| Mixed hemorrhoids are currently the most common anorectal disease in clinical practice,accounting for 98%of all anorectal diseases.The anal canal,rectum,and prostate are closely related to each other in anatomical location,microcirculation,and physiopathology.In clinic,many patients with mixed hemorrhoids have frequent urination,urgency,dysuria,incomplete urination,burning urethra,and painful ejaculation.The symptoms of chronic prostatitis such as lower abdominal distension and pain,and may have a trend that the symptoms of chronic prostatitis will also increase as the course of mixed hemorrhoids is prolonged and the condition aggravated.In addition,many patients with mixed hemorrhoids and chronic prostatitis have psychological problems of anxiety and depression.A survey on the prevalence of chronic prostatitis in patients with mixed hemorrhoids in BeijingObjective:To clarify the incidence of chronic prostatitis in patients with mixed hemorrhoids in various stages,to explore whether the incidence and severity of chronic prostatitis are related to mixed hemorrhoids,and to explore the incidence of chronic prostatitis in mixed hemorrhoids of different ages and different occupations.On the regularity of the onset,research on the causes of mixed hemorrhoids and chronic prostatitis,clarify the anxiety and depression of the same patients with mixed hemorrhoids and chronic prostatitis,and finally clarify the TCM syndrome types and the distribution of TCM syndrome elements in patients with mixed hemorrhoids and chronic prostatitis Features provide new ideas and basis for clinical decision-making of anorectal department and andrologists.Method:Conduct an epidemiological survey in the form of a questionnaire validated by methodological experts.Doctors need to fill in 5 objective questions,and patients need to fill in 4 questionnaires.Results:Among 1217 patients with mixed hemorrhoids,571 were diagnosed with chronic prostatitis,and the overall prevalence rate was 46.92%.(1)Basic information of patients:According to age distribution,household registration and medical insurance status,permanent administrative division,ethnicity,marital status,education level,occupation,height,weight and BMI,smoking and drinking status,mixed hemorrhoid inducement,chronic prostatitis risk factors Statistic results of the number and proportion of patients with prostatitis,whether they have confidence in the treatment of mixed hemorrhoids,whether they have confidence in the treatment of mixed hemorrhoids,and whether they have prostatitis and their proportions;(2)Diagnosis of chronic prostatitis based on the NIH-CPSI score Situation:According to the NIH-CPSI scores of 1217 patients with mixed hemorrhoids and the NIH-CPSI scores of mixed hemorrhoids staging,the statistical results of the number and proportion of patients with prostatitis;(3)According to the Generalized Anxiety Disorder Scale(GAD-7)and PHQ-9 Depression Screening Scale survey results,respectively,based on the statistical results of the number and proportion of patients with prostatitis;(4)The results filled in by the doctor:according to Beijing mixed hemorrhoid patients The distribution of symptoms,the staging of mixed hemorrhoids for the first visit,the texture of the prostate,the analysis of TCM syndromes in patients with and without chronic prostatitis of mixed hemorrhoids,the relationship between the length of the mixed hemorrhoids and the prevalence and severity of chronic prostatitis for classification data statistics result.Conclusion:(1)There is a certain internal connection between the incidence of mixed hemorrhoids and chronic prostatitis.Household registration and medical insurance factors,long-term Beijing administrative divisions,and different nationalities have no effect on the incidence of chronic prostatitis in patients with mixed hemorrhoids.(2)Divorced people are more likely to suffer from chronic prostatitis than married and unmarried people.The higher the educational background of the patients with mixed hemorrhoids,the higher the prevalence of chronic prostatitis.Civil servants and business personnel are more likely to suffer from chronic prostatitis,while service personnel in the tertiary industry are less likely to suffer from chronic prostatitis.Overweight,smoking,and drinking can cause chronic prostatitis,and the longer the smoking age or the higher the frequency of drinking,the higher the incidence of chronic prostatitis.The top four most likely causes of mixed hemorrhoids are:constipation or long defecation time,sitting for a long time,drinking less water and eating fruits and vegetables,high mental stress and work stress;the top four risk factors for chronic prostatitis are:none Restricted sex life,frequent masturbation,often wearing tight pants and holding urine for a long time,the psychological state of anxiety ranked fifth.Little,never labor or physical exercise are the triggers of chronic prostatitis.Whether the patient has confidence in the treatment of mixed hemorrhoids has no effect on the prevalence of chronic prostatitis,but the anxiety and depression of patients who are confident in the treatment of mixed hemorrhoids Significantly better than patients without confidence.