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痔病的常見原因

醫(yi)案日(ri)記 2023-06-14 08:17:52

痔病的(de)常見原因(yin)1、中醫認為痔瘡的(de)常見病因(yin)是什(shen)么?祖(zu)國醫學通過(guo)長期的(de)臨床經(jing)驗,總結出痔的(de)發病原因(yin),不(bu)單純是局(ju)部因(yin)素,更主要的(de)是由于人體陰陽失調(diao),加之外(wai)感、內傷、六淫(yin)、七情等因(yin)素所致,歸納(na)起來(lai)有以下幾個方(fang)面:

(1)飲(yin)食(shi)不(bu)(bu)(bu)節:飲(yin)食(shi)過(guo)多(duo)(duo)、過(guo)飽或(huo)(huo)食(shi)用肥(fei)膩炙?之(zhi)(zhi)品,或(huo)(huo)大量飲(yin)酒及食(shi)用辣椒、姜、蔥(cong)等刺激(ji)性食(shi)物(wu),容易生(sheng)(sheng)濕(shi)積(ji)熱(re)(re)(re),濕(shi)熱(re)(re)(re)下(xia)注(zhu)肛門(men),使肛門(men)充血(xue)灼痛(tong),引發(fa)(fa)痔(zhi)瘡(chuang)(chuang)。(2)便(bian)秘:久(jiu)(jiu)(jiu)忍大便(bian),大腸(chang)(chang)(chang)積(ji)熱(re)(re)(re),是痔(zhi)瘡(chuang)(chuang)發(fa)(fa)病的(de)一個原因(yin)(yin)。(3)勞累過(guo)度(du)(du):久(jiu)(jiu)(jiu)坐則(ze)血(xue)脈(mo)不(bu)(bu)(bu)行(xing)(xing),久(jiu)(jiu)(jiu)行(xing)(xing)則(ze)氣(qi)(qi)血(xue)縱橫,經(jing)絡交錯。久(jiu)(jiu)(jiu)坐久(jiu)(jiu)(jiu)行(xing)(xing),勞累過(guo)度(du)(du),使腸(chang)(chang)(chang)胃(wei)受(shou)傷(shang),以致(zhi)(zhi)(zhi)濁氣(qi)(qi)瘀血(xue),流(liu)注(zhu)肛門(men)而生(sheng)(sheng)痔(zhi)疾。(4)久(jiu)(jiu)(jiu)病:久(jiu)(jiu)(jiu)瀉、久(jiu)(jiu)(jiu)痢、久(jiu)(jiu)(jiu)咳,易使氣(qi)(qi)血(xue)虧損,氣(qi)(qi)虛(xu)下(xia)陷(xian),而生(sheng)(sheng)痔(zhi)瘡(chuang)(chuang)。(5)感受(shou)外邪(xie):《金匱要略》指(zhi)出(chu)(chu):“小腸(chang)(chang)(chang)有(you)寒者,其人下(xia)重(zhong)便(bian)血(xue),有(you)熱(re)(re)(re)者,必痔(zhi)”。可見感受(shou)寒邪(xie)、熱(re)(re)(re)邪(xie)均可發(fa)(fa)生(sheng)(sheng)痔(zhi)疾。古人又(you)指(zhi)出(chu)(chu)痔(zhi)因(yin)(yin)“皆(jie)是濕(shi)熱(re)(re)(re)風(feng)(feng)燥四氣(qi)(qi)所(suo)(suo)傷(shang),而熱(re)(re)(re)為最(zui)多(duo)(duo)也”之(zhi)(zhi)說。(6)婦人妊(ren)娠(shen)(shen)、月經(jing)不(bu)(bu)(bu)調:婦人妊(ren)娠(shen)(shen)、月經(jing)不(bu)(bu)(bu)調,易致(zhi)(zhi)(zhi)關(guan)格壅塞,經(jing)血(xue)流(liu)溢滲(shen)漏于腸(chang)(chang)(chang)間,而誘發(fa)(fa)痔(zhi)瘡(chuang)(chuang)。(7)遺(yi)傳(chuan)因(yin)(yin)素:《薛氏醫案》中(zhong)有(you)“痔(zhi)瘡(chuang)(chuang)之(zhi)(zhi)癥或(huo)(huo)稟受(shou)胎(tai)毒,或(huo)(huo)母腹中(zhong)受(shou)熱(re)(re)(re)也”。表明(ming)痔(zhi)瘡(chuang)(chuang)與遺(yi)傳(chuan)有(you)關(guan)。(8)情(qing)(qing)志(zhi)因(yin)(yin)素:中(zhong)醫很(hen)重(zhong)視七(qi)情(qing)(qing)致(zhi)(zhi)(zhi)病,因(yin)(yin)此有(you)喜傷(shang)心、怒傷(shang)肝之(zhi)(zhi)說。