity, etc., the right point should be found to prevent injection in the subcutaneous. Generally not more than 30m. 6. moxibustion Moxibustion with moxa cones is mainly used for postoperative urinary retention. Using the effect of warmth and drugs, through the meridian conduction, to warm the meridian, harmonize the qi and blood to achieve the effect of urine. Methodology Treatment tray, moxa cones, matches, curved tray, bath towel, screen, etc. [Operation procedure] 1, prepare all the materials, bring them to the bedside, explain well and obtain the patient’s cooperation. 2. Assist to take appropriate position, expose the moxibustion site, pay attention to keep warm. 3. Select acupuncture points: Sanyinjiao, Qihai, Guangyuan, each point for 5 minutes, as long as the patient is comfortable. Precautions 1. Prevent the moxa ash from falling off and burning the skin or clothing. After extinguishing the moxa cones, they should be put into small-mouth bottles to prevent rekindling and fire. 2.After the application of moxibustion, the local skin may appear slightly red and burning. If small blisters appear after moxibustion, they can be absorbed by themselves without treatment. If the blisters are large, use a sterile syringe to draw off the body, cover with sterile gauze and keep it dry. Seven, hanging thread Traditional treatment method of Chinese anorectal medicine, applicable to the treatment of anal fistula, expand the treatment of puborectal hypertrophy. Operation: After anesthesia, the probe is gently probed from the external mouth of the anal fistula, the skin subcutaneous tissue is cut, the rubber band is brought in, tightened and then ligated with line 7. Caution: 1. Instruct the patient not to drag the rubber band left outside the anal canal to avoid pain and fracture. 2.Check whether the ligature rubber band (line) is slack, in general 8-11 days off, such as slack tight line 1 time. 3.Observe whether there is adhesion in the wound where the thread is hung, if the skin is prematurely adhered then it should be separated or gauze filled. 4. Encourage the patient to move appropriately to speed up the dissection of the fistula. VIII. Buried seeds in auricular points Purpose Buried seeds in auricular points (kidney, bladder, endocrine) in anorectal medicine are used to stimulate acupuncture points or reaction points on the auricle with Wang Bu Liuxing seeds (or rapeseeds) to achieve the purpose of disease prevention and treatment through meridian conduction. It is suitable for painful evidence and urinary retention. Prepare the treatment tray, probe, cotton swab, 0.5% iodine volt, forceps, Wang Bu Liu Xing seeds, adhesive tape, scissors, etc. Operation procedure 1. Prepare all the materials, bring them to the bedside, explain well and get the patient’s cooperation. 2. The patient should be in lateral recumbent or sitting position. 3. The operator holds one hand above the posterior part of the ear wheel, and the other hand holds a probe to find sensitive points in the selected area from top to bottom, and routinely disinfect. 4. Embedding the seeds: stick the seeds of Wang Bu Liuxing in the middle of 7 mm × 7 mm adhesive tape, put them on the selected acupuncture point and press them with the index finger. 5. Ask the patient if there is any “qi” feeling such as soreness, swelling and pain while pressing. 6. Teach the patient or family members how to apply pressure and leave the seeds for 2~3 days as needed. 7. Withdraw the seeds: remove the adhesive tape and Wang Bu Liuxing seeds, observe whether there is local skin redness, swelling and damage, and give timely treatment. 8. When the operation is finished, clean up the material and return it to the original place. Precautions 1. Pregnant women with inflammation of the auricle, frostbite or a history of habitual abortion are prohibited. 2. Move gently and press moderately hard, so that the patient can have the feeling of “getting air”. IX. Ligation Ligation therapy for hemorrhoids is a traditional method, which is recorded in the “52 Disease Formula” excavated from the Mawangdui Han Tomb in Changsha. Summarizing the experience of previous generations, the ligation method is now categorized as simple ligation method and segmental ligation method, etc. 1.Simple ligation method: Applicable to stage II and III internal hemorrhoids. Ligation steps: The patient should be in the lithotomy position or lateral recumbent position. Routinely disinfect and spread the towel. After local infiltration anesthesia takes effect, disinfect the inner anus and lower rectum. Perform preoperative examination with anoscope, design the circumferential ligation site, pull the internal hemorrhoid out of the anus with tissue forceps, fully expose the ligated part, clamp the base of the hemorrhoid nucleus with curved vascular forceps, cut a small opening at the skin-mucosal junction in the dentate area, and ligate with No. 7 or No. 10 wire under hemostatic forceps, or use needle with wire to penetrate twice from the central part of the base, make a figure-8 suture ligation, pull the ligated wire firmly while slowly releasing The hemostatic forceps are slowly released and withdrawn. Other hemorrhoids ligated at the same time, after surgery, rectal put chlorhexidine suppository and oil gauze, tower gauze arrangement at the anus, pressure bandage can be. 2.Segmental ligation method: suitable for circumferential mixed hemorrhoids and mixed hemorrhoids. The steps of segmental ligation: routine disinfection, towel laying, local anesthesia; divide the circumferential hemorrhoids into 3 to 4 areas, preferably in the parent hemorrhoid area, make a radial fan-shaped or prismatic incision, cut the subcutaneous to the hemorrhoid in the direction of the anus, and cut to the base of the internal hemorrhoid one by one, and make an 8-string suture with 7 threads throughout, from 12, 5px from the ligature line, cut off the excess tissue that has been separated, after checking that there is no active bleeding, and reposition the tissue stump in the To reduce postoperative anal edema and pain, the stump was repositioned in the intestine. The rest is the same as the simple ligation method. Firstly, the incision of circular hemorrhoid should be chosen to peel off the corresponding part of the parent hemorrhoid, and the successive damage to the anal canal and anal skin should not exceed 1/2. Secondly, each ligature point should not be flush and at the same height to prevent anal contracture due to postoperative scarring. Ten, plugging medicine plugging medicine method is the common method of hemorrhoid treatment color. The drug is made into a suppository and is inserted into the anus. After dissolving the suppository, the drug acts on the local lesion to play a therapeutic role, as the rectal local administration of the drug acts directly on the local area and works fast, while the drug is absorbed through the rectum and can directly enter the large circulation without liver detoxification. The most common suppositories are hemorrhoids pain suppositories, hemorrhoid suppositories, bear bile hemorrhoid suppositories, Ma Yinglong hemorrhoid suppositories, anal tide suppositories, etc. Functions: Clearing heat and swelling, stopping pain and bleeding, astringent and fixing. Indications: For internal hemorrhoids to stop bleeding, pain, astringency and anti-inflammatory effects, and also for systemic symptoms and proctitis. Use: Cleanse the anus daily after defecation, and incorporate one suppository into the anus. Note: The suppository should be located above the dentate line.