TCM Acupuncture and Massage

Chapter 51 Digestive System Diseases (4)
(4) Thrombosed external hemorrhoids: Thrombosed external hemorrhoids are the most common type of external hemorrhoids.Often due to excessive force during defecation, strenuous activities or forceful coughing, the anal vein ruptures, blood leaks into the connective tissue, and becomes a blood clot, forming a round or oval mass under the skin of the anus, varying in size, located in the anal canal or outside the anal margin.The lump is soft at first and hardens after a few days.If there is no inflammation, the mass can be completely absorbed and dissipated within 3 to 4 weeks without leaving any traces; if there is repeated inflammation, the connective tissue in the mass will proliferate and become an external hemorrhoid of connective tissue; if infection occurs, an abscess can form.After defecation or straining in this type, a round or oval lump suddenly appears under the skin of the anal margin, and the patient feels abnormal pain, which aggravates during activities or defecation.Due to sphincter spasm, I felt a foreign body sensation in the lower rectum and anus, hindered walking, and felt restless.The surface of the lump is slightly darker, sometimes purplish red, slightly hard, and tender, and sometimes after 2 to 3 days the blood clot is absorbed, the pain is relieved, and it can heal itself.Sometimes the infection suppurates and the epidermis breaks down, resulting in anal fistula. 3. Mixed hemorrhoids are located above and below the dentate line. The internal and external venous plexuses in the same position are varicose, communicate with each other and expand, the dentate line groove disappears, and the upper and lower hemorrhoids become a whole, which is called mixed hemorrhoids.There are two characteristics of internal hemorrhoids and external hemorrhoids.

([-]) Harm of hemorrhoids to the human body

The main symptoms of hemorrhoids are blood in the stool and prolapse.Repeated bleeding during defecation will cause the body to lose a large amount of iron, causing iron deficiency anemia.Iron deficiency anemia caused by blood loss from hemorrhoids generally develops slowly, and there may be no symptoms or mild symptoms in the early stage. When the anemia is severe or progresses rapidly, pale complexion, fatigue, loss of appetite, palpitations, rapid heart rate and physical strength will appear. Shortness of breath and edema after activities, some patients may have nervous system symptoms such as irritability, excitement, irritability, etc. Some people think that it is caused by the lack of iron-containing enzymes in the cells.The above symptoms can disappear after correcting anemia and treating hemorrhoids.Therefore, if you find that you have hemorrhoids, you should treat them as soon as possible to avoid the above symptoms and complicate the treatment.

Another major symptom of hemorrhoids is prolapsed internal hemorrhoids.The internal hemorrhoid protruding from the anus is clamped by the sphincter, and the venous return is blocked, but the arterial blood is still continuously infused, which increases the volume of the hemorrhoid until the arterial blood vessel is compressed, thrombosis forms, and the hemorrhoid becomes hard and painful, making it difficult to return to the anus Inside.The traditional view is called "squeezing internal hemorrhoids".However, in clinical external hemorrhoids, thrombosis is more common, so it is often accompanied by pain. When the hemorrhoid prolapses and cannot be returned, it is also called "incarcerated hemorrhoid".Incarcerated hemorrhoids for a long time, necrosis and infection will also occur.Therefore, it should be treated early.

In short, hemorrhoids have many harms to the human body, and should attract the attention of the majority of clinical workers, and take every hemorrhoid patient seriously.Patients with hemorrhoids do not need to be too nervous, as long as they can be treated early and properly, the occurrence of the above serious complications can be avoided.

([-]) Treatment

1. General handling

(1) Maintain good eating and hygiene habits, avoid spicy and irritating food, and keep the stool smooth.

(2) If you have been engaged in sedentary or standing work for a long time, you should pay attention to changing your body position frequently to achieve a balance between work and rest.

(3) If hemorrhoids prolapse, they should be bathed in warm water in time, washed and sent back to the anus to prevent incarceration.

(4) Timely treatment of intestinal chronic diseases, such as diarrhea, dysentery, enteritis, etc.

2. Principles of treatment
For hemorrhoids in the asymptomatic quiescent period, you only need to pay attention to diet, keep the stool unobstructed, and prevent complications, without treatment.In addition, injection therapy, cryotherapy and so on.When the non-surgical treatment of hemorrhoids fails or the connective tissue supporting the hemorrhoids is extensively destroyed, hemorrhoids bleeding, thrombosis, prolapse of hemorrhoids cause symptoms or incarceration, etc., surgical treatment should be taken.

3. Treatment methods
It should be decided according to the type of hemorrhoids, the degree of severity, the presence or absence of complications and the physical condition of the patient. In summary, it can be divided into two categories: surgical therapy and non-surgical therapy.Generally speaking, non-surgical treatment can be adopted in the early stage of various hemorrhoids and when the symptoms are not serious, such as: daily care, oral administration of Chinese and Western medicine, external application, etc., can achieve satisfactory results; In severe cases, the effect of surgical treatment is relatively satisfactory, and the long-term curative effect is sure, while the effect of non-surgical treatment is relatively poor.In addition, there are still treatment methods such as infrared irradiation, laser and freezing. The short-term curative effect of infrared irradiation is relatively obvious, but the long-term curative effect is not yet very sure. Bleeding, scar stenosis, etc., so it is rarely used at present. Cryotherapy has a good effect on internal hemorrhoids, but poor curative effect on external hemorrhoids, and there are many postoperative reactions and complications, so it is not often used.

