IV. Western Medicine Treatment

Tian Lixiong et al. treated 50 pediatric cases of varicella with a decoction for internal and external use, randomly assigning 50 cases to the treatment group. The observation group received the decoction (composition: Honeysuckle Flower, Forsythia, Banlan Gen, Polygonum Cuspidatum, Fangfeng, Jingjie, Poria, Scutellaria Baicalensis, Raíma, Coix Seed, Woodtongue, Licorice, etc.) for treatment. The treatment regimen involved two doses daily, with one dose brewed in water and taken orally in two separate administrations; another dose was prepared in water for inhalation and external application. The control group received intravenous infusions of Acyclovir. The treatment group achieved a cure rate of 76.0%, with 16.0% showing marked improvement, and a total effective rate of 92.0%; the control group had a cure rate of only 28.0%, with a total effective rate of 56.0%. Statistical analysis revealed that the difference in efficacy between the two groups was statistically significant (p<0.01) (Journal of Hunan Normal University, Medical Edition, May 2008).

IV. Western Medicine Treatment (1) General Care

This disease is highly contagious; once a child is identified as infected, they should be immediately isolated until all the rashes have formed scabs. During the fever phase, the child should rest in bed and consume easily digestible foods along with adequate hydration. The child’s skin should be kept clean, with nails trimmed short to prevent scratching and subsequent infections. In collective settings such as daycare centers, it is important to keep the living space clean, disinfect, and well-ventilated, utilizing ultraviolet irradiation, sun exposure, and boiling bedding items. Improper care can lead to secondary skin infections, which may result in pus formation and even joint inflammation.

(2) Medicinal Treatment

1. For symptomatic treatment, apply 10% Gentian