Sacrococcygeal Pilonidal Sinus

Sacrococcygeal pilonidal sinus is a cyst or sinus tract located in the skin of the sacrococcygeal region. It is relatively uncommon in clinical practice and occurs more often in men than in women, usually after puberty, between the ages of 20 and 30. In traditional Chinese medicine (TCM), this condition falls within the categories of “Rui Ju,” “Wei Lü Fa,” and “Wei Lü Sinus Tract.”

TCM Pattern Identification and Formula Reference

| Common Symptoms

Clinical description:

The mass grows slowly and is smooth and mobile, without tenderness. It may be accompanied by a bland taste in the mouth and aversion to cold; the tongue is pale red with a thin white coating, and the pulse is deep and tight.

In plain language:

  • The mass grows slowly, feels smooth and movable, and is not painful when pressed.
  • The mouth has a bland taste, with little or no taste, and you feel cold easily or more uncomfortable in cold weather.
  • The tongue is pale with a slight reddish tinge.
  • The tongue coating is thin and white, not thick or dense.
  • The pulse is easier to feel with deeper pressure and feels tight rather than relaxed.

| Treatment approach

Clinical description:

Warm the interior and dispel dampness

In plain language:

  • Warm the body’s interior and dispel cold, supporting warmth in the digestive system and abdomen and easing discomfort such as aversion to cold, abdominal pain, and loose stools.
  • Promote the processing and elimination of dampness, easing sensations of heaviness, swelling, a sticky mouth, and a thick, greasy tongue coating.

| Related formulas

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Fu Zi Li Zhong Tang

| Common Symptoms

Clinical description:

Aversion to cold and fever, with local redness, swelling, and pain that worsens with pressure; the tongue is red, the coating is yellow, and the pulse is rapid.

In plain language:

  • You may feel both chills and fever, alternating between feeling cold and feverish, with a general sense of discomfort.
  • The skin over the affected area is red and swollen, with visible bulging.
  • Touch or pressure makes it more painful, and the area is tender to pressure.
  • The tongue is reddish.
  • The tongue coating is yellow.
  • The pulse is faster than usual.

| Treatment approach

Clinical description:

Clear heat and promote urination to resolve dampness

In plain language:

  • Reduce excessive internal heat and ease discomfort such as redness, a burning sensation, dry mouth, and restlessness.
  • Promote the elimination of dampness and ease symptoms such as a sticky, heavy feeling, swelling, or increased discharge.

| Related formulas

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Long Dan Xie Gan Tang

| Common Symptoms

Clinical description:

The mass has ruptured and has not healed for a long time, with thin, clear discharge. This may be accompanied by lethargy and a thin build; the tongue is tender and reddish, with a thin coating, and the pulse is fine and weak.

In plain language:

  • The lump has broken open and ulcerated, leaving a visible wound in the skin.
  • The condition has persisted and has not improved for a long time.
  • Thin, clear, watery fluid drains from the wound.
  • You feel lethargic and easily tired, with little energy.
  • You have a slender build and appear noticeably thin.
  • The tongue is a tender, soft reddish color.
  • The tongue coating is very thin, without a thick or greasy buildup.
  • The pulse is fine and weak, with little force when felt.

| Treatment approach

Clinical description:

Tonify qi and nourish yin

In plain language:

  • Support vitality and qi, and support digestive function and stamina, easing feelings of shortness of breath and fatigue.
  • Nourish fluids and yin, and help ease deficiency-related heat and thirst, dry mouth, night sweats, and restlessness.

| Related formulas

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Sheng Mai San

References

  1. Chen Hua, Xu Wufang, Zheng Weiqin, et al. Diagnosis and treatment of 11 cases of sacrococcygeal pilonidal sinus[J]. Zhongguo Yiyao Zhinan, 2014, 12(17): 248–249.
  2. Yu Jinli, Duan Hongyan, Wang Kai, et al. Sacrococcygeal pilonidal sinus treated with two types of transposition flap reconstruction[J]. New Medicine, 2015, 46(3): 157–161.
  3. Zhang Dongming. Theory and Clinical Practice of Pelvic Floor, Anal Canal and Rectal Surgery[M]. Beijing: People’s Military Medical Press, 2011.
  4. Nunes LF, Castro-Neto AK, Vasconcelos RA, et al. Carcinomatous degeneration of pilonidal cyst with sacrum destruction and invasion of the rectum[J]. An Bras Dermatol, 2013, 88(6 Suppl 1): S59-S62.
  5. Rao Shanshan, Yang Haili, Hu Shengli. A case of cervical pilonidal sinus with meningomyelocele in a child[J]. Chongqing Medicine, 2015, 44(24): 3456.
  6. Chen Yehong, Fei Fengzhen, Lin Caizhao. Surgical treatment of 13 cases of sacrococcygeal pilonidal sinus: experience[J]. Clinical Education of General Practice, 2008, 6(5): 419–420.
  7. Dong Shujiang. Surgical treatment of sacrococcygeal pilonidal sinus[J]. Changzhou Practical Medicine, 2014, 30(5): 296–297.
  8. Cao Jixun. New Edition of Chinese Hemorrhoid and Fistula Studies[M]. Chengdu: Sichuan Science and Technology Press, 2015.