TERAPI AKUPRESUR CHUZHEN

PADA HEMOROID
Willie Japaries
KaProdi Dharma Usada
STAB NALANDA
Anatomi anus
Hemoroid: pelebaran vena di
dalam pleksus hemoroidalis
yang tidak merupakan
keadaan patologik ( Sjamsu
Hidajat & Jong, 2004 ).
Bagian usus besar dekat dubur
disebut rektum (dari kolon
sigmoid s/d anus). Satu inci
terakhir disebut kanalis ani,
dijaga oleh sfingter
eksternus dan internus.
Panjang rektum dan kanalis
ani sekitar 15 cm.
Pasokan darah ke usus besar:
Usus besar secara klinis dibagi
menjadi dua belahan, kanan dan
kiri berdasarkan pasokan
darahnya. Arteri mesentrika
superior memperdarahi belahan
kanan (sekum, kolon asendens
dan dua pertiga proksimal kolon
tranversum); A. mesentrika
inferior memperdarahi belahan
kiri (sepertiga distal kolon
transversum, kolon desendens
dan sigmoid), dan bagian
proksimal rektum. Pasokan
darah tambahan ke rektum dari
A. sakralis media dan A.
hemoroidalis inferior dan media
yang dicabangkan dari A. iliaka
interna dan aorta abdominalis.
Aliran darah balik dari kolon
Aliran balik vena dari kolon dan rektum
superior melalui V. mesentrika
superior dan inferior dan V.
hemoroidalis superior, yaitu bagian
dari sistem portal yang mengalirkan
darah ke hati.
Darah dari V. hemoroidalis media dan
inferior mengalir ke V. iliaka, bagian
dari sirkulasi sistematik.
Terdapat anastomosis V. hemoroidalis
superior, media dan inferior, maka
peningkatan tekanan portal dapat
mengakibatkan aliran darah balik ke
dalam vena-vena ini.

http://digilib.unimus.ac.id/files/disk1/126/jtptunimus-gdl-restyasrin-6288-2-babii.pdf
 Gejala klinis hemoroid
Hemoroid eksternal (wasir luar)
• Gatal, iritasi area dubur;
• Nyeri atau tidak nyaman;
• Pembengkakan area dubur;
• Perdarahan.
Hemoroid Internal (wasir dalam)
• jarang bergejala, waktu mengedan atau iritasi dapat timbul:
• Perdarahan (sedikit atau banyak) waktu bab.
• Wasir menonjol keluar (stadium III/IV), timbul nyeri/ iritasi.
Hemoroid trombosis:
Jika darah menggumpal beku dalam vena hemoroid luar: nyeri
hebat, bengkak, meradang.
https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
 Penyebab & faktor risiko hemoroid
Hemoroid dapat terjadi akibat dari:
• Mengedan waktu bab;
• Duduk terlalu lama di kloset;
• Diare atau sembelit kronis;
• Obesitas;
• Hamil;
• Koitus anal;
• Diet rendah serat;
• Angkat berat;
• Jaringan penunjang melemah krn usia dll.
Hemoroid internal & eksternal
Derajat keparahan hemoroid

*
Titik Bazhen perianal untuk retraksi hemoroid
Manipulasi: Kai He (buka tutup; tekan lepas) digital.
Qi-Xue lancar, darah dari pleksus vena hemoroid ke sekitar – wasir retraksi
https://pubmed.ncbi.nlm.nih.gov/32798197/
J Integr Med 2020 Nov;18(6):492-498.
Effects of the pestle needle therapy, a type of acupoint
stimulation, on post-hemorrhoidectomy pain: A
randomized controlled trial
Xian Wang 1, Xuan Yin 2, Xiu-Tian Guo 3, Yan Wang 1, Wen-Qi Jin 3, Ai-Jun Mao 1, Lixing Lao 4, Zhang-Jin Zhang 5, Jie
Zhang 6, Shi-Fen Xu 7
Objective: This study evaluates the clinical efficacy of the pestle needle therapy, an
acupoint stimulation method, for relief of post-hemorrhoidectomy pain.
Design, setting, participants and interventions: This was a single-center, patient-assessor-
blinded and randomized controlled trial with 154 patients receiving Milligan
hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment
group or a control group at a ratio of 1:1. The treatment group received the pestle needle
therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1),
Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock
around the lesion); while the control group received a sham treatment with very light
pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the
surgery, and each lasted for 15 min.
Main outcome measures: The primary outcome was post-operative pain measured with
the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the
VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the
time and the VAS score of the patients' first defecation after surgery, as well as the
Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.
Design, setting, participants and interventions: This was a single-center,
patient-assessor-blinded and randomized controlled trial with 154 patients
receiving Milligan hemorrhoidectomy surgery.
Results: The mean pain score of the treatment group was significantly lower
than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h
after surgery. Compared with the control group, patients in the treatment
group needed a smaller dose of analgesic within the first 24 hours after
surgery (P = 0.002); and their HAMA scores before discharge were lower
(4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group,
patients in the control group had a greater time to the first defecation after
surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no
difference in their VAS scores at the first defecation (P = 0.092).
Conclusion: The pestle needle therapy was effective for relieving pain,
reducing anxiety and improving bowel function after hemorrhoidectomy,
and it is worthy of clinical application.
 Simpulan:
Stimulasi digital titik2 Bazhen sekitar anus efektif
melancarkan aliran energi dan darah (Qi-Xue),
merangsang kontraksi otot perianal (levator ani,
sfingter ani eksternus dan internus), sehingga
hemoroid tereduksi dan keluhan membaik.

Selamat mencoba, semoga sukses!

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