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If you have internal hemorrhoids, what should you pay attention to?

If you have internal hemorrhoids, what should you pay attention to? Experts from Guangdong Min'an Anorectal Hospital said that the treatment method for internal hemorrhoids is that those with blood-collar injury syndrome have bright red stools, or red and dirty stools, variable before and after defecation, varying amounts, such as dripping or ejaculation, and prolapse. The hemorrhoids are bright red in color, with constipation, dry stools, abdominal pain that refuses to be pressed, dry mouth and tongue, yellow and dry coating, and weak pulse. In patients with deficiency syndrome, the blood in the stools is light red and thin, or dark but not fresh, with continuous pain in the anus and fatigue. , pale tongue, thin and weak pulse. The treatment method is to clear away heat and cool the blood. For deficiency syndrome, it is better to strengthen the spleen and absorb blood. Prescription 1. Main prescription (1) For clearing heat and cooling blood, choose Liangxue Rehmannia Decoction (Qi Kun's "Surgery Dacheng"). Modified prescription: 15 grams of raw rehmannia glutinosa, 9 grams of red peony root, 9 grams of citrus aurantium, 9 grams of skullcap, 12 grams of sophora japonica. 12 grams of Sanguisorba, 9 grams of coptis, 9 grams of Schizonepeta, 6 grams of licorice, 6 grams of Fangfeng, and 9 grams of Mudan Bark. Decoction in water, 1 dose per day. For constipation, add 12 grams of Trichosanthes trichosanthes (beat) and Hemp. 12 grams of benevolence (beat). (2) Choose Guipi Decoction for strengthening the spleen and invigorating blood (Yan Yonghe "Jisheng Prescription"). Modified prescription: 30 grams of Codonopsis pilosula, 12 grams of Poria, 9 grams of Atractylodes, 15 grams of Astragalus, Angelica sinensis. 9 grams, 9 grams of Baiji, 6 grams of Scutellaria baicalensis charcoal, 3 grams of Scutellaria baicalensis charcoal (to be taken with water), 9 grams of sophora charcoal, 6 grams of donkey-hide gelatin (to be taken with water). Decoct in water and take 1 dose per day. 2. Chinese patent medicine (1) Zanglian Pills, 9 grams each time, 2 times a day, with warm water. Suitable for empirical evidence. (2) Dandou Pills, 3 pills each time, 2 times a day, with warm water. Suitable for deficiency syndrome. (3) Guipi Pills, 9 grams of honey pills each time, 6 grams of water honey pills each time, 3 times a day, with warm water. Suitable for deficiency syndrome. (4) 10 Quandabu Pills, honey The pills are 9 grams each time, and the water honey pills are 6 grams each time, 3 times a day with warm water. Suitable for deficiency syndrome. 3. Uniform prescriptions (1) Compound Zanglian Pills (prescription by Chen Songshan): 156 grams of Diyu charcoal, 150 grams of Coptis chinensis, 150 grams of Scutellaria baicalensis, 150 grams of Fangfeng, 150 grams of raw rhubarb, 150 grams of Schizonepeta charcoal, and 250 grams of raw Sophora japonica rice. , 250 grams of hemp seeds, 250 grams of raw rehmannia glutinosa, 5 pairs of pig intestines. Apply the medicine and grind into fine powder to make honey pills, as big as sycamore seeds. Pack into 20 grams per bag. Take 5 grams each time. Twice a day, 10 days is a course of treatment. It is suitable for bleeding internal hemorrhoids, prolapse and embolism, internal and external hemorrhoids, etc. (2) Xiaozhi Decoction (Ling Chaoguang's prescription) prescription: 10 grams of black plum, 10 grams of quinoa, and 15 grams of Sophora flavescens. , 10 grams of dried shoots, 10 grams of pangolin, 30 grams of calcined oysters, 10 grams of hemp seeds. Decoction in water, 1 dose per day. If there is severe blood in the stool, add Sanguisorba charcoal and Platycladus orientalis leaves. If the inflammation is severe, add Cortex Phellodendron, Phellodendron orientalis, Coptis. For constipation, add senna leaves. For severe pain, add frankincense and Corydalis. For anal swelling, add agarwood and Citrus aurantium. For spleen deficiency and depression, add astragalus, kudzu root, and cohosh. It is suitable for hemorrhoid bleeding, swelling and pain. , prolapse. In lower burner damp-heat syndrome, hemorrhoids prolapse outside the anus, with a purple-red