Exploration And Analysis About Ancient Literature Of TCM For External Treatment Of Anal Fistula

BackgroundTraditional Chinese medicine (TCM) has a long history, which academic theory transfers thousands of years without decay. China is the earliest country understanding anal fistula in the world. There are a lot of ancient medical literature records on the anal fistula, which are the important carriers passing down the knowledge about the traditional medical understanding and treatment of anal fistula. Domestic treatment of anal fistula mostly adopt integrative medicine, thus TCM external treatment plays an important role in curing anal fistula.ObjectSort out the relevant ancient literatures of TCM about anal fistula and collect the external treatment characteristics of anal fistula in those literatures. And thus lay the literal foundation for the guide of TCM treatment for anal fistula.MethodUse "anal fistula" as key word, set out from the ancient literatures of TCM, collect and sort out the ancient literatures of TCM associated with anal fistula in "Chinese Medical Classics" in all the Dynasties. Then establish the databases of the ancient literature of TCM about curing anal fistula. Summarize the data about the methods of external treatment and set up word documents and SPSS databases, then carry out sorting and statistical analysis. ResultThe number of TCM ancient books included in the study is 88, which discussed the principle of treatment about anal fistula was internal and external combination, both organic wholeness and locality. The treatment methods in addition to medication includ 6 external therapies, such as moxibustion, incision therapy, plastering therapy, fumigation and washing method, therapy of interposing drugs to the anal tube and method of cutting with thread ligation. The study collects 141 prescriptions of external treatment, including 53 prescriptions of plaster therapy,55 of fumigation method,33 of guiding drugs therapy in addition to 5 texts about method of cutting with thread ligation and 8 about moxibustion. The 114 kinds of drugs in external prescriptions are mainly drugs for external use, totally 66 categories which account for 57.9 %. The function, nature and flavors of drugs used are:50 cold drugs (44.2%),34 warm drugs (30.1%),22 plain drugs (19.5%), both cool and heat drugs are 4 (3.5 %); 41 bitter drugs (36.3%),51 pungent ones (45.1%),38 sweet (33.6%),20 salty (17.7%),15 sour (13.3%),4 tasteless (3.5%); 19 heat-clearing and detoxication drugs (16.8%),13 blood-activating ones (11.5%),11 for insecticide and relieving itch (9.7%),7 supplementing (6.2%),6 for eliminating toxicity and promoting granulation (5.3%),6 superficies-resolving (5.3%),5 for purgation (4.4%),6 for dispelling pathogenic wind and removing dampness (5.3%),4 for diuresis and dampness (3.5 %),4 carminative and warming the interior (3.5%),2 digestive and helminthic (1.7%),7 hemostatic (6.2%),6 phlegm-expelling and resuscitation (5.3%),4 sedative (3.5%),7 suppressing hyperactive liver for calming internal wind (6.2%), and 6 astringent and emetic (5.3%).ConclusionChinese ancient medical, continuously improved in the development of both internal and external treatment programs, has a systematic understanding of anal fistula. Ancient TCM books included in the study stood for a comprehensive treatment of anal fistula. They attached importance to the organic whole theory and reducing patients'injuries while radical treatment. External therapy of TCM treat patients in accordance with differentiation of syndromes, such as moxibustion, fumigation and wash, or plastering therapies were used for shallow leaks to eliminate necrotic tissues and promote granulation, for deep ones, therapy of incision or interposing drugs to the anal tube can be used before treatment for shallow ones above; and for deeper ones, method of cutting with thread ligation could be selected. Drugs in formulas of external treatment, mainly composed by external Chinese herbs, mostly including bitter and cold drugs, have the function of clearing heat and removing toxicity, antiphlogistic and relieving pain, eliminating necrotic tissues and promoting granulation, promoting blood circulation for removing blood stasis, promoting granulation and astringing sores and so on. Currently, therapy method of cutting with thread ligation in TCM, a historic technique, is led in surgical treatment of anal fistula. External treatment of TCM can play a important role in postoperative wound care and curing patients who can not accept surgical treatment.