粤北部分肛痈患者的证型、体质分布及防治研究

Syndrome Type,Constitution Distribution and Prevention and Treatment of Partial Anal Carbuncle Patients in North Guangdong

目的分析粤北地区肛痈患者的体质特点、证型分布及诱发因素,为该类疾病的预防和临床治疗调护提供参考依据。方法对肛痈患者519例的中医证型、体质、体型、饮食嗜好及发病时间进行统计分析。结果1)肛痈主要证型为热毒炽盛,近61%,火毒蕴结有33%,阴虚毒恋型约为5%,其他证型有1%。患者发病期舌红,苔黄或薄黄,脉数或弦滑、细数。2)湿热、痰湿和阴虚型体质为肛痈患者的主要体质类型,湿热型比重犹大,占53%,痰湿为17%,阴虚11%,其余体质占比均在5%以下。3)肛痈患者体型无明显特征偏向,多数患者喜食肥甘辛辣、醇酒等物,发作前有饮食不节史。发病时间集中在冬末、春初之际,高发时间为每年2月前后。4)83%的患者有肛窦炎病史。有部分患者合并消渴发生,且该类患者感染较难控制,病情缠绵,恢复时日较久。结论肛痈防治要因地因时因人制宜,本地要尽早防暑,避耗阳气;及时祛湿,免蕴化热。了解不同体质人群的阴阳虚实,调和阴阳,防患未然。个人做到饮食节制,避免辛辣燥热;保持肛周卫生清洁;及早处理肛门不适,重视肛窦炎的治疗。

Objective： To analyze the physical characteristics,syndrome distribution and predisposing factors of patients with anal carbuncle in North Guangdong,to provide reference for the prevention and treatment of the dis-ease in clinical nursing. Methods： TCM syndrome types,physical condition,body size,diet habit and onset time were statistically analyzed among 519 cases with anal carbuncle. Results：1）The main syndromes of anal carbun-cle were noxious heat nearly 61%,virulent fire accumulation 33%,poison due to Yin deficiency about 5%,other syndromes 1%. At onset stage,the patients had red tongues,yellow or light yellow coated tongues,and slippery and thin string-based pulse. 2）The main constitution types of patients with anal abscess were damp heat,phlegm dampness and Yin deficiency type. The dampness heat type accounted for the largest proportion 53%,phlegm dampness 17%,Yin deficiency 11%,and the rest of body constitution below 5%. 3）The patient with anal abscess had no obvious characteristic deviation,and most of them loved eating fat,sweet or spicy food and wine,etc. There was a history of improper diet before attack. The onset time was concentrated in late winter and early spring,and the high incidence time was around February. 4）83% of patients had a history of anal sinusitis. Some patients complicated with diabetes,and the infection of this kind of patient was more difficult to control;the condition was lingering;the recovery needed a long time. Conclusion： Prevention and treatment of anal carbuncle should be conducted in accordance with the time,the place and the individual. The patient should avoid heatstroke and consumption of Yang,clear damp timely,and dissipate heat. The different constitution in Yin and Yang should be known;Yin and Yang should be regulated,and the disease should be prevented before it happens. Individual achieves dietary abstinence and avoids spicy,hot and dry. One should keep anal hygiene clean,treat anal discom-fort early,and pay attention to the treatment of anal sinusitis.