喜怒無(wu)常,氣(qi)(qi)血(xue)侵(qin)入大腸(chang)(chang)(chang),結積(ji)成塊(kuai),易生(sheng)(sheng)便(bian)血(xue)。(9)房事過(guo)度(du)(du):《諸(zhu)病源候論》中(zhong)有(you)“諸(zhu)痔(zhi)皆(jie)由傷(shang)風(feng)(feng)、房室不(bu)(bu)(bu)慎所(suo)(suo)致(zhi)(zhi)(zhi)”。古人又(you)有(you)“忍精不(bu)(bu)(bu)泄而致(zhi)(zhi)(zhi)痔(zhi)漏”之(zhi)(zhi)說。(10)臟腑虛(xu)弱:臟腑虛(xu)弱,加之(zhi)(zhi)外感風(feng)(feng)濕(shi),內(nei)蘊熱(re)(re)(re)毒,而致(zhi)(zhi)(zhi)氣(qi)(qi)血(xue)下(xia)墜,結聚于肛門(men),易生(sheng)(sheng)痔(zhi)瘡(chuang)(chuang)。

2、西(xi)醫認(ren)為痔瘡的常(chang)見病因(yin)是什(shen)么?西(xi)醫認(ren)為痔瘡的病因(yin)尚未完(wan)全闡明,一般與以(yi)下(xia)幾種(zhong)因(yin)素有關:

(1)生(sheng)(sheng)(sheng)理結(jie)構的(de)(de)缺(que)陷和(he)直(zhi)(zhi)立體(ti)(ti)位(wei)(wei):人(ren)體(ti)(ti)站(zhan)立或直(zhi)(zhi)坐時,肛(gang)(gang)門(men)(men)(men)(men)(men)(men)位(wei)(wei)置低,受(shou)(shou)地心(xin)引(yin)力(li)(li)(li)的(de)(de)影響,直(zhi)(zhi)腸(chang)(chang)肛(gang)(gang)門(men)(men)(men)(men)(men)(men)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)血(xue)(xue)(xue)液(ye)回流受(shou)(shou)障礙,直(zhi)(zhi)腸(chang)(chang)上(shang)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)及(ji)其分(fen)支缺(que)少(shao)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)瓣,血(xue)(xue)(xue)液(ye)容(rong)(rong)(rong)易(yi)(yi)產生(sheng)(sheng)(sheng)瘀(yu)積,且直(zhi)(zhi)腸(chang)(chang)血(xue)(xue)(xue)管排列(lie)特殊,在不(bu)同(tong)平(ping)面穿過肌層容(rong)(rong)(rong)易(yi)(yi)受(shou)(shou)糞(fen)便(bian)(bian)壓(ya)迫(po),使(shi)(shi)(shi)粘(zhan)(zhan)膜下(xia)疏(shu)松組(zu)織(zhi)中(zhong)的(de)(de)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)容(rong)(rong)(rong)易(yi)(yi)擴大、曲張(zhang)(zhang)(zhang)而產生(sheng)(sheng)(sheng)痔(zhi)(zhi)(zhi)。所以(yi)有(you)人(ren)說痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)是人(ren)體(ti)(ti)特有(you)的(de)(de)疾病(bing)(bing)。四肢爬(pa)行動(dong)(dong)(dong)物(wu)(wu)如牛、馬、狗、兔等動(dong)(dong)(dong)物(wu)(wu)不(bu)患痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang),也主要是因(yin)為(wei)爬(pa)行動(dong)(dong)(dong)物(wu)(wu)肛(gang)(gang)門(men)(men)(men)(men)(men)(men)位(wei)(wei)置高(gao),有(you)益于(yu)肛(gang)(gang)門(men)(men)(men)(men)(men)(men)直(zhi)(zhi)腸(chang)(chang)部血(xue)(xue)(xue)液(ye)回流,不(bu)易(yi)(yi)產生(sheng)(sheng)(sheng)肛(gang)(gang)門(men)(men)(men)(men)(men)(men)直(zhi)(zhi)腸(chang)(chang)部靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)曲張(zhang)(zhang)(zhang)。