4. Sports Therapy
Physical therapy can do a lot to prevent bruising.Properly engaging in sports can reduce venous pressure, strengthen the function of the cardiovascular system, eliminate constipation, and enhance muscle strength, which play an important role in the prevention and treatment of hemorrhoids.

(1) Levator ani exercise: relax the whole body, clamp the buttocks and thighs firmly, cooperate with inhalation, lick the palate with the tongue, and lift the anus upward at the same time.As if enduring defecation, after levator ani, close your breath for a while, then cooperate with exhalation, and relax your whole body.Do it twice a day, morning and evening, and do it a dozen times each time.

(2) Lifting the pelvis: Lie on your back and bend your knees so that your heels are close to your buttocks, put your hands under your head, use the soles of your feet and your shoulders as fulcrums, lift your pelvis, lift and retract your anus at the same time, and lower your pelvis when you relax.After proficiency, you can also cooperate with breathing, inhale when lifting the anus, and exhale when relaxing.This method can be done 1 to 3 times a day, 20 times each time.

(3) Abdominal rotation exercise: Lie on your back, stretch your legs naturally, and use the palm of your hand to rotate around Qihai Point.Rotate counterclockwise 20 to 30 times, and clockwise 20 to 30 times, first counterclockwise and then forward.

(4) Cross-up exercise: cross your legs, sit on the edge of a bed or a chair, and relax your whole body; keep your legs crossed and stand, at the same time close your buttocks and legs, and lift your anus; when you sit down and restore your body, relax, do this continuously for 10~ 30 times.

(5) Body forward flexion exercise: Stand with legs apart, hold both palms loosely, lift up from both sides of the chest to the breast, and at the same time inhale with the head upright; after the breath is full, the upper body bends forward like a bow, At the same time, the two fists change into palms and are inserted along the side of the armpit to the back and lower part of the body, and take a deep breath according to the movement.Do this 5-6 times in a row.

(6) Lifting the center of gravity exercise: Keep your legs together, lift your arms to the top of your head, lift your heels at the same time, and take a deep breath; lower your arms naturally in front of your body, and at the same time, let your heels fall firmly, and take a deep and long breath , This potential can be done continuously 5-6 times.

5. Remedies for hemorrhoids

(1) Decoct 500 grams of raw twig tree roots or fig leaves, take a sitz bath after the temperature is suitable, and soak the affected area twice a day.

(2) Two to three raw persimmons, eaten raw.Can stop bleeding.

(3) Take more than a dozen peppercorns and a teaspoon of salt, rinse with boiling water, sit on the basin, fumigate and wash the affected area, once a day, about 10 minutes each time, or once a day in the morning and evening for severe cases.It has the function of reducing swelling and relieving pain.

(4) Wash the potatoes and cut 3 to 5 thin slices, stack them together, apply them on the hemorrhoids before going to bed, cover with a layer of gauze and fix them with adhesive strips, take them off the next morning, and continue for several days.

(5) Put 100 grams of fresh walnut leaves in an earthen pot, add 100 ml of water, seal the mouth of the jar with paper, boil for 20 minutes, put the medicine jar in a pail, and tear off the sealing paper on the mouth of the medicine jar.Immediately sit on the pail, use the steam to point at the affected area and smoke for 30 minutes, then pour the medicinal liquid with residue into the basin, wait for the water temperature to cool to about 50°C, take a hip bath for 30 minutes, and scrub the affected area with medicinal residue, 3 days a day times, consecutively for 5 days.

(6) 3 wood turtles, a little borneol.Shell the wood turtle seeds and take the meat, add a little water to grind the juice, add a little rock sugar powder, stir, and rub the affected area with a cotton swab, 3 times a day.

(7) 2 figs and 1 fig leaf.Wash the figs, decoct them with fire (or eat them raw on an empty stomach), 2 times a day.At the same time, wash with fig leaves and boil soup every night, and then take a sitz bath, once a day.

(8) Take an appropriate amount of leek root, wash and decoct in water, pour it into a basin while it is hot and smoke it, twice a day.

