脱肛源流考

Investigation on Origin and Development of Anal Prolapse

脱肛是肿物(直肠黏膜、肛管、直肠全层、部分乙状结肠)自肛门脱出于肛外的疾病。早在《五十二病方》中就有对脱肛治疗的记载,而其病名首见于《神农本草经》。本病与脾胃、肺、肾密切相关,以上脏腑病变皆可影响大肠,发生脱肛。其病机不外虚实两端,但总体上是虚多实少。虚证因肺脾肾虚,气陷于下;实证乃湿热下注所致。脱肛的治疗以辨虚实为要。虚证治以补气升提,收敛固涩;实证治以清热化湿;虚实夹杂者,当攻补兼施。

Anal prolapse is the disease of the mass(rectal mucosa,anal canal,rectum,partial sigmoid colon)prolapsing from the anus and out of the anus.As early as the 52 Bing Fangs,there were records on the treatment of anal prolapse,and the name of the disease first appeared in Shennong Bencao Jing.This disease is closely related to Spleen,Stomach,Lung and Kidney,of which pathological changes can affect Large Intestine,resulting in anus prolapse.The pathogenesis of this disease is divided into deficiency and excess,but in general,the number of deficiency patterns is more than excess ones.The deficiency pattern is caused by deficiency of Lung,Spleen and Kidney,which leads to qi collapse below.The excess pattern is due to down flow of dampness-heat.The treatment of anal prolapse takes deficiency-excess pattern differentiation as the point.The treatment principle of deficiency pattern is to tonify and raise qi,as well as astringe Large Intestine.The treatment principle of excess pattern is to clear heat and drain dampness.The mixed one should be treated by both principles.