从络病探析功能性肛门直肠痛

Analysis of functional anorectal pain based on collateral disease

络病广泛存在于各类外感重症及内伤疑难杂病之中,功能性肛门直肠痛作为肛肠科非器质性难治性疾病,往往缠绵难愈,给患者的身心健康以及日常生活带来极大困扰,其契合络病“久病入络”的病程演变规律。现代医学认为其主要与肠-脑互动异常、盆腔神经肌肉功能紊乱、精神心理等因素相关。本文重点阐述从络病论治功能性肛门直肠痛的理论,认为本病的病位在肠络,络中气血升降失常,清阳浊阴交争导致络脉绌急是本病发生的关键。对于功能性肛门直肠痛的治疗策略应当以复通络脉中气血升降有序为着眼点,病在局部而治在整体,采用补虚以荣络、辛温以通络、祛瘀以通络、藤虫以搜络等法,充分展现中医辨证论治以及络病学说的特色,以期对临床诊疗提供进一步导向。

Collateral disease is widely presented in various types of severe external infections and complex internal injuries.Functional anorectal pain,as a non-organic and intractable disease in the field of proctology,is lingering and difficult to heal,affecting their physical and mental health as well as daily life.It conforms to the evolutionary law of the disease course of“prolonged illness entering the collateral”.Modern medicine believes that it is mainly related to abnormal gut-brain interaction,pelvic neuromuscular dysfunction,psychological and other factors.This article focuses on the theory of treating functional anorectal pain from the perspective of collateral diseases.The location of this disease is in the intestinal collateral.It is deemed that the key to the occurrence of this disease is the abnormal rise and fall of Qi and Blood in the collaterals,and the conflict between clear Yang and turbid Yin which leads to the stagnation and urgency of the collaterals.The treatment should pay attention to restore the orderly rise and fall of Qi and Blood in the collaterals.In addition,the disease should be treated locally with a holistic approach,employing methods such as Buxu Rongluo,Xinwen Tongluo,Quyu Tongluo,Tengchong Souluo.It will fully reflect the characteristics of collateral disease theory based on traditional Chinese medicine syndrome differentiation and treatment,with the aim of providing further guidance for clinical treatment.