(3)Even though the prevalence of chronic prostatitis is relatively high in patients with mixed hemorrhoids,mild and moderate patients account for the vast majority,and there are not many severe patients As the stages of mixed hemorrhoids increase,the symptoms of chronic prostatitis will gradually worsen.(4)The mental state of generalized anxiety disorder and depression is an important cause of chronic prostatitis.Moreover,the more severe the symptoms of chronic prostatitis,the more severe the patient’s anxiety disorder and depression;at the same time,the patient’s tendency to anxiety and depression The higher the value,the greater the risk of chronic prostatitis.(5)Patients with mixed hemorrhoids with prolapsed hemorrhoids are less likely to suffer from chronic prostatitis,while patients with mixed hemorrhoids with anal itching,discharge,uncleanness of defecation,painful stools and other symptoms are more likely to suffer from chronic prostatitis.(6)The higher the stage of mixed hemorrhoids,the greater the chance of chronic prostatitis.Hemorrhoids in Ⅳ stage are the inducement of chronic prostatitis.(7)Patients with normal and full prostate have the mildest symptoms and the lowest prevalence of chronic prostatitis.Prostate flattening,increased hardness,reduced volume,nodules,and tenderness are high-risk factors for chronic prostatitis.These patients also have severe symptoms of chronic prostatitis.(8)In patients with mixed hemorrhoids who do not suffer from chronic prostatitis,the main syndromes are the spleen and kidney,qi stagnation and blood stasis are the main solid syndromes,and Qi deficiency and Yin deficiency are the main deficiency syndromes;In patients with chronic prostatitis and mixed hemorrhoids,the main disease location syndromes are kidney and liver.Qi stagnation and damp-heat are the main solid syndromes,and Yang deficiency and Yin deficiency are the main deficiency syndromes.(9)The prolonged course of mixed hemorrhoids is a risk factor for chronic prostatitis.(10)Two or more pelvic floor diseases appear at the same time,and their pathogenesis is mainly concentrated in the two aspects of qi stagnation,blood stasis and damp-heat toxin stagnation."Is the end point of its local pathogenesis and solid pathogenesis Therefore,we put forward the theory of "Pelvic Floor Stasis and Toxin",which can give full play to its distinctive advantages in the differentiation and treatment of this type of diseaseClinical observation of 68 cases of phase Ⅱ internal hemorrhoids(Syndrome of Dampness-heat Pouring Downward)complicated with chronic prostatitis treated with Hua Zhi ShuanObjective:To treat internal hemorrhoids with external medications and observe the effect of improvement of internal hemorrhoids on the severity of combined chronic prostatitis.Methods:Using self-controlled research methods,68 patients with damp-heat betting type Ⅱ hemorrhoids and chronic prostatitis were included in the outpatient department of the Anorectal Department of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from December 25,2019 to December 15,2020.Summarize its epidemiology,evaluate the efficacy of internal hemorrhoids and the National Institutes of Health Chronic Prostatitis Symptom Score(NIH-CPSI)in this population after 1,2,and 4 weeks of treatment with Hua Zhi Shuan,and complete the treatment before and 4 weeks.After evaluating the EPS test result scores,and comparing the WBC and lecithin body counts in the prostate fluid.Results:After using Hua Zhi Shuan for 1 week,the amount of blood in the stool was reduced,the frequency of blood in the stool was reduced,and the symptoms of internal hemorrhoids were improved,but there was no statistical difference(P>0.05).At this time,patients with severe symptoms of chronic prostatitis were significantly reduced,and there was no significant difference.Statistical difference(P>0.05).After using Hua Zhi Shuan for 2 weeks,the blood volume and frequency in stool decreased significantly,and there were significant statistical differences before and after treatment(P<0.05).At this time,the proportion of patients with moderate and severe symptoms of chronic prostatitis was significantly reduced,with statistical differences(P<0.05).After 4 weeks of use of Hua Zhi Shuan,the total effective rate of internal hemorrhoids was 94.1%.Patients with moderate symptoms of chronic prostatitis accounted for only 14.7%,and patients without severe symptoms.The scores of EPS test results before and after treatment,WBC and lecithin body counts in prostate fluid all improved significantly,with statistical differences(P<0.05).Both internal hemorrhoids and combined chronic prostatitis improved in parallel.Conclusion:Hua Zhi Shuan can improve the symptoms of internal hemorrhoids and at the same time reduce the severity of chronic prostatitis,indicating that the severity of chronic prostatitis is closely related to the occurrence and development of internal hemorrhoids,and there is an internal connection.This provides new and broader ideas for the clinical treatment of chronic prostatitis. |
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