Internal and External Co-Treatment of Rhinitis-asthma Syndrome Test Case
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1.No.1 Clinical Medical College, Yunnan University of Chinese Medicine, Kunming 650051, China
2.Department of Pediatrics ,Yunnan Provincial Hospital of Chinese Medicine, Kunming 650021, China
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Xingzhu YU, Ziwei WANG, Ji BIAN, et al. Internal and External Co-Treatment of Rhinitis-asthma Syndrome Test Case[DB/OL].(2022-09-06)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29555986&Fpath=home&index=0
病史摘要,2,患儿杨某,男,3岁。曾因“支气管肺炎”住院治疗,好转后仍持续咳嗽,继发鼻塞、鼻痒、流涕等症状,长期使用孟鲁司特钠咀嚼片、糠酸莫米松鼻喷雾剂等药物后,患儿咳嗽症状仍无明显改善,夜咳明显,动后尤甚,并时有喷嚏鼻塞、喜揉眼鼻等症状,迁延至今,家长多地求医无果。患儿于2022年3月9日前来我院儿科门诊就诊,主因“反复咳嗽、鼻塞5月余,再发加重1周”,刻下咳嗽阵作,痰声重浊,伴有鼻塞、流清涕、清嗓,舌尖红,苔白厚腻,脉数微软。患儿既往有“尘螨、蛋白、牛奶”过敏史。中医诊断 咳嗽(风伏肺络,痰湿壅滞证)西医诊断 1.慢性咳嗽;2.鼻炎-哮喘综合征;3.鼻窦炎;4.腺样体肥大干预措施 中药处方予自拟“麻辛旋红通窍汤”祛风化痰,宣肺止咳,清解郁热。外治疗法:1.给予我院“止咳化痰贴”外敷以消痰利肺,顺气止咳,降低气道高反应。2.揿针外贴于面部通窍止涕,改善鼻塞气闭。3.足部熏洗方“降火散”疏风清肺,抗敏通窍。西医治疗:患儿无明显喘息,暂不予抗炎止咳及糖皮质激素联合支气管舒张剂等对症处理治疗。疗效转归 2022年3月23日三诊,患儿咳嗽渐止,鼻塞缓解,少有清涕,肺气通畅,宣肃有度,再拟方药益肺健脾,化瘀通络,调理巩固。2022年6月21日门诊随访,患儿咳嗽自3月痊愈后无复发。
Summary of case history ,The child, named Yang, male, 3 years old. This child had been hospitalized for ,Bronchopneumonia, still continued to cough after improvement, then suffered secondary nasal congestion, nasal itching, runny nose and other symptoms, after long-term use of montelukast sodium chewable tablets, mometasone furoate nasal spray and other drugs, the child's cough symptoms are still not significantly improved, the night cough is obvious, especially after movement, and sometimes there were symptoms such as sneezing, nasal congestion, eyes and nose rubbing, etc. which have been postponed so far, and his parents have sought many medical treatments in many places without results. The child came to our pediatric outpatient clinic on March 9, 2022 for ,Repeated Cough, Nasal Congestion for More Than 5 Months and Aggravated for 1 Week, the patient coughed intermittently and frequently at the moment, and it sounded that the sputum was heavy, accompanied by nasal congestion, runny nose, throat clearing, red tip of the tongue, white and thick moss and the fast but slightly soft pulse. The child has a previous history of allergy to Dust Mites, Protein, and Milk.,TCM diagnosis ,Cough (The syndromes of wind in lung veins, obstruction of sputum and dampness),Western medicine diagnosis ,1. Chronic cough; 2. Combined Allergic Rhinitis and Asthma Syndrome; 3. Sinusitis; 4. Adenoid hypertrophy,Therapeutic methods ,The Chinese Medicine prescription was self-formulated ,Ma Xin Xuan Hong Tong Qiao Decoction,which was given to dispel the wind and phlegm, stop lung cough, and relieve internal fever. External treatment method: 1. Provide our hospital's ,Zhi Ke Hua Tan Patch, to compress externally to eliminate sputum in lung, straighten out Qi and relieve cough, reduce airway high response. 2. Stick the needle patch on the face to stop the rhinorrhoea and improve nasal congestion. 3. Foot bath prescription ,Jiang Huo San, to clear the lung and resist allergy. Western medical treatment: the child had no obvious wheezing, so symptomatic treatment such as anti-inflammatory and antitussive disposal, and glucocorticoids combined with bronchodilators were temporarily not available.,Clinical outcomes, On March 23, 2022, the third diagnosis, the child's cough gradually stopped, nasal congestion eased, there was little dilute snot, lung Qi was unobstructed, and there was a balance of publicity and suppression, and then the prescription drug was used to strengthen the lung and spleen, dissolve the congestion and dredge veins, adjust body and consolidate the treatment. Outpatient follow-up on 21 June 2022, the child's cough had not recurred since recovering in March.
内外合治鼻炎-哮喘综合征小儿顽咳麻辛旋红通窍汤
Internal and external co-treatmentCombined Allergic Rhinitis and Asthma SyndromePediatric stubborn coughMa Xin Xuan Hong Tong QiaoDecoction
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