Anorectal disease (Lecture-6hrs, SDL-9hrs)
[Teaching Aim]
1.Understand the anatomy and physiology of anorectum
2.Understand the etiology and pathogenesis of anorectal diseases
3.Familiar with syndrome differentiation, examination method and therapeutic principle of anorectal disease
4.Understand the general prevention and care of anorectal diseases
[Teaching Content]
1.Concept: Scope and types of anorectal diseases
2.Anatomy and physiology: Anal canal, tooth trace and anorectal ring and etc
3.Etiology and pathogenesis: Include wind, dryness, dampness, heat, Qi deficiency, blood deficiency and etc. This disease can be caused by either one factor, but commonly it is caused by multiple factors
4.Syndrome differentiation:
（1）Differentiate symptoms: Hematochezia, swelling pain, anal prolapsed, festering, constipation and abnormal discharge
（2）Differentiate disease location
1.Examination method: Inspection of anus, digital examination of rectum, anal speculum,
sigmoidoscopy, examination of bulb silver wire and etc, and their precautions
6. Treatment: Internal treatment using heat clearing and blood cooling method, heat clearing and dampness resolving method, heat clearing and detoxify method, blood nourishing and tonifying method, heat clearing and unblocking Fu method, fluid production and dryness nourishing method, tonifying middle energizer and Qi method. External therapy using fumigation, topical application and surgical treatmen.
7.Maintain a regular bowel habits and perform appropriate physical exercise.
[Teaching Method]
Multimedia lecture.
Hemorrhoids
[Teaching Aim]
- Master the syndrome differentiation, internal therapy,External therapy, fumigation treatment. Understand surgical treatment principle of hemorrhoids and management of complication after surgery
[Teaching Content]
1. Concept: Definition, characteristics, onset, classification, location and signs and symptoms of hemorrhoids
2. Etiology and pathogenesis: Main 3 etiologies are down flowing of damp-heat, wind-heat with dryness in intestine, sinking and deficiency of Qi. Pathogenesis is flaccidity of sinews and vessels
3. Diagnosis: Clinical presentation: Hematochezia, prolapse, pain and constipation
4. Differential diagnosis: Differ from rectal polyps, hypertrophy of anal papilla, anal prolapse, rectal cancer, anal fissure and etc
5. Treatment:
5.1 Internal therapy: Oral intake medicine and topical application medicine are used to treat hematochezia, swelling, pain and anal prolapse
5.2 External therapy: Injection therapy, suppository drug, ligation, hemorrhoidectomy, Milligan-Morgan Hemorrhoidectomy and etc, their adaptability, contraindications and therapeutic principles
[Teaching Method]
Multimedia lecture.
Rectal polyps
[Teaching Aim]
- Understand the treatment method of this disease
[Teaching Content]
1. Concept: Rectal polyps are neoplasm within intestine
2. Etiology and pathogenesis: Contention of blood stasis and turbid Qi within intestine
3. Syndrome differentiation: Main symptom is fresh blood in stool. There are differences in location of polyps, can be high or low, single or multiple polyps
4. Treatment: Including both internal therapy and external therapy. External therapy includes enema treatment, injection therapy, ligation method and diathermocoagulation
[Teaching Method]
Self-study.
Anal abscesses
[Teaching Aim]
- Understand the signs and symptoms of this disease
- Master the treatment method of this disease
[Teaching Content]
1. Concept: Definition, different naming and characteristics of perianal and perirectal abscess
2. Etiology and pathogenesis: Downwards flowing of damp-heat are the main injection, supplemented by deficiency of spleen and kidney
3. Syndrome differentiation: Anal abscesses may cause pain,swelling and a lump in the perianal area. Differences in clinical manifestations of abscesses on different parts of body
4. Diagnosis and differential diagnosis:Laboratory tests and auxiliary examinations
5. Treatment: Treat according to syndrome differentiation. Locally manage with normal procedure of abscess management.
[Teaching Method]
Multimedia lecture.
Anal fistula
[Teaching Aim]
- Master syndrome differentiation of this disease, understand the therapeutic principle of surgical treatment
[Teaching Content]
1. Concept: Definition and characteristics of anal fistula
2. Etiology and pathogenesis: Caused by residual toxin after pus formation of perianal and perirectal abscess and carbuncle
3. Syndrome differentiation: Clinical manifestations of anal fistula(discharge of pus,pain and Itching),higher position or lower position, simple or complicated fistula
4. Diagnosis and differential diagnosis:Laboratory tests and auxiliary examinations
5. Treatment: Include internal and external therapy. External therapy is mainly surgical treatment. The key point of succeed and failure of surgery, adaptability, contraindication and operational method of thread ligation and incision method
[Teaching Method]
Multimedia lecture.
Anal fissure
[Teaching Aim]
- Familiar with the characteristics and prevention method of this disease. Master internal therapy, topical application and fumigation method and understand surgical treatment of this disease
[Teaching Content]
1. Concept: Definition of anal fissure is complete skin tearing of anal canal, causes infection and ulceration. Characteristics of anal fissure
2. Etiology and pathogenesis: Mainly due to blood heat and dryness of intestine
3. Syndrome differentiation: Classification and symptoms of anal fissure
4. Treatment:
4.1 Internal and external therapy of pain, hematochezia and constipation
4.2 Adaptability, contraindications and therapeutic principle of anal dilatation, incision, lateral analectomy and longitudinal section transverse suture
[Teaching Method]
Self-stud.
Anal prolapse
[Teaching Aim]
- Understand the symptoms and treatment method of this disease
[Teaching Content]
1. Concept: Definition and characteristics of this disease
2. Etiology and pathogenesis: Deficiency of middle Qi, sinking and deficiency of Qi
3. Syndrome differentiation: Symptoms and classification of anal prolapse
4. Treatment: Internal and external therapy, injection and acupuncture
[Teaching Method]
Self-stud.
Anorectal carcinoma
[Teaching Aim]
- Master the examination method and key point of diagnosis of this disease
[Teaching Content]
1. Concept: This disease is the growth of malignant tumor in anorectum, its onset and characteristics
2. Etiology and pathogenesis: Idiopathy. Related to consumption of spicy, greasy and sweet food and chronic diarrhea or dysentery
3. Syndrome differentiation: In early stage, main symptom is hematochezia, changes of bowel habit, followed by purulent bloody stool (blood becomes turbid with foul odour), tenesmus, increase frequency of bowel movement, abnormal shape of stool, digital examination of anus, unsmooth surface of masses or narrowing of anus
4. Treatment: In early stage, surgical treatment can be done. In late stage, treatment methods are strengthening vital Qi and eliminating toxin, activate blood and soften hardness.
[Teaching Method]
Self-study.
