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Combined TCM and WM analysis of 144 cases of hand, foot and mouth disease_1894

By Lucille Carroll,2014-10-30 15:05
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Combined TCM and WM analysis of 144 cases of hand, foot and mouth disease_1894

    Combined TCM and WM analysis of 144 cases of hand, foot and mouth disease

     Author: Wang Xushao Su Feng ZHANG Wen-liang Liu Zhiyuan Yang

    Huiquan

     Abstract Objective To evaluate the combination of Chinese and Western medicine

    treatment method of hand, foot and mouth disease in order to more effectively reduce the morbidity and mortality in children. Methods Retrospective analysis of 144 cases of hand, foot and mouth disease a few cases of data, taken in the treatment of integrative

    medicine, including attention to rest, better nutrition, joint use of ribavirin and Shuanghuanglian anti-virus, aerosol inhalation, oral care measures; severe in children with high dose immune globulin, methylprednisolone shock, dehydration reduced

    intracranial pressure, symptomatic treatment and nutritional support and other measures. Results 144 children were cured and discharged without any complications, the average length of stay 6.5 d. Conclusion The combination of Chinese and Western medicine treatment of hand, foot and mouth disease in an effective manner.

     Key words Hand, Foot and Mouth Disease / epidemiology; rash; heat syndrome; herpes viruses, human; intestinal infection; Zhong Xi Yi Jie

     Hand, Foot and mouth disease is caused by a variety of intestinal virus, an acute

    infectious disease common to infants and young children the main disease. In particular, by the new enterovirus EV71 infection caused by hand, foot and mouth disease in recent years, outbreaks in various districts across the country, resulting in

    some infants and young children disability and even death. Since the end of March 2008 since the Fuyang City, Anhui Province of hand, foot and mouth disease outbreak (via Anhui Province Center for Disease Control and Prevention, sample testing, caused

    by the EV71 infection), and led to several infant and child mortality. Bengbu City, and subsequently took place in parts of hand, foot and mouth disease outbreak. The Court

    , foot and mouth disease

    children. After taking a comprehensive treatment measures, to achieve a satisfactory effect, all recovered without serious complications and deaths, are summarized below.

     A clinical data

    admitted to Children's Hospital 144 cases of hand, foot and mouth disease children, 79

patients were male and female 65 cases, male to female ratio 1.2:1; aged 2 months to 9

    years old , with an average of 2.9 years of age; course of 4 ~ 7 d, an average of 4.7 d.

     1.2 diagnostic criteria for the diagnosis of all cases are in line with, "Zhu Futang Practical Pediatrics," the standards set by [1].

     1.3 in 144 cases of epidemiological history, recognizes the same class, same school, the village with a history of close contact with 89 cases, there were 37 cases of the general history of exposure to the surrounding epidemic no clear history of exposure in

    10 cases, nor a clear contact with the surrounding non-epidemic a history of 8 cases.

    There is a history of exposure accounted for 92.4%.

     1.4 Clinical manifestations of all children are hands, feet, oral herpes. In addition to

    the above-mentioned 34 cases in which parts of the herpes, there are also hip herpes. The main clinical manifestations are as follows: fever 82 cases (58.3%), 144 cases of hand, foot and skin rash (100%), 144 cases of oral herpes (100%), loss of appetite 78

    cases (54.2%), salivation 65 cases (42.4%), cough 42 cases (28.9%), diarrhea, vomiting in 13 cases (9.7%), seizure in 1 case (0.7%).

     1.5 Laboratory tests were 144 cases of children made a routine blood test, enzymes, blood sugar, chest X-ray, electrocardiogram and other tests: one rise 46 cases of peripheral white blood cells, platelets 46 patients with elevated serum creatine phosphate isoenzymes l High 24 cases, 23 cases of elevated lactate dehydrogenase, chest X-ray film abnormalities (was bronchitis, pneumonia change) 82 cases, 25 cases of

    abnormal electrocardiogram (including 21 cases of sinus tachycardia, T-wave changes

    in 2 cases, not completely right bundle branch block in 1 case, left ventricular high-

    voltage 1 case), elevated blood glucose in 8 cases. 1 case was severe in children with cerebrospinal fluid examination (Hint elevated nucleated cells, protein elevated), the children with head CT, EEG, are prompted with inflammatory changes.

