梁林江治疗陈旧性肛裂经验  

Liang Lin-jiang′s Experience of Treating Old Anal Fissure

作　　者：柳瑞瑞 徐浩[1] 李嘉钦 钟盛兰 梁林江 LIU Rui-rui;XU Hao;LI Jia-qin;ZHONG Sheng-lan;LIANG Lin-jiang(Shanghai Fourth People′s Hospital Affiliated to Tongji University,Shanghai,China,200434)

机构地区：[1]同济大学附属上海市第四人民医院,上海200434

出　　处：《河南中医》2022年第8期1173-1177,共5页Henan Traditional Chinese Medicine

基　　金：上海市基层名老中医专家传承工作室建设项目(2020JCGZS-006);2021年度上海市虹口区卫生健康委员会中医药科研课题项目(HKQ-ZYY-2021-17);2020年度上海市虹口区卫生健康委员会中医药科研课题项目(HKQ-ZYY-2020-45);2020年度上海市第四人民医院学科助推计划项目(SY-XKZT-2020-1018);2021年度上海市第四人民医院学科助推计划项目(SY-XKZT-2021-2003)。

摘　　要：梁林江主任医师认为,陈旧性肛裂术后易复发的原因有:(1)内括约肌切开不够充分;(2)裂口周围炎性增生物残留;(3)裂面顶端的肛隐窝存在“肛腺感染”。梁老师将传统的肛裂切除术改为经括约肌间沟入路的探针引导下内括约肌切开术,使肛门括约肌松解更充分,粪便对创面的摩擦损伤减少。肛门疾病术后经络受损,气滞血瘀,湿热未尽,邪毒留滞,应治以清热解毒、化瘀消肿、收敛祛湿、止血止痛,梁老师自创止血通便方,在补气养血止血的同时,行气润肠通便,并自制外用药红玉膏和生肌散,早期外敷红玉膏收湿敛疮,后期内掺生肌散敛疮生肌,配合自拟梅石熏洗方熏洗治疗,多法共用,避免肛裂术后复发。The chief physician Liang Lin-jiang believes that the causes of recurrence of old anal fissure after operation are as follows:(1) Internal sphincter incision is insufficient;(2) There are inflammatory proliferator residues around the fissure;(3) There is "anal gland infection" in the anal recess at the top of the fissure surface.Professor Liang has changed the traditional anal fissure resection to the probe-guided internal sphincterotomy through the intersphincter sulcus approach,which makes the anal sphincter release more fully and reduces the friction damage of feces to the wound.After the operation of anal diseases,the meridians and collaterals are damaged,qi stagnation and blood stasis,dampness heat still exist,and pathogenic toxins remain.Therefore,the treatment should focus on clearing heat,removing toxin,resolving blood stasis and swelling,removing dampness with astringent,stopping bleeding and pain.He has created Formula for Stopping Bleeding and Dredging Stool,which can not only boost qi,nourish blood and stop bleeding,but also move qi,moisten the intestines and dredge stool.In addition,he has made external Hongyu Ointment(HYO),and Muscle-Generating Powder by himself.Early external application of HYO can reduce dampness and astringe sores.In the later stage,Muscle-Generating Powder can astringe the sores and generate muscle,and is often combined with the self-made Processed Mume and Pericarpium Granati Fumigation Washing Formula.So many methods are adopted properly to avoid recurrence of anal fissure after operation.

关 键 词：陈旧性肛裂 内括约肌切开术 止血通便方 红玉膏 生肌散 梅石熏洗方 梁林江 

分 类 号：R266[医药卫生—中医外科学]