and moist color. The anus feels distended and painful, as if there is tenesmus. The stool is uncomfortable, accompanied by bleeding, and the urine is yellow and red. The tongue is red, and the coating is yellow and greasy. , the pulse is slippery or stringy. Treatment method: clear away heat and detoxify, dispel wind and remove dampness. Prescription 1. Main prescription (1) Fangfeng Qinjiang Decoction (Chen Shigong's "Authentic Surgery") modified prescription: 9g Fangfeng, 15g Qinjiang, 9g Angelicae, 15g Rehmannia glutinosa, 9g red peony root, 12g Poria, 9g Forsythia suspensa, 9 grams of areca nut, 12 grams of Sanguisorba, 12 grams of Sophora japonica, 9 grams of Citrus aurantium, 9 grams of Angelica dahurica, 9 grams of Atractylodes, 6 grams of licorice, 9 grams of Gardenia, 9 grams of Alisma. Decoct in water and take 1 dose per day. (2) If there is dampness and heat combined with blood stasis, swelling, pain and itching, you can use Rushen Decoction to relieve pain (Wu Qian et al. "Yi Zong Jin Jian") prescription: 15 grams of rhinopteris, 9 grams of atractylodes, 12 grams of peach kernel, 9 grams of saponin. 9 grams of Fangfeng, 9 grams of Cortex Phellodendron, 9 grams of Angelicae tail, 12 grams of Alisma, 9 grams of Betel nut, 9 grams of rhubarb. Decoct in water and take 1 dose per day. 2. Chinese patent medicine (1) Diyu Huaijiao Pills, 9 grams each time, 2 times a day, with warm water. (2) Hemorrhoid Suning, 9 grams each time, 2 times a day, with warm water. 3. The single-prescription prescription refers to the single-prescription prescription for blood collateral injury syndrome. In the syndrome of Qi and blood deficiency, hemorrhoids prolapse and are difficult to absorb. Those with severe Qi deficiency will have a sinking feeling in the anus, shortness of breath, laziness, lack of appetite, and bloody stools; those with severe blood deficiency will have bloody stools. The blood is light and heavy, dizzy, pale complexion, fatigue and palpitations. Pale tongue, thin and weak pulse. The treatment method is to nourish qi, nourish blood and soften the liver. Prescription 1. Main prescription (1) Buzhong Yiqi Decoction (Li Gao's "Ten Books on Dongyuan") combined with Xiaoyao Powder ("Taiping Huimin Hejiju Prescription" by Chen Shiwen et al.) Modified prescription: 30 grams of Astragalus, 30 grams of Codonopsis pilosula, Cimicifuga 9 grams, Bupleurum 6 grams, Atractylodes 9 grams, Angelica sinensis 9 grams, White peony root 9 grams, Poria cocos 9 grams, Licorice 6 grams, Sophora japonica 9 grams, Rehmannia glutinosa 12 grams. Decoction in water, 1 dose per day. (2 ) If the deficiency of Qi and blood is severe, use 1

0Quandabu Decoction ("Heji Bureau Prescription" by Chen Shiwen et al.) plus or minus prescription: 30g astragalus, 30g dangshen, 12g atractylodes, 12g poria, 6g chuanxiong, 9g angelica, 18g rehmannia root, white peony root 9 grams, 6 grams of licorice, 9 grams of jujube, 9 grams of donkey-hide gelatin (take as a yanghua drink), 9 grams of patchouli (take it later). Decoct in water, take 1 dose per day. 2. Chinese patent medicines (1) Buzhong Yiqi pills, 9 grams of honey pills each time, 6 grams of water honey pills each time, 3 times a day, take with warm water. (2) 10 Quandabu pills, 9 grams of honey pills each time , 6 grams of water honey pill each time, 3 times a day, take with warm water. 3. The single-prescription prescription is based on the single-prescription prescription for the syndrome of blood collateral injury. In the case of constipation due to intestinal dryness and constipation, the abdomen is distended and painful, constipation refuses to be pressed, dry mouth, belching, and upset. The fur is yellow and dry, and the pulse is weak and weak. In the case of constipation due to constipation, the abdominal pain is continuous. , fullness likes to be pressed, dizziness, palpitations and spontaneous sweating. Pale lips and tongue, thin and weak pulse. Treatment method: If it is a secret, it is better to relieve the bowels and relieve heat; if it is a secret, it is better to moisten the intestines and relieve constipation. Prescription 1. Main prescription (1) The prescription for clearing the fu-organs and purging heat is Dachengqi Decoction (Zhang Zhongjing's "Treatise on Febrile Diseases"). The flavored prescription is: 9 grams of raw rhubarb (recipe), 9 grams of Glauber's salt (taken as a drink), 9 grams of Fructus Aurantii, and 9 grams of Magnolia officinalis. , 9 grams of sophora flower, 15 grams of radish seed, 9 grams of honeysuckle, 6 grams of licorice. Decoction in water, 1 dose per day to reduce bloating. (2) For laxatives, choose Zengye Chengqi Decoction (Wu Jutong) "Tiao Bian of Febrile Diseases") combined with Wuren Pill (Wei Yilin's "Shiyi Dexiao Prescription") plus or minus prescription: 9 grams of Scrophulariaceae, 12 grams of Rehmannia glutinosa, 9 grams of Ophiopogon japonicus, 9 grams of rhubarb, 6 grams of licorice, 9 grams of almonds, 12 grams of plum kernels, 12 grams of hemp seeds (broken), 9 grams of tangerine peel, 9 grams of sophora root, 9 grams of citrus aurantium. Decoct in water and take 1 dose per day. 2. Chinese patent medicine (1) Niuhuang Jiedu Tablets, 3 tablets each time, 3 times a day, taken with warm water. Suitable for secretion. (2) Liangge Powder, 9-15 grams daily, add 1 piece of bamboo leaves, honey A little, decoct in water and take in 2 doses. Suitable for deficiency and secretion. (3) Runchang Pills, 9 grams each time, 2 times a day, take with warm water, suitable for deficiency and secretion. (4) Maren Zipi Pills, 10 grams each time, 2 times a day, with warm water. Suitable for constipation. 3. The unilateral prescription refers to the unilateral prescription of blood collateral injury syndrome.---------------------------------------- ----------------------------------External treatment of internal hemorrhoids 1. To fumigate and cleanse hemorrhoids in each period, you can boil the medicine with water, fumigate first and then wash. Commonly used recipes are 5-bezoar soup or sophora flavescens soup, or use Glauber's salt, honeysuckle, forsythia, sophora flavescens, burnet burnt, purslane, Sichuan pepper, etc. 1~2 flavors of boiled water, fumigation and washing. Fumigation and washing can activate blood circulation, reduce swelling, clear away heat and relieve pain, and astringe and relieve itching. 2. In the later stage of external application of internal hemorrhoids, if the surface of the hemorrhoids is eroded and exuded, and the operation is temporarily inoperable, the above method can be used to fumigate and cleanse the affected area, and then external application can be done with Wubeizi powder, Xiaozhi powder and dried alum powder. External application has the effects of clearing away heat, reducing swelling, relieving pain, astringing and stopping bleeding. It can shrink hemorrhoids and heal the ulcers. 3. For internal hemorrhoids in stages I, II, and III, and for those who are inconvenient to apply medicine after internal hemorrhoid surgery, the medicine can be made into a paste or plug and inserted into the anus to achieve the purpose of clearing away heat, reducing swelling, analgesia and stopping bleeding. Jihua ointment can be used as a stopper. , Lithospermum ointment, etc. 4. In the withered hemorrhoid method, medicinal strips or nails are inserted into the hemorrhoid core to make the hemorrhoids dry, necrotic, fall off and heal. Currently, arsenic-free medicinal nails such as 7 fairy strips, 2 yellow withered hemorrhoid nails, etc. are generally used. Indications: hemorrhoids in stages II and III. Internal hemorrhoids include internal and external hemorrhoids. Contraindications: Patients with various acute diseases, severe chronic diseases, acute inflammation of the anorectum, diarrhea, malignant tumors, bleeding, and those allergic to arsenic. Operation method: Clean enema before surgery, lie on your side or lithotomy position, fully expose the anus. After washing with normal saline, turn the hemorrhoids out of the anus, fix the hemorrhoids with the index and middle fingers of your left hand, and perform surface disinfection. Hold the tail section of the medicine nail with the thumb and index fingers of your right hand, and place it on the calcaneus. At 0.3-0.5 cm of the line, rotate it in a direction of 250.350 with the longitudinal axis of the intestinal wall and insert it into the center of the submucosal hemorrhoid, about 1 cm deep. Generally, 4 to 6 pieces are inserted into