abstracted & translated by
Honora Lee Wolfe, L.Ac., FNAAOM (USA)
Keywords: Chinese medicine, acupuncture, proctology, anal fissures
Most patients with nala fissures are treated surgically. However, commonly, the incision is slow to heal and the disease course is prolonged. In addition, the pain is typically severe. On page 36 of issue #5, 2005 of the Zhen Jiu Lin Chuang Za Zhi (Clinical Journal of Acupuncture & Moxibustion), He Zhou and Lu A-li published an article titled, "Clinical Observations on the Acupuncture Treatment of 60 Cases of Anal Fissure." A summary of this article is presented below.
Of the 60 patients included in this study, 32 were male and 28 were female aged 20-56 years. These patients had suffered from anal fissures for from 1-15 years, with most of the patients suffering from this condition for from 1-5 years. No other description of these patients was given.
Acupuncture was performed at Chang Qiang (GV 1), Da Chang Shu (Bl 25), and Qu Chi (LI 11). Twisting hand technique was used to obtain and move the qi, and strong needle sensation was used to promote retention of this qi and to prevent its dispersion. The needles were retained for 30 minutes, and treatment was carried out once every other day, with 10 treatments equaling one course. Results were analyzed after one course. During this course of treatment, patients were forbidden to eat acrid, peppery foods and were advised to increase their consumption of high fiber foods. They were also encouraged to keep their anal region clean and their defecations smoothly and freely flowing.
Cure was defined as complete disappearance of symptoms and healing of the fissures in the anal region. Improvement meant that the symptoms disappeared and that the lesions had basically closed. No effect meant that there was no obvious improvement in symptoms and that the opening of the lesions had not changed. Based on these criteria, 48 cases (80%) were judged cured, 10 cases (16.6%) improved, and two cases (3.3%) got no effect. Therefore, the total effectiveness rate was 96.7%. The patients who got no effect went on to surgery.
According to the Chinese authors, anal fissures are mostly due to dry fire or damp heat brewing and binding in the anal region combined with blood vacuity and intestinal dryness. According to the Zhen Jiu Jia Yi Jing (The Systematic Classic of Acupuncture & Moxibustion): "Piles, Hui Yin governs these." The governing vessel arises from the lower abdoment. It descends to exit from Hui Yin (CV 1, but also the perineum in general). If there is stomach and intestinal damp heat internally obstructing, this may lead to stasis and stagnation of the channel qi. If this gathers and binds in the anus, it will engender piles. Therefore, the authors have chosen Chang Qiang, a governing vessel point in the vicinity of Hui Yin to diffuse and abduct the qi and blood, dispel stasis and free the flow of the network vessels. Da Chang Shu is the large intestine transport point on the bladder channel. It transmits and transports the large intestine qi. It has the function of regulating and rectifying the intestines and stomach, clearing heat and moistening dryness. Qu Chi is the uniting point of the large intestine. Therefore, it can clear and disinhibit large intestine damp heat. When all these points are used together, their effect is to clear heat, dispel wind, eliminate dampness, and moisten dryness. This protocol definitely stops pain and bleeding and promotes the healing of anal fissures. The therapeutic efficacy is high, the course of treatment is short, the pain from the treatment is slight, and the hand technique is simple.
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