中藥治療肛裂患者病例報告

Chinese Medicine Treatment for Anal Fissure: A Case Report

10.7102/JTCIM.201812_16(2).0010

陳治洋(Chih-Yang Chen)；陳家駒(Chia-Chu Chen)；陳重嘉(Chung-Chia Chen)

肛裂 ； 溼熱下注 ； 中藥治療 ； anal fissure ； hot-and-damp downward syndrome ； Chinese medicine treatment

中醫內科醫學雜誌

16卷2期（2018 / 12 / 01）

108 - 116

繁體中文

肛裂為肛門齒狀線以下的裂傷，此位53歲男性，肛裂反覆發作已6年，發作時疼痛劇烈，並伴隨傷口黃綠色分泌物，至皮膚科就診，使用外用抗生素、抗黴菌藥物及類固醇等藥物效果皆不佳，故前來求診中醫治療，經過中醫縝密之四診診察後，判斷患者為溼熱下注之證型，並予以內服科學中藥粉劑治療，患者於服用後肛裂傷口疼痛減輕、分泌物減少以及傷口癒合加速，本案例患者主動提供病灶處照片，使中醫於臨證得以治療參考。

Anal fissure is a tear below the dentate line. This 53-year-old man has suffered from anal fissure for 6 years. He complained about severe anal pain. Yellowish-green discharge was also present. The efficacy of the treatments of external ointments, antibiotics, antifungal and steroid was not successful. As a result, he turned to the Chinese Medicine outpatient department for help. After receiving four examinations of traditional Chinese Medicine, he was diagnosed with hot-and-damp downward syndrome. After receiving oral traditional Chinese medicine powder as treatment, his pain subsided. The anal fissure discharge was reduced and the wound healed quickly. The patient provided a lot of photos of the wound for reference.

1. Acheson, A. G.(2005).Anal fissure: the changing management of a surgical condition.Langenbeck's Archives of Surgery,390(1),1-7.
2. Golfam, F(2010).The effect of topical nifedipine in treatment of chronic anal fissure.Med Iran,48(5),295-9.
3. Grekova, NM(2015).The effects of topical application of metronidazole for treatment of chronic anal fissure: A randomized, controlled pilot study.Indian J Gastroenterol,34(2),152-7.
4. Gupta, Pravin J.(2011).Topical Sucralfate Treatment of Anal Fistulotomy Wounds: A Randomized Placebo-Controlled Trial.Dis Colon Rectum,54(6),699-704.
5. Jonas, Marion(2001).Aanl fissure.Gastroenterology Clinics,30(1),167-181.
6. Poh, Aaron(2010).Innovations in chronic anal fissure treatment: A systematic review.World J Gastrintest Surg,2(7),231-241.
7. 丁宇麗(2005)。辨證治療肛裂 45 例。陝西中醫，26(6)，500-501。
8. 張伯臾(1989)。中醫內科學。臺北:知音出版社。
9. 顧伯康(1989)。中醫外科學。臺北:知音出版社。