“The main manifestations of anal swelling are: localized pain, swelling, foreign body, bowel movement, anxiety and burning sensation. The main manifestations include: localized downward pain, swelling, foreign body, bowel movement, anxiety and burning sensation. If the disease is prolonged, it is often combined with psychiatric symptoms, such as nervousness, anxiety, paranoia, insomnia and light-heartedness. The cause of this disease is very complex, both primary and secondary. The main causes are the following three aspects. I. Anorectal neurosis. Mental trauma and misinformation or local pain stimulation lead to cortical dysfunction, plant nerve dysfunction, local nerve dysfunction, and abnormal anorectal sensation. In Chinese medicine, it is called “yu syndrome”, which is caused by deficiency of heart qi and heart blood due to emotion and depression. Diagnostic points: (1) Subjective and bizarre anal symptoms, such as swelling, numbness, burning, foreign body sensation or severe pain. (2) Difficult to distinguish the main and secondary aspects of the condition in each narrative, inconsistent, extremely unstable, and frequent visits to the clinic. There are no positive signs in the specialized examination. (3) Mental depression, depressed mood, easily agitated, and lack of confidence in health. (4) The symptoms may change and worsen with mood fluctuations. Functional anorectal pain Rome III divides this disease into chronic anal pain and spasmodic anal pain, and the two types often coexist, but can be distinguished according to the duration, frequency and characteristics of pain. There are two subtypes of chronic anorectal pain: anal raphe syndrome and nonspecific functional anorectal pain. 1. Chronic anorectal pain Diagnostic points: (1) Chronic or recurrent anorectal pain. (2) The pain lasts at least 20 min (3) The above symptoms appear at least 6 months before the diagnosis and last at least 3 months. (4) Exclude other causes: ischemia, inflammatory bowel disease, cryptitis, intermuscular abscess, anal fissure, hemorrhoids, prostatitis, and caudalgia. Subtype anal raphe syndrome: (1) It meets the diagnostic criteria for chronic anal pain and causes tenderness when the puborectalis muscle is pulled from the posterior. (2) The pain is usually vague and dull, electric shock-like, tearing, or burning pain, or manifests as increased pressure sensation in the rectum, aggravated by prolonged sitting and lying, and lasting from several hours to several days. Non-specific functional anorectal pain: (1) It meets the diagnostic criteria for chronic anorectal pain and does not cause tenderness when the puborectalis muscle is pulled from the posterior. (2)The cases are rare. (2) Spasmodic anorectal pain Diagnostic points: (1) Sudden and severe pain in the anal area, lasting for several seconds or minutes, then disappearing completely. (2) After the attack, the pain will disappear completely like normal people until the next attack. The duration of the attack is uncertain and irregular, it can occur once in a few days or once in a few years. (3) Both anal canal and sigmoid colon pressure are elevated. (4) The duration is 3 months or more. (5) The etiology is mostly related to psychological disorders, and the mechanism may originate from abnormal contraction of smooth muscle. (3) Anal sinusitis Causes anal and rectal swelling due to inflammation stimulating the dentate line and pelvic floor nerves. TCM: Damp-heat injection and internal heat toxicity knots. Diagnostic points: Symptoms (1) Anal swelling and vague pain, aggravated after defecation. (2) Feeling of bowel movement, incomplete bowel movement, or urgency and heaviness. (3) Reflexes to the urogenital area through the internal pubic nerve and the second and fourth sacral nerves, or to the sacrum and coccyx through the inferior iliac abdominal and anal caudal nerves, or to the lower extremities through the sciatic nerve. (4) Or with gastrointestinal symptoms, such as dyspepsia, excessive gas and constipation. (5) It may be accompanied by insomnia, anxiety, paranoia and other psychiatric symptoms over time. Signs: Tension of the anal sphincter, hardness and tenderness of the anal fossa and anal papilla. Under the anoscope, the anal sinus and flap are congested and edema is obvious. The probe can probe deeper (only 0.2-0.3 cm when normal), and pain is obvious when probing. Careful clinical identification is needed to make a clear diagnosis, and then a reasonable treatment method of Chinese and Western medicine can be adopted to achieve good results.