以“青蒿”论治湿热下注型混合痔的临床经验  

Clinical experience of applying Artemisia annua in the treatment of mixed hemorrhoids of damp-heat infusion type

作　　者：陆蓉蓉 杨越 王欢 李志鹏 LU Rongrong;YANG Yue;WANG Huan;LI Zhipeng

机构地区：[1]山西中医药大学,山西太原030024 [2]山西中医药大学附属医院,山西太原030024

出　　处：《中医临床研究》2023年第12期19-22,共4页Clinical Journal Of Chinese Medicine

基　　金：“四联术”治疗环状混合痔的临床研究,山西省卫生健康委科研课题(2020098);一种治疗湿热下注型痔裂瘘的中药组合物,山西中医药大学校课题(2021PY-ZH-1);自拟中药熏洗方治疗湿热下注型混合痔的临床观察,山西中医药大学研究生创新项目(2022CX004)。

摘　　要：混合痔是肛肠科常见病、多发病,占到肛门部常见疾病的80%以上,其中辨证为湿热下注型和脾虚气陷型的患者在中医临床证型中占80.63%。虽然,目前能根治混合痔的治疗方式仍为手术疗法,但是始终困扰医生和患者的问题是术后的愈合、疼痛及并发症等,甚至部分患者会对手术产生恐惧心理,故临床上大部分患者治疗混合痔时首先偏向于选择保守治疗。李志鹏老师认为混合痔病变部位特殊,内服药物起效慢,患者依从性差,一般首选外治法治疗,主要包括中药熏洗、敷药及塞药法等,其中,首推中药熏洗疗法。中药熏洗疗法在治疗肛肠疾病方面有独特的优势,既可以直接作用于病变局部治疗疾病,快速改善局部症状,减轻患者痛苦,提高患者生存生活质量,又可以达到“以外调内”的目的,疗效确切,并且操作简单,易于被患者接受。老师根据多年临床观察和试验,发现青蒿药寒、熏痔休已,尤其对治疗湿热下注型混合痔有独特的疗效,故首次采用青蒿为君,配伍黄柏、苦参、马齿苋、蛇床子等苦寒之品,清热利湿凉血,佐以丹参活血化瘀,凉血消痈,全方共奏清热利湿、凉血止血之效,又可使气机升降有序,瘀血祛而新血生,标本兼治,对治疗湿热下注型混合痔疗效显著,值得学习和推广。Mixed hemorrhoids is a common disease in anorectal department,it is frequently occurring,accounting for more than 80%of the common diseases in the anus.Among them,80.63%of the clinical syndrome types of traditional Chinese medicine are in patients with damp-heat infusion type and spleen deficiency and Qi(气)depression type.Although the current treatment for mixed hemorrhoids is still surgical treatment,the problems that always perplex doctors and patients are postoperative healing,pain and complications,and even some patients will fear surgery.Therefore,most patients prefer conservative treatment in treating mixed hemorrhoids clinically.Teacher LI Zhipeng thinks that the lesion of mixed hemorrhoids is special,the effect of internal medicine is slow,and the compliance of patients is poor.Generally,external treatment is the first choice,mainly including TCM medicine fumigation,dressing and drug tamponade.Among them,TCM medicine fumigation is the first choice.The TCM medicine fumigation and washing therapy has unique advantages in treating anorectal diseases.It not only directly acts on the local lesion to treat the disease,but also can quickly ameliorate the local symptoms,alleviate the pain of patients,improve the quality of life of patients,and achieve the goal of adjusting from outside to inside.It has definite curative effects,is simple to operate,and is easy to be accepted by patients.After many years of clinical observation and experiments,the teacher has found that the herbal medicine Qinghao(Artemisia annua)has a unique effect on mixed hemorrhoids,especially on mixed hemorrhoids of the damp-heat infusion type.Therefore,for the first time,Artemisia annua is used as the monarch drug,along with bitter cold products as Huangbo(Phellodendron),Kushen(Sophora flavescens),Machixian(Portulaca),and Shechuangzi(Cnidium monnieri).It could clear heat,dispel dampness,remove blood stasis,cool blood and eliminate carbuncle.The whole recipe plays the role of clearing heat,dispelling dampness,cooling blood and stopping blee

关 键 词：湿热下注型混合痔 青蒿 自拟中药熏洗方 临床经验 

分 类 号：R266[医药卫生—中医外科学]