each core at a time, or depending on the size of the hemorrhoid. Set the spacing to 0.3~0.5 cm. Then cut off the excess medical nails exposed outside the hemorrhoids, leaving about 1 mm of nail roots exposed. Too short can easily cause bleeding from the socket and is difficult to fix; too long can easily damage the opposite side. Intestinal wall. Then push the hemorrhoids back into the anus. Treat other hemorrhoids in the same way, up to 3 at a time. After each nail insertion, insert coptis or lithospermum ointment at the same time. The hemorrhoids usually shrink and fall off in about 7 days. Precautions: The inserted nails should not overlap and should be of appropriate depth. Too deep can damage the sphincter and lead to infection and pain; too shallow nails can easily fall off, causing bleeding at the socket and failing to achieve the purpose of treatment. Insert small hemorrhoids first, then insert large hemorrhoids, or insert them first For hemorrhoids with bleeding points, inserting a nail at the bleeding point can stop the bleeding. When inserting the screws, you should correctly grasp the tooth line.

distance, too close can cause pain. The total number of screws inserted at one time should not exceed 20. Postoperative treatment: Do not defecate within 24 hours after surgery to prevent the screws from slipping and causing bleeding. If the hemorrhoids prolapse after defecation, they should be pushed back immediately. To avoid severe pain caused by edema and incarceration, supplementary treatment is provided with drugs to stop bleeding, reduce swelling and moisturize the intestines. If arsenic-containing mercury nails are used, the patient should be instructed to drink more boiled water, or take orally with Yinhua and mung bean decoction to facilitate the excretion of arsenic poison. At the same time, pay attention to observe whether the patient has high fever, abdominal pain, vomiting, oral ulcers and other poisoning conditions for timely treatment. 5. Ligation method uses medicinal thread, thick silk thread, or rubber ring to ligate the root of hemorrhoids to block the blood supply of the hemorrhoids, causing them to dry up due to ischemia, necrosis and fall off, thereby achieving the purpose of cure. Generally, the more commonly used methods include through ligation and rubber ring ligation. Ligation method, etc. (1) Through ligation method: use silk thread to penetrate the hemorrhoid root to block the flow of blood and qi in the diseased area to achieve the purpose of causing the hemorrhoid core to necrosis and fall off. Indications: Stage II and III internal hemorrhoids, especially fibrous type Internal hemorrhoids are more suitable. Contraindications: acute and chronic inflammation of the anus, acute and chronic dysentery, diarrhea, infiltrative tuberculosis, severe liver and kidney diseases, high blood pressure, patients with various blood diseases and pregnant women in labor. Operation methods: routine skin preparation and cleaning For enema, lumbar anesthesia or local anesthesia is used. The anus is fully exposed in the lateral decubitus or lithotomy position, and draped with routine disinfection. The surgeon crosses the index fingers of both hands and slowly expands the anus to relax the sphincter and fully expose the hemorrhoids. Use a curved vascular forceps to clamp the base of the hemorrhoid, use your left hand to gently pull it outward from the anus, hold a curved needle in your right hand and thread a No. 10 thick silk thread through the center of the base of the hemorrhoid slightly above, and then use scissors to cut a superficial line along the tooth line. Make an incision and tie the suture around the "8" figure at the base of the hemorrhoid core. After ligation, the hemorrhoid core is injected with 15% alum solution or Xiaozhiling injection, or the hemorrhoid core is pressed to accelerate the hemorrhoid core necrosis and fall off. Finally, cut the tying suture short, leaving about 3.5 centimeters, and then push the hemorrhoids back into the anus. After the operation, inject Lithospermum ointment and fix it with a gauze cover. Generally, 3 hemorrhoids are treated at one time. If it is an annular internal hemorrhoid, the hemorrhoids can be divided into several