另外,在齒線附近,細小的(de)(de)動(dong)(dong)(dong)脈(mo)(mo)(mo)(mo)(mo)和(he)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)直(zhi)(zhi)接(jie)吻合而構成(cheng)洞狀(zhuang)(zhuang)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo),洞狀(zhuang)(zhuang)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)肌層發(fa)育不(bu)良,彈力(li)(li)(li)纖維(wei)較(jiao)(jiao)(jiao)少(shao),膠原纖維(wei)較(jiao)(jiao)(jiao)多,容(rong)(rong)(rong)易(yi)(yi)擴張(zhang)(zhang)(zhang)而形成(cheng)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(2)便(bian)(bian)秘(mi):排便(bian)(bian)時間過長或長期腹(fu)(fu)瀉,可(ke)(ke)使(shi)(shi)(shi)腹(fu)(fu)壓(ya)增高(gao),肛(gang)(gang)門(men)(men)(men)(men)(men)(men)直(zhi)(zhi)腸(chang)(chang)部充血(xue)(xue)(xue),痔(zhi)(zhi)(zhi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)曲張(zhang)(zhang)(zhang),甚至可(ke)(ke)導(dao)致(zhi)直(zhi)(zhi)腸(chang)(chang)粘(zhan)(zhan)膜與(yu)(yu)肌層分(fen)離(li)脫出,肛(gang)(gang)管隨糞(fen)便(bian)(bian)下(xia)移,久之(zhi)容(rong)(rong)(rong)易(yi)(yi)產生(sheng)(sheng)(sheng)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(3)感染因(yin)素(su):肛(gang)(gang)竇炎(yan)(yan)、肛(gang)(gang)腺感染、肛(gang)(gang)周(zhou)(zhou)膿腫、痢(li)疾、腸(chang)(chang)炎(yan)(yan)、腸(chang)(chang)道寄(ji)生(sheng)(sheng)(sheng)蟲(chong)病(bing)(bing)、大腸(chang)(chang)炎(yan)(yan)等,可(ke)(ke)引(yin)起(qi)直(zhi)(zhi)腸(chang)(chang)下(xia)部周(zhou)(zhou)圍組(zu)織(zhi)發(fa)炎(yan)(yan),痔(zhi)(zhi)(zhi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)受(shou)(shou)累,產生(sheng)(sheng)(sheng)炎(yan)(yan)癥(zheng),使(shi)(shi)(shi)痔(zhi)(zhi)(zhi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)管壁變脆,繼(ji)發(fa)血(xue)(xue)(xue)管擴張(zhang)(zhang)(zhang)充血(xue)(xue)(xue)而引(yin)起(qi)或加(jia)(jia)重痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(4)妊娠(shen)與(yu)(yu)分(fen)娩:妊娠(shen)婦女(nv),胎兒(er)壓(ya)迫(po)盆(pen)腔靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo),使(shi)(shi)(shi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)回流受(shou)(shou)阻(zu),肛(gang)(gang)門(men)(men)(men)(men)(men)(men)直(zhi)(zhi)腸(chang)(chang)部血(xue)(xue)(xue)管擴張(zhang)(zhang)(zhang),同(tong)時由于(yu)體(ti)(ti)內孕激素(su)含量上(shang)升,造成(cheng)水鈉潴留,血(