锁肛痔的中医误诊分析  

The TCM misdiagnosed analysis on anorectal cancer

作　　者：陆南山[1] 

机构地区：[1]广西中医药大学附属瑞康医院,南宁530001

出　　处：《中国处方药》2017年第5期95-96,共2页Journal of China Prescription Drug

摘　　要：目的研究锁肛痔在中医诊断中容易出现误诊的原因,以及如何提高锁肛痔的早期发现率和正确的检查辨别方法。方法选取1996年1月~2008年1月期间收治的50例锁肛痔患者为研究对象,对所选患者的临床资料进行回顾性分析,总结归纳锁肛痔的中医误诊原因,并探讨减少和避免误诊发生的有效措施。结果 50例锁肛痔患者被误诊14例,误诊为细菌性痢疾4例,内痔6例,慢性肠炎2例,肛瘘1例,湿疣1例;误诊原因包括医生对该病的临床症状特点认识不足;锁肛痔经常与其他良性肛肠疾病并行,干扰诊断;临床上对肛门指检的重视程度不够;忽视镜检等辅助临床检查。结论普及教育锁肛痔的相关知识,重视鉴别诊断、肛门指检及电子肠镜等检查,在不能确定时采取病理活检能有效降低锁肛痔的中医误诊率。Objective To study the reason why the lock anal piles in TCM diagnosis is easy to be misdiagnosed, finding out how to improve the rate of lock anal hemorrhoid detection in early time and to make sure a correct method to detect this disease in checking and discrimination. Methods From January 1996 to January 2008, we have treated fifty cases of lock anal hemorrhoid patients, and their clinical data were retrospectively analyzed, then summarized. We have tried to make a conclusion why there are so many misdiagnosis in TCM diagnoses in terms of lock anal hemorrhoid, and discussed to find effective measures to reduce and prevent misdiagnosis from happening ever again. Results 14 cases of lock anal hemorrhoid patients were misdiagnosed. Among them, 4 cases were misdiagnosed as bacterial dysentery, 6 cases as hemorrhoids, 2 cases as chronic enteritis, 1 case was misdiagnosed as anal fistula and the last 1 case as condyloma. The misdiagnosis are caused by many reasons, doctors are not familiar with the characteristics of clinical symptoms of lock anal hemorrhoid for example. Their inadequate understanding of that disease is not the only reason, lock anal hemorrhoid often break out along with other benign anorectal diseases which would interfere the doctors＇ diagnosis; digital anus examination haven＇ t been thought much of in clinical examination; Ignoring microscopy and auxiliary clinical examination is another cause. Conclusion To make lock anal hemorrhoidal related knowledge known to doctors of this section, pay more attention to standard digital anus examination and electronic colonoscopy inspection.When it is not sure what the disease is, take pathological biopsy can effectively reduce the misdiagnosis of lock anal hemorrhoid in TCM.

关 键 词：锁肛痔 中医 误诊 直肠肿瘤诊断 

分 类 号：R266[医药卫生—中医外科学]