hemorrhoid blocks first, and between the hemorrhoid blocks Use two hemostatic forceps to clamp the mucosa on one side. Cut it in the middle. Treat the opposite side of the hemorrhoid in the same way. Then perform an "8" figure penetrating ligation on the hemorrhoid. Use the same method to treat other hemorrhoids one by one. Note: When ligating It should be smaller first and then larger. When the suture needle passes through the base of the hemorrhoid, it should not penetrate into the muscle layer to avoid causing muscle necrosis or complications of perianal abscess. Defecation is prohibited on the day after surgery. If the hemorrhoid prolapses after defecation, it should be pushed back into the anus immediately. To prevent edema from aggravating the pain. The hemorrhoids fall off period is 7 to 14 days after the operation. Patients should be advised to reduce their activities as much as possible and should not exert force when defecating to prevent heavy bleeding. (2) Rubber band ligation method: insert a small latex band with the help of a device At the root of the hemorrhoids, use the contraction force after the expansion of the rubber ring to block the blood supply of the hemorrhoids, causing ischemic necrosis and falling off. Indications: Stage II and III internal hemorrhoids and the internal hemorrhoids of internal and external hemorrhoids. Contraindications: Same as through ligation. Operation method : Before the operation, instruct the patient to empty the stool or clean the soup, and take a lateral decubitus or knee-chest position. First insert an oblique anoscope to determine the location and number of hemorrhoids, and select the ligation site; fully expose the hemorrhoid area. Use 0.1 % Xinjier cotton ball disinfection. Then the assistant fixes the anoscope. The surgeon holds the ligation device in his left hand to cover the hemorrhoids. He holds the wheat tongs in his right hand, clamps the root of the hemorrhoids through the ligation ring, and pulls the hemorrhoids into the ligation device. Press the sleeve Use the handle of the ligation device to move the ferrule coat toward the root of the hemorrhoids; then push out the ferrule and pierce it to the root of the hemorrhoids. Then loosen the wheat tongs and withdraw the ligation device together, and then slowly withdraw from the anoscope. Notes: Same as Through ligation.6. Injection therapy (1) Sclerosing and atrophic injection method: Inject the sclerosing and atrophic injection into the space of the submucosal venous plexus of the hemorrhoids, causing a chemical inflammatory reaction. The varicose hemorrhoidal venous plexus is also caused by vein and periphlebitis and progressive fibrous tissue hyperplasia. Gradually occlude, achieving the purpose of hardening and shrinking the hemorrhoids. Indications: Internal hemorrhoids in stages I, II, and III, internal hemorrhoids and anemia that are not suitable for other treatments, and the internal hemorrhoids part of internal and external hemorrhoids. Contraindications: Internal hemorrhoids are incarcerated; internal hemorrhoids are accompanied by acute and chronic conditions Inflammation and diarrhea; combined with severe tuberculosis, hypertension, liver and kidney diseases and blood diseases; internal hemorrhoids, external hemorrhoids caused by abdominal tumors, pregnant women in labor, and those with severe prostatic hyperplasia. Commonly used drugs: Xiaozhiling, 6%~10% alum solution, 5% sodium cod liver oleate, 5% to 10% carbolic glycerin, etc. Operation method: Take the lateral decubitus position or lithotomy position, perform routine surgical field disinfection, and after local anesthesia, use 0.1% Xinjilin to disinfect the anal canal and intestines. After dilation of the anus, use a skin test needle to extract the medicinal solution and inject it under a trumpet-shaped anoscope. The medicinal solution should be injected into the submucosa of the hemorrhoids 0.5 cm away from the tooth line, and the needle should be injected at an angle of 150 degrees. Each time Inject 0.5 to 1 ml of medicinal solution into the nucleus, and the degree is that the color of the swollen surface of the hemorrhoids does not change. No more than 3 hemorrhoids should be injected at each time.