xue)(xue)(xue)管擴張(zhang)(zhang)(zhang)而誘發(fa)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(5)肛(gang)(gang)門(men)(men)(men)(men)(men)(men)括約肌松弛:年(nian)老體(ti)(ti)弱及(ji)多次肛(gang)(gang)門(men)(men)(men)(men)(men)(men)手術(shu)而破壞括約肌完(wan)整結(jie)構的(de)(de)患者,因(yin)括約肌無力(li)(li)(li)使(shi)(shi)(shi)痔(zhi)(zhi)(zhi)脫垂(chui)加(jia)(jia)重。(6)門(men)(men)(men)(men)(men)(men)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)高(gao)壓(ya):肝硬變、門(men)(men)(men)(men)(men)(men)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)血(xue)(xue)(xue)栓(shuan)炎(yan)(yan)等,可(ke)(ke)引(yin)起(qi)門(men)(men)(men)(men)(men)(men)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)高(gao)壓(ya),由于(yu)門(men)(men)(men)(men)(men)(men)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)系統缺(que)乏靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)瓣,可(ke)(ke)直(zhi)(zhi)接(jie)導(dao)致(zhi)痔(zhi)(zhi)(zhi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)叢壓(ya)力(li)(li)(li)升高(gao),引(yin)起(qi)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(現有(you)研(yan)究認(ren)為(wei),門(men)(men)(men)(men)(men)(men)脈(mo)(mo)(mo)(mo)(mo)高(gao)壓(ya)所致(zhi)的(de)(de)肛(gang)(gang)周(zhou)(zhou)血(xue)(xue)(xue)管的(de)(de)改變,和(he)痔(zhi)(zhi)(zhi)病(bing)(bing)的(de)(de)血(xue)(xue)(xue)管改變并不(bu)相同(tong))。(7)腫瘤(liu):腹(fu)(fu)部和(he)盆(pen)腔的(de)(de)腫瘤(liu),如結(jie)、直(zhi)(zhi)腸(chang)(chang)腫瘤(liu),卵巢腫瘤(liu)和(he)子宮肌瘤(liu)等均(jun)可(ke)(ke)壓(ya)迫(po)盆(pen)腔靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo),使(shi)(shi)(shi)痔(zhi)(zhi)(zhi)靜(jing)(jing)脈(mo)(mo)(mo)(mo)(mo)回流受(shou)(shou)阻(zu)而產生(sheng)(sheng)(sheng)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)。(8)遺傳因(yin)素(su):關于(yu)遺傳因(yin)素(su),西醫(yi)觀(guan)點尚不(bu)統一(yi),需(xu)進一(yi)步驗證(zheng)。有(you)人(ren)認(ren)為(wei)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)在一(yi)個家族中(zhong)發(fa)病(bing)(bing)率較(jiao)(jiao)(jiao)高(gao),可(ke)(ke)能(neng)與(yu)(yu)遺傳因(yin)素(su)有(you)關。總之(zhi),現代醫(yi)學認(ren)為(wei)痔(zhi)(zhi)(zhi)瘡(chuang)(chuang)(chuang)產生(sheng)(sheng)(sheng)的(de)(de)因(yin)素(su)是復(fu)雜(za)的(de)(de),可(ke)(ke)能(neng)是以(yi)上(shang)幾種(zhong)因(yin)素(su)相互(hu)作用的(de)(de)結(jie)果。

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