1、 What is perianal abscess in traditional Chinese medicine?
Perianal abscess, also known as perianal abscess, is referred to as anal abscess in traditional Chinese medicine. Perianal abscess is an acute suppurative infectious diseases that occurs around the anus, anal canal and rectum. It belongs to bacterial infection and is the precursor of anal fistula. This disease, along with anal fistula, is one of the three major diseases of the rectum. It is mostly seen in men aged 20-40 years old. The incidence rate of men is 3-4 times that of women, and the incidence rate of children is relatively high.
2、 Why do you suffer from perianal abscess?
1. Zheng Xu Deng Shi: Due to the deficiency of the lungs, spleen, and kidneys, dampness and heat flow down while taking advantage of the deficiency. Due to the deficiency of qi and depression, dampness and heat flow down, carrying heavy loads and running around, working tirelessly, and post illness fatigue, all of these factors damage the vital energy. Qi injury leads to dampness accumulation, dampness accumulation leads to heat generation, and dampness and heat flow down the large intestine, forming an abscess. 2. Irregular diet: overeating spicy, pungent, rich, and mellow food to the point where dampness and turbidity do not dissolve, dampness and heat are endogenous, and dampness and heat viruses flow into the anus and form lumps. 3. External wind and heat: The body senses external evil, and the evil qi does not dissipate. The evil of wind and heat is strong, and the valley air flows to the lower part. Causing anal swelling and accumulation into a lump.
3、 Symptoms of perianal abscess: The main symptom of perianal abscess is pain, which is very severe and gradually worsens. The pain will only temporarily ease after the abscess has self ruptured. Low abscesses can cause severe anal pain, and this pain persists. And abscesses around the rectum (in high positions) may not necessarily cause pain. Because the area around the rectum belongs to the pelvic cavity, the autonomic nerves distributed here are insensitive to ordinary stimuli, and the main manifestations are local bloating and a sensation of defecation. Another symptom of perianal abscess is fever, which can reach up to 40 ° C. Generally speaking, the larger and deeper the abscess cavity, the higher the probability of fever. Some patients may also experience difficulty urinating, loss of appetite, and insomnia.
4、 Diagnosis of perianal abscess:
(1) Disease diagnosis
Traditional Chinese medicine diagnostic criteria: 1. Local symptoms: sudden onset, perianal swelling and pain, severe pain during defecation, followed by rupture and persistent pus discharge. 2. Systemic symptoms: headache, fatigue, constipation, yellow and red urine. 3. Classification: Based on the levator ani muscle, perianal and rectal abscesses are divided into low perianal and rectal abscesses and high perianal and rectal abscesses. The former includes subcutaneous abscesses around the anus, ischiorectal space abscesses, anal sphincter space abscesses, and anal canal posterior space abscesses, while the latter includes pelvic rectal space abscesses, rectal posterior space abscesses, and rectal submucosal abscesses.
（2） Syndrome diagnosis
1. Fire toxin accumulation syndrome: sudden swelling and pain around the anus, continuously worsening, accompanied by chills, fever, constipation, and redness. Perianal redness and swelling, obvious tenderness, hard texture, and a burning surface. Tongue red, thin yellow coating, pulse count. 2. Heat toxin syndrome: Severe anal swelling and pain that can last for several days, with pain like chicken pecking, insomnia, accompanied by chills, fever, dry mouth, constipation, and difficulty urinating. Perianal redness and swelling, with a wave like sensation when pressed or pus when punctured. Tongue red, moss yellow, and smooth veins. 3. Yin deficiency toxin love syndrome: Anal pain, burning sensation, red skin color, difficult to retract after rupture, accompanied by afternoon hot flashes, restlessness, dry mouth, and night sweats. Tongue red, little moss, fine veins.
5、 Traditional Chinese Medicine Treatment
1. Treatment Method for Fire Poison Accumulation Syndrome: Clearing Heat, Purging Fire, and Detoxifying
(1) Recommended Formula: Xianfang Huosheng Yin, Modified. Bai Zhi, Bei Mu, Feng Feng, Hong Shao Yao, Danggui Wei, Licorice nodes, Zaojiao Ci (stir fried), pangolin (roasted), Tian Fen pollen, frankincense, myrrh, honeysuckle, tangerine peel, etc. Or choose traditional Chinese patent medicines and simple preparations with the same effect. (2) Chinese herbal fumigation and washing: Based on the characteristics of the patient's syndrome, select Chinese herbal medicines that have the properties of clearing heat, purging fire, and detoxifying according to the syndrome. After boiling, pour them into a fumigation and washing container. The temperature of the medicine should be around 80 degrees Celsius, and fumigate for 10-15 minutes until the temperature drops to around 38 degrees Celsius. Then, take a local sitz bath for 10-15 minutes. (3) For external use of traditional Chinese medicine: suppositories with heat clearing and detoxifying properties, as well as anti-inflammatory and pain relieving properties, can be used to apply to the anus, or Chinese herbal ointments can be applied externally.
2. Treatment method for the syndrome of excessive heat toxicity: clearing heat, detoxifying, and clearing pus
(1) Recommended prescription: modified version of clearing pus powder. Huangqi, Shanjia (stir fried powder), Chuanxiong, Danggui, Zaojiao needle, etc. Or choose traditional Chinese patent medicines and simple preparations with the same effect. (2) Chinese herbal fumigation and washing: Based on the characteristics of the patient's syndrome, select Chinese herbal medicines that have the properties of clearing heat, detoxifying, and clearing pus, and make adjustments according to the syndrome. (3) For external use of traditional Chinese medicine: suppositories with heat clearing and detoxifying properties, as well as anti-inflammatory and pain relieving properties, can be used to apply to the anus, or Chinese herbal ointments can be applied externally.
3. Treatment for Yin Deficiency, Poison and Love Syndrome: Nourishing Yin, Clearing Heat and Detoxifying
(1) Recommended Formula: Modified Qinghao Biejia Decoction. Qinghao, Biejia, Shengdi, Zhimu, Danpi, etc. Or choose traditional Chinese patent medicines and simple preparations with the same effect. (2) Chinese herbal fumigation and washing: Based on the characteristics of the patient's symptoms, select Chinese herbal medicines with nourishing yin, clearing heat, and detoxifying properties, and make adjustments according to the symptoms. (3) External use of traditional Chinese medicine: suppositories with nourishing yin, clearing heat, and detoxifying properties can be used to apply to the anus, or Chinese herbal ointments can be applied externally.
6、 Prevention of perianal abscess before illness occurs
1. Avoid excessive alcohol consumption and avoid eating spicy, stimulating, and hot foods. 2. Regulate the internal organs, promote smooth bowel movements, and prevent constipation and diarrhea. 3. Keep the anus fresh and avoid contamination. 4. Actively treat other anal and rectal diseases, such as anal antrum inflammation, anal fissures, and intestinal disorders.