The total amount should not exceed 3~4 ml. If one injection does not heal, another injection can be given 7 days apart. Generally, 3-4 times can cure the problem. (2) Xiaozhiling 4-step injection method: It is also a part of the sclerosis and atrophy injection method. The principle is the same as that of the sclerosing atrophic injection method. ① Indications: varicose internal and external hemorrhoids formed by internal hemorrhoids and bleeding in various stages, and further development of stage III hemorrhoids. ② Contraindications: incarcerated and inflamed internal hemorrhoids; accompanied by acute enteritis and dysentery; Skin tag external hemorrhoids. ③ Operation method: Take lateral decubitus position or lithotomy position, use 0. . Use 5% e chlorhexidine cotton balls for local disinfection to fully expose the lesion, use 10-15 ml of 1% procaine for local anal anesthesia, and then use 0.5% o chlorhexidine cotton balls to disinfect the anal hemorrhoid area. Use Expand the anus with your hands, carefully check the location, number and size of internal hemorrhoids under the trumpet-shaped anoscope, and then use your index finger to touch the hemorrhoid area to see if there is arterial pulsation to determine the injection site. Then use a No. 5 needle and a 5 ml syringe to aspirate the hemorrhoids. Liquid, perform low-concentration, high-dose injection in 4 steps under anoscope. The specific operations are introduced below. Injection in the superior rectal artery area: In order to avoid tissue necrosis and bleeding caused by concentration of the liquid, use 1% procaine to dissolve the liquid. Hemorrhoid liquid is injected according to the ratio of 1:1 dilution, and each point is injected with 2~3 ml. Hemorrhoid submucosal injection: In order to prevent tissue necrosis, use 1% procaine to dilute Xiao Zhiling liquid at 2:1 Insert the needle from the middle part of the hemorrhoids to the muscle layer. When muscle resistance occurs, withdraw the needle and inject, and then inject in a fan shape to evenly fill the submucosal tissue with the medicine. The amount of medicine injected can show that the hemorrhoids are diffuse. It is appropriate to inject 4-6 ml of medicine per nucleus. Injection into the lamina propria of hemorrhoidal mucosa: When the injection in step 2 is completed, slowly withdraw the needle, and when a feeling of loss appears, enter the lamina propria of the hemorrhoidal mucosa and slowly inject the medicine. Inject 2-3 ml of medicine into each core. After injection, the hemorrhoidal mucosa can be seen to be blister-like, and the microscopic blood vessels of the mucosa can be seen. Injection into the cave-like vein area: Finally, inject at the lowest part of the internal hemorrhoid slightly above the tooth line, that is, from the cave-like vein. Inject at the beginning of the hemorrhoids. In order to prevent the liquid from spreading below the dental line and causing pain, dilute the liquid to a concentration of 1:1. Expose the lower part of the internal hemorrhoid under an anoscope or use your fingers, and place O on the dental line. Insert the needle at 1 cm, and insert the tip of the needle into the oblique upper part of the internal hemorrhoid for a fan-shaped injection. Inject 1-3 ml into each core. The amount of medicine injected at one time for stage III internal hemorrhoids is 20-45 ml (diluted dose). Finally, use a 3 cm long, Most of the 1 cm wide Vaseline gauze is put into the anus to fix the internal hemorrhoids and prevent incarceration. Use gauze for external fixation. In principle, all internal hemorrhoids should be injected at one time. After the injection, the internal hemorrhoids will shrink and dry up and become foreign bodies. This method generally has no adverse reactions. , if there is slight pain after the injection, no treatment is required; there may be low-grade fever, and in rare cases the body temperature is high, which can be treated symptomatically and return to normal in 3-5 days. Notes: Strict disinfection is required during injection, and the