I. Overview Anal pruritus is a common local pruritus, limited to the itching discomfort of the skin around the anus, and some can spread to the entire perineum. The incidence of anal pruritus is about 1%-5% in the general population, mostly in middle-aged and elderly people aged 40-60 years, but now there is a tendency to be younger, with a male to female ratio of about 4:1. 70% of anal pruritus is secondary to perianal disease, which has obvious causative factors and is easily treated. Primary anal itching is not easy to cure, but also often recur. (1) Allergic reactions: such as the consumption of irritating foods, such as chili, mustard, spices, wine or atopic protein food, but also certain drug allergies cause anal itching. (2) Parasites: such as pinworms, roundworms, trichomonas vaginalis, scabies, etc., can cause anal pruritus. (3) Endocrine and metabolic diseases such as increased sugar content in diabetic patients, which stimulates nerve endings; hyperthyroidism, which may be related to excessive sweating, increased basal metabolism and emotional stress. (4) Hematological disorders iron deficiency anemia. (5) Gastrointestinal disorders: acute and chronic diarrhea, constipation gastrointestinal neurosis. (6) the sequelae of surgery caused by prolapse of rectal mucosa, or prolapse, intestinal mucus stained around the anus. 2, local factors (1) skin lesions: anal skin diseases such as anal eczema, neurodermatitis, moss, various warts, sweat gland inflammation, etc., feces attached to the anal skin folds, chronic stimulation can also cause itching. (2) perianal microorganisms: pinworms are often the cause of anal itching in children. (3) Anorectal diseases: such as hemorrhoids, anal fissures, anal sinusitis, anal papillomegaly, rectal prolapse, anal incontinence, etc., which make the anal opening secretions increase to stimulate the skin can cause itching. (4) Female vaginitis, more secretions can also stimulate the perineum and perianal skin. Anal itching may also be due to poor hygiene habits, not timely cleaning of the anal perineum, wearing narrow and poorly textured thick and rough underwear, which makes it difficult to distribute sweat from the buttocks and friction can induce itching. The pathogenesis is unclear, but it is generally believed that the free nerve endings in the epidermis are stimulated by physicochemical factors, resulting in the release of chemical mediators such as local tissue histamine kinins, which act on the nerve endings and produce itching. Fourth, treatment 1, pay attention to hygiene, keep the anus clean and dry, do not use hot water to clean the perianal area, heat will accelerate the release of inflammatory factors, aggravating itching. Do not eat or eat less stimulating food, such as chili, strong tea, coffee, high alcohol, etc. Allergic people should eat less allergy-prone food, such as fish, shrimp, etc., and avoid contact with allergy-causing chemicals. 2, underwear should not be too tight, too hard, it is appropriate to wear pure cotton loose fitting underwear, do not wear artificial fiber underwear, and should be diligently washed and changed. 3, timely treatment of local and systemic diseases that cause anal pruritus, such as internal hemorrhoids, anal fissures, anal fistula, diarrhea, diabetes, parasitic diseases, etc. 4, pay attention to the combination of work and rest, keep a happy mood, prevent excessive tension and anxiety, do not scratch the anus, do not use too hard objects to rub the anus. 5, anal itching more than but the skin is not broken, you can immerse the gauze into the external Chinese medicine soup, the water temperature to maintain at 4-5 ℃ is appropriate, you can add ice cubes, remove the wring to not dripping water, compress around the anus, can immediately stop the itching. Continue to apply cold and wet compresses every day. Wipe dry after dressing, puffing with talcum powder. 6, Chinese medicine believes that anal itching more heart meridian fire, blood heat and wind; or qi and blood deficiency, blood does not feed the wind, liver wind, wind win is itch; or by damp heat within the embodiment of the wind evil depressed for a long time, heat into dryness. Externally, we can add and reduce the amount of Wu Bei Zi Tang; Wu Bei Zi, bitter ginseng 30, snake bed seeds, thorn, white fresh, pepper, Xu Changqing, two-sided needle, mulberry, cypress, scutellaria, rhubarb, alum 15 grams, water decoction continued cold wet compresses on the affected area. If there are pinworms, a decoction of 30 grams of Baibei can be used as an enema. The Chinese medicine must be treated according to the evidence and added or subtracted according to the evidence. 7, red light therapy (Carnation photon): Carnation 33 photon therapy instrument using high optical power integrated semiconductor solid-state cold light source, its treatment mechanism is photochemical effect, rather than the traditional infrared thermal therapy effect, photons can penetrate the human epidermis into the subcutaneous tissue 3 ~ 5 cm, the energy is strongly absorbed by the cell mitochondria, resulting in efficient enzymatic reaction, promote cell metabolism Photons can increase the content of cellular glycogen, thus promoting the decomposition of adenosine triphosphate and protein synthesis, improving microcirculation and local nutrition, not only accelerating the growth of granulation tissue and wound healing; at the same time, photons can increase the phagocytosis of leukocytes, improve the immunity of the body, promote autoinflammation, and reduce the exudate of incision; photons can simultaneously reduce the content of pentraxin at the inflammation site through biological effects, which has obvious anti-inflammatory effects.