([-]) Prevention

The incidence of hemorrhoids is high, and the recurrence rate of hemorrhoid patients is also high after surgical treatment or other treatments.The reason is that in addition to incomplete treatment, not paying attention to preventing the occurrence of hemorrhoids is also an important factor. Preventing the occurrence of hemorrhoids mainly includes the following aspects:

1. Strengthen exercise Regularly participate in various sports activities such as radio gymnastics, Tai Chi, Qigong, etc., which can enhance the body's disease resistance, reduce the possibility of disease, and also have a certain preventive effect on hemorrhoids.This is because physical exercise is beneficial to blood circulation, can reconcile the body's qi and blood, promote gastrointestinal peristalsis, improve pelvic congestion, prevent constipation, and prevent hemorrhoids.On the other hand, self-massage can be used to improve local blood circulation in the anus.There are two methods: one is to self-massage the Changqiang acupoint on the tip of the coccyx with hands before going to sleep, each time for about 5 minutes, it can dredge the meridians and improve blood circulation in the anus; the other method is to use the mind to consciously contract the anus upwards , 1 time in the morning and 30 time in the evening, [-] times each time, this is a method of internal massage, which can transport and remove blood stasis, exercise the anal sphincter, and lift the middle Qi.Regular use can improve the venous return of hemorrhoids, and has a certain effect on the prevention and self-treatment of hemorrhoids.

2. Prevent constipation. Normal people defecate once a day, and the defecation time has different habits in the morning, noon, and after dinner.Normal stools are formed soft stools, neither dry nor runny, no difficulty in defecation, and a relaxed and comfortable feeling after defecation, which indicates that the gastrointestinal function is good.If the stool is hard and hard, not only is it difficult to defecate, but also due to the accumulation of feces in the intestinal cavity, the pressure in the anorectal blood vessel increases, and the blood reflux is hindered, which makes the hemorrhoidal plexus varicose and form hemorrhoids.

3. Keep the area around the anus clean. The anus, rectum, and sigmoid colon are the places to store and excrete feces. There are many bacteria in the feces. The anus area is easily contaminated by these bacteria, which can induce sweat glands and sebaceous glands infection around the anus, resulting in boils and abscesses.The female vagina is adjacent to the anus, and there are more vaginal secretions, which can irritate the anal skin and induce hemorrhoids.Therefore, you should always keep the area around the anus clean, fumigate and wash with warm water every day, and change your underwear frequently, which can prevent hemorrhoids.

4. Other increased abdominal pressure can block the venous return of hemorrhoids and cause hemorrhoids.There are many diseases that cause increased abdominal pressure clinically, such as abdominal tumors compressing intra-abdominal blood vessels, which can block the return of hemorrhoidal veins and cause hemorrhoids.Portal hypertension caused by liver cirrhosis can cause dilation of anorectal blood vessels and cause hemorrhoids. At this time, liver cirrhosis should be treated first.Don't rush to treat hemorrhoids, because the symptoms of hemorrhoids can be improved after cirrhosis is relieved.

There are many ways to prevent hemorrhoids. As long as you do it carefully in your daily life, you can not only prevent and reduce the occurrence of hemorrhoids, but also reduce and prevent the occurrence of hemorrhoids for patients who already suffer from hemorrhoids.

[-]. Point massage

([-]) Acupuncture therapy

1. Acupuncture
Huiyin, Huiyang, Changqiang, Erbai, Chengshan, Baihui, Zusanli.

2. Positioning
Perineum—the perineum, the midpoint of the connection between the root of the scrotum and the anus in males, and the midpoint of the connection between the labia majora and the anus in females.

Huiyang—sacrum, 0.5 cun lateral to the end of the coccyx.Changqiang—below the end of the coccyx, at the midpoint of the line connecting the end of the coccyx to the anus.

Erbai—on the palm side of the forearm, 4 cun above the transverse crease of the wrist, on both sides of the flexor carpi radialis tendon, 1 point on each side, 2 points on one arm, 4 points in total on the left and right arms.

Chengshan—in the middle of the back of the calf, where a pointed depression appears under the belly of the gastrocnemius muscle when the calf is straightened or the heel is raised.

Baihui—on the head, 5 inches straight above the center of the front hairline, or the midpoint of the line connecting the two ear tips.

Zusanli - anterolateral side of the calf, 3 cun below the calf's nose, one finger (middle finger) away from the front edge of the tibia.

([-]) Self-massage
1. Lift the anus exercise to relax the whole body, clamp the buttocks and thighs firmly, cooperate with inhalation, lick the palate with the tongue, and at the same time lift the anus upwards.As if enduring defecation, after levator ani, close your breath for a while, then cooperate with exhalation, and relax your whole body.Twice a day in the morning and evening, do twenty times each time.

2. Lifting the pelvis: Lie on your back and bend your knees so that your heels are close to your buttocks, put your hands under your head, and use the soles of your feet and shoulders as fulcrums to lift your pelvis while lifting and retracting your anus. When you relax, lower your pelvis.After proficiency, you can also cooperate with breathing, inhale when lifting the anus, and exhale when relaxing.This method can be done 1 to 3 times a day, 20 times each time.

3.摩腹以气海穴（脐下1.5寸处）为中心，用手掌作旋转运动。逆时针旋转20～30次，顺时针旋转20～30次，先逆后顺旋转。

4. Acupuncture Press the aforementioned acupoints for 1 to 2 minutes per acupoint, depending on the degree of soreness.

5. Wipe Shenshu with both hands backwards and rub the Shenshu points on both sides with the palms, taking the heat as the degree.

(End of this chapter)