孙化中治疗湿热下注型痔病临证经验

Professor SUN Huazhong’s clinical experience in treating hemorrhoids of the dampness-heat diffusing downward type

痔是最常见的肛肠疾病。痔的病因尚未完全明确,关于其发生机制有肛垫下移学说和静脉曲张学说两种学说。另外,遗传、饮食、排便习惯等因素跟痔的发生也有一定关系。山西省人民医院孙化中教授从医30余年以来一直致力于肛肠疾病临床诊治及教学科研工作,强调治疗应保守疗法和手术疗法并重,避免过度医疗。他坚持“从湿热论治、重视中药外治法”的治痔原则及术后恢复原则,自拟痔安方和玉黄膏用于临床治疗,疗效可靠。他认为湿热下注型痔患者进行手术治疗后虽已祛除病邪表象,但创面湿热未尽,湿性黏腻、趋下,与热邪搏结,蕴结于创面,且因手术过程中造成局部经络损伤,血瘀阻滞,肛门局部气机不畅,导致术后创口发生疼痛、愈合较慢的情况。为减轻患者痛苦,加速创口愈合,孙化中总结多年用药经验结合经典方,自拟玉黄膏以清热解毒,生肌止痛,促进患者术后创口恢复。文章通过案例,介绍孙化中教授治疗湿热下注型痔病的临床经验,以期为临床提供参考。

Hemorrhoids is the most common anorectal disease.The etiology of hemorrhoids is not completely clear,and there are two theories about the mechanism of hemorrhoids:the theory of anal pad descending and the theory of varicose veins.In addition,genetics,diet,defecation habits and so on are also related to the occurrence of hemorrhoids.Professor SUN Huazhong from Shanxi Provincial People’s Hospital has been engaged in the clinical diagnosis,treatment,teaching and research of anorectal diseases for more than 30 years.He emphasizes that both conservative treatment and surgical treatment should be equally emphasized to avoid over treatment.He insists on the treatment principle of treating hemorrhoids from the aspect of dampness-heat and attaching importance to TCM medicine external treatment method and the postoperative recovery principle.He self-designed the Zhi’an prescription(痔安方)and the Yuhuang ointment(玉黄膏)for clinical application,with reliable efficacy.He believes that although the superficial pathogenic factors of hemorrhoid patients with dampness-heat diffusing downward have been removed after surgical treatment,that the wound is still with dampness-heat,and that the sticky dampness-heat is injected downwards and combines with the heat pathogenic factors on the wound surface.He also believes that the local meridian injury,blood stasis blockage,and local Qi(气)movement obstruction in the anus caused by the operation results in postoperative wound pain and slower wound healing.In order to alleviate the pain of patients and accelerate wound healing,Professor SUN Huazhong summarized many years of medication experience combined with classic prescriptions,and self-made the Yuhuang ointment to clear heat and detoxify,promote tissue regeneration and relieve pain.This paper introduces Professor SUN Huazhong’s clinical experience in treating hemorrhoids of dampness-heat diffusing downward type through case analyses,in order to provide a reference for clinical practice.