needle insertion site for each injection It must be disinfected to prevent infection. A fine needle must be used to prevent the needle hole from being too large and causing bleeding. After inserting the needle, a blood return test should be done. If there is no blood return, the medicine can be pushed slowly. Do not insert the needle into the hemorrhoids in any direction to avoid damaging the hemorrhoids. Internal blood vessels cause bleeding, resulting in hemorrhoidal hematoma, increased local exudate, and prolonged hemorrhoidal atrophy time. The depth of the injection should be moderate. Too shallow can easily cause mucosal ulceration, and too deep can harden the muscle tissue. Do not inject the liquid into the external hemorrhoid area. Or the injection position is too low to prevent the liquid from spreading to the anal canal, causing perianal edema and pain. It is not advisable to defecate for 24 hours after the injection, and reduce activities. (3) Necrotic and withered injection method: Inject the corrosive liquid into the hemorrhoids. The hemorrhoid tissue is necrotic and falls off, and the wound is repaired and healed. Indications: Stage II and III internal hemorrhoids. Contraindications: Same as sclerosing atrophy injection method. Commonly used drugs: dry hemorrhoid oil, Xin No. 6 injection. Operation method: Yaoshu anesthesia or Under local anesthesia, take the lithotomy position, fully expose the anus, and disinfect with 0.1% Xinjier cotton balls. Turn the internal hemorrhoids out of the anus, hold the mosquito-type hemostatic forceps in the left hand to clamp part of the hemorrhoids on the tooth line, and fix it with your right hand. Use a syringe of medicinal solution, pierce the submucosal layer of the hemorrhoid core at 0.3~0.5 cm on the tooth line, and slowly inject the medicinal solution into the hemorrhoid core in a columnar shape from low to high until the hemorrhoid core is slightly enlarged and discolored. After injection , push the hemorrhoids back into the anus. The hemorrhoids will become necrotic and dry up and fall off in about 7 to 14 days. No more than 3 hemorrhoids should be injected at one time; if the hemorrhoids are larger or more numerous, injections can be made in stages, once every 2 weeks. If you use dry hemorrhoids For oil injection, 0.5~1 ml is injected into each nucleus, and the total volume does not exceed 4 ml. Notes: Same as the sclerosis and atrophy injection method. Reduce activities 7-14 days after the injection to prevent heavy bleeding when the hemorrhoids fall off. 7. Postoperative complications and treatment of internal hemorrhoids. Pain: Oral analgesics, or use 10 ml of 1% procaine to seal the Zhongliao or Xialiao points, 5 ml on each side. You can also use Shaofu Zhuyu Decoction (Wang Qingren's " "Yilin Correction"), add honeysuckle

15 grams, 10 grams of forsythia, and 20 grams of dandelion. It can activate blood circulation and relieve pain, clear away heat and detoxify. Bleeding: If the internal hemorrhoids are not firmly ligated, or the hemorrhoids are withered and the wound is bleeding, you can use Vaseline gauze to fill it, compress it to stop the bleeding, or apply external hemostatic powder .If small arteries bleed, they should be sutured to stop bleeding under conditions that can fully expose the bleeding point; Yunnan Baiyao, etc. can be taken orally after surgery to prevent bleeding. Fever: Fever caused by tissue necrosis being absorbed, the body temperature is usually not high (38 below ℃), generally no treatment is required, and attention should be paid to observation. If the high fever is caused by local infection, you should take heat-clearing and detoxifying drugs, and then choose Huanglian Jiedu Decoction (Wang Tao's "Waitai Mi Yao") plus honeysuckle, forsythia, and soybean grass. Edema: You can use 30 grams of saltpeter, 30 grams of Phellodendron, 15 grams of honeysuckle, 15 grams of safflower, 20 grams of dandelion, and 3 grams of alum, decoction and fumigation, 1-2 times a day. Or use 1:5000 potassium permanganate hot water. Take