     1.6 Treatment and prognosis of general treatment of attention to rest, better

    nutrition, more children with visions of water, eat easily digestible food. To anti-virus-

    based drug treatment. Use of ribavirin (Shanghai Modern Pharmaceutical Co., Ltd. Shangqiu Hassan) 15 ~ 20 mg / (kg * d), and Shuanghuanglian (Harbin Pharmaceutical

    three production plants dry powder) 60 mg / (kg * d) intravenous injection of , treatment 3 ~ 5 d. Complicated with bacterial infection plus antibiotics (usually penicillin or selected cephalosporins antibiotics). At the same time inhalation of

    ribavirin and dexamethasone, 2 times a day to strengthen oral care. For the hands, feet, buttocks and other parts of the rash to the on acyclovir cream (noon Hubei Pharmaceutical Co., Ltd.) were coated with. 1 case transferred from the primary

    hospital merger of nervous system damage in children, in addition to the above treatment measures, given high-dose immune globulin, methylprednisolone shock,

    dehydration reduced intracranial pressure, symptomatic treatment and nutritional support, comprehensive treatment .

     After 4 ~ 8 d of treatment, all children in this group were discharged. The average hospital stay was 6.5 d. 1 case complicated with nervous system damage in children discharged from hospital 15 d recovery.

     2 Discussion

     Hand, Foot and mouth disease is discovered in New Zealand in 1957 for the first time a new type of infectious disease [2]. Hand, Foot and mouth disease caused by many types of viruses, but belong to the Picornavirus, human enteric viruses. Including the

    Coxsackie virus group 5,10,16,19 type (CA5, 10,16,19) and gastro-intestinal ECHO 71

    virus (EV71) intestinal virus type and the new. But the most common for the CA16 and EV71-type [3]. The first time in 1981, reported a hand, foot and mouth disease

    outbreak. Tianjin in 1983 and 1986 took place between 5 October the two large-scale

    epidemic of hand, foot and mouth disease. In 1998 the Taiwan region in June and in October reported in the two popular nearly 130,000 children hand, foot and mouth

    disease, etiology confirmed that CA16 and EV71 is the main pathogen. In Shanghai in 2002 for children 4 to June period of hand, foot and mouth disease epidemic 67 cases of children with etiology survey showed that CA16 and EV71 of the ratio of 6.4:1 [4]. In

    2007, Linyi City, Shandong Province, hand, foot and mouth disease epidemic and by the end of March 2008 appeared in the city of Fuyang, Anhui Province of hand, foot and mouth disease epidemic. The aetiology is mainly caused by EV71 virus [5]. The hospital patients admitted to children by the hand, foot and mouth in Anhui Province Center for Disease Control and Prevention Department of sampling also confirmed that due to EV71 infection. Reposted elsewhere in the paper for free download http://

     In children with symptoms of hand, foot and mouth disease in general less. Clinical basis for the epidemiological history, oral mucosa rash, ulcers, hand, foot and buttocks and other parts of the skin rash appears. Most children have a fever. Rash as to the main part of hand, foot and heart. Easy with chicken pox, herpes angina Yandeng identification of common diseases [6]. As long as the detection and treatment of a timely, more can be cured. Chinese medicine believes that the occurrence of hand, foot and mouth disease infected evil to the main cult poison from the nose and mouth into the room Yun Yu Fei Pi, intrusion Health and wet heat, and external fat on the muscle form, and therefore see the hand, foot and mouth Department of herpes. Expelling heat, dampness, detoxification-based. Shuanghuanglian dry powder of pure traditional

    Chinese medicine preparation, by the honeysuckle, forsythia, Scutellaria baicalensis by scientific methods such as extraction of their active ingredients are made with the dual role of anti-bacterial and anti-virus, it can accelerate remission, speed up the process of fever. 144 cases of children admitted to hospital, only 1 patient developed central nervous system complications. Since I adopted a combination of Chinese and Western medicine, comprehensive treatment measures, treatment properly, makes the children were discharged without complications and sequelae. Lu equality [7] concluded Critical Care Hand, Foot and mouth disease (EV71 infection), diagnosis and treatment in retrospective analysis of severe and critical illnesses, the early days of the following characteristics: (1) age

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