Thrombosed external hemorrhoid is a common clinical disease among external hemorrhoids, which is often caused by the rupture of the perianal subcutaneous veins and the accumulation of blood under the skin due to over-eating spicy and stimulating food and straining at the toilet; it is manifested by local swelling and pain, and mostly requires surgical treatment to peel off the thrombus, which is not easily accepted by patients because of the long healing time, easy bleeding and infection. In recent years, our hospital used self-designed fumigation formula to treat thrombosed external hemorrhoids, and achieved more satisfactory results. It is reported as follows.
1.Objects and methods
1.1.Objective data
All 110 cases admitted to our hospital from January 2012 to April 2014 met the diagnostic criteria of the Diagnostic and Therapeutic Criteria of Chinese Medicine: subcutaneous greenish-purple mass at the anal verge, local skin edema, the mass was initially soft, painful, gradually hardened, movable, and obvious pain to touch.
The patients were randomly divided into 55 cases in the treatment group and 55 cases in the control group, of which 47 were male and 8 were female, 21 were aged 20-30, 20 were aged 31-40, 9 were aged 41-60, and 5 were aged 61-70; 34 were male and 21 were female in the control group, 19 were aged 20-30, 19 were aged 31-40, 11 were aged 41-60, and 6 were aged 61-70; the duration of the disease ranged from 1 to 7 days , mean 3 days. There was no statistically significant difference between the two groups in terms of gender, age, and duration of disease (P>0.05).
1.2 Methods
In the treatment group, we used a self-designed fumigation formula consisting of 20g of bitter ginseng, 20g of angelica dahurica, 20g of yuan hu, 20g of angelica, 30g of horsetail, and 10g of pepper, and then decocted the medicine with water three times, adding 1000ml of water each time for about 10 min, and then decocted the filtrate. The affected area was fumigated with steam for about 5 min, and then the affected area was bathed for about 15 min after the temperature of the solution was suitable (not too hot to prevent scalding).
In the control group, 1:5000 potassium permanganate solution was used twice a day for 20 min, and the treatment course was two weeks.
1.3 Precautions
Both groups need precautions. Pay attention to rest; eat more fruits and vegetables, avoid alcohol and spicy stimulating food; keep the bowel movement smooth; control the defecation time within 5 min; avoid prolonged sitting, standing and squatting.
1.4 Evaluation of therapeutic effect
Cured: symptoms disappear, hemorrhoids disappear; improved: symptoms improve, hemorrhoids shrink; not cured: symptoms and signs are no change.
2.Results
In the treatment group, 39 cases were cured, 14 cases were improved, the cure rate reached 70.9%, and the total effective rate reached 96.36%; in the control group, 23 cases were cured, 21 cases were improved, the cure rate reached 41.8%, and the total effective rate was 80%; no adverse reactions occurred in both groups. The cure rate and efficiency of the treatment group were significantly greater than those of the control group, and the difference between the two groups was statistically significant (P<0.05).
3. Discussion
Thrombosed external hemorrhoids are a common type of external hemorrhoids. Western medicine considers hemorrhoids as a venous mass formed by stasis, enlargement and varices of the venous plexus in the lower rectum, anal canal and anal verge, due to the formation of intravascular thrombus in the inferior rectal plexus, or due to the rupture of the veins at the edge of the anus due to defecation and forceful activities blood leaks into the subcutaneous tissue, causing a mass to form in its local tissue. The clinical manifestations are mostly a raised lump in the anus after defecation or strenuous activity, with severe pain and burning sensation and restricted movement.
In the Yellow Emperor’s Classic of Internal Medicine, which was written more than 2,000 years ago, the cause of hemorrhoids is “thus fullness of food, the tendons and veins are crossed, and the intestines are smoked”, which clearly points out that the formation of hemorrhoids is related to unclean diet, living from time to time, and feeling dampness and heat. The hemorrhoids can be caused by improper body position such as sitting, standing, squatting; improper diet such as excessive drinking and spicy food; improper bowel habits such as constipation and prolonged diarrhea.
Therefore, the treatment of thrombosed external hemorrhoids is mainly to activate blood, reduce swelling and relieve pain, but at the same time, the patient should pay attention to physical position, diet and bowel habits to enhance the effect and prevent recurrence.
In the self-designed fumigation formula, bitter ginseng and amaranth clear heat and reduce swelling; dahurica, angelica and yuan hu activate blood circulation and relieve pain; and pepper relieves pain. The combination of all these medicines can clear heat and reduce swelling, unblock blood circulation, resolve blood stasis and relieve pain. Modern medical research shows that bitter ginseng and horsetail have antibacterial and antimicrobial effects; dahurica, angelica and yuan hu have antithrombotic and anticoagulant effects; dahurica, angelica, yuan hu and pepper have blood activating, swelling and analgesic effects.
Through fumigation, the medicinal effect can reach the affected area directly, and the active ingredients in the medicinal solution can be absorbed through the skin or the granulation tissue of the wound surface to exert pharmacological effects. The warm medicinal solution can warm up the local qi and blood meridians, relax the anal sphincter, promote blood flow, enhance the resistance of local tissues, effectively relieve local pain, control lesions, promote blood circulation, accelerate the absorption of thrombus, and promote the repair and healing of the wound surface.
The results showed that the treatment of thrombosed external hemorrhoids with self-designed fumigation formula can relieve pain within a short period of time, with good efficacy, high safety, no adverse reactions, easy to use, and avoiding surgery, which is easily accepted by patients, and is an ideal method for the conservative treatment of thrombosed external hemorrhoids and is worth promoting.