a sitz bath and apply hemorrhoid ointment externally after bathing. For mild cases, you can apply hot compress with a hot water bottle. Urination is easier: ask the patient to drink more water, or take 30 grams of psyllium and 30 grams of winter melon peel in boiled water instead of tea; you can also use acupuncture at 3 Yinjiao. , water, Guanyuan, Zhongji and other acupoints, or use 10 ml of 1% procaine to seal the long strong points, or use hot water bottles for hot compresses. ------------------- -------------------------------------------------- -----------How to treat internal hemorrhoids 1. Acupuncture therapy Acupuncture: Mainly suitable for hemorrhoids during the construction period, or hemorrhoids in stages II and III that cannot be operated temporarily. Main acupoints: Changqiang, Chengshan, 8liao. Accessory acupoints: perineum, Zu3li, 3Yinjiao, Dachangshu. Those with dampness and heat should use the purgative method, and those with spleen deficiency should use the tonic method. Hemorrhoid picking therapy: suitable for hemorrhoids in stages II and III. Points such as Dachangshu and Ciliao can be used, or hemorrhoids can be found on both sides of the patient's back and spine in the lumbosacral region, that is, For small red or off-white papules that protrude from the epidermis and do not fade when pressed, after routine disinfection, use a thick needle to break the epidermis of the hemorrhoids, and then break off several white fibers under the skin. Cover with sterilized gauze after the operation. 2. Diet therapy banana and water spinach porridge: 100 grams of bananas are peeled and pureed, 100 grams of water spinach (macaroni) are cut into tips, and 50 grams of japonica rice. Boil the japonica rice with water until it is almost cooked, add water spinach tips, banana puree, and add an appropriate amount of salt. Or white sugar, boil together into porridge, as breakfast staple food. Suitable for hemorrhoids and fistulas with excessive heat. Dandelion pig intestine soup: 50 grams of fresh dandelion (25 grams of dry product), 25 grams of dandelion, wrapped in cloth, Stew 250 grams of pig intestines in a casserole until thoroughly cooked, remove the bag, add salt to taste, and eat the pig intestines in two portions to drink the soup. Suitable for hemorrhoids and fistulas due to heat syndrome. Stewed lean pork with Codonopsis and figs: 50 grams of Codonopsis pilosula and 250 grams of figs. , 500 grams of lean pork, stew until the meat is cooked, add salt to taste, eat meat and drink soup separately. Suitable for hemorrhoids and fistulas with long-term weakness of qi and blood. Jujube and mullet soup: 50 grams of jujube (pitted), 500 grams of mullet, stew in a casserole until thoroughly cooked, add a little salt and ginger, eat in separate meals. Suitable for hemorrhoids and fistula deficiency syndrome. 3. Preventive care requires cultivating good eating habits, eating regularly and quantitatively, avoiding spicy food, alcoholic drinks and strong flavor. Live a regular life and combine work and rest. Workers who stand for long periods of time should change their positions in a timely manner. Pay attention to anal hygiene and develop good habits. Maintain good defecation habits and always keep the stool unobstructed. Treat diarrhea, constipation, dysentery and other diseases promptly. After internal hemorrhoid surgery, the diet should be light, and if necessary, a semi-fluid or full-fluid diet should be given. During the post-operative hemorrhoid shedding period, try to reduce activities and rest in bed as much as possible. .After each bowel movement after surgery, take a sitz bath with light salt water or 1:5000 potassium permanganate solution, and then change the dressing. Pay attention to the patient's postoperative reaction. If there is fever, pain, difficulty urinating, or bleeding after defecation, check in time. Understand the cause and handle it properly. If the hemorrhoids prolapse after surgery, they should be put back into the anus in time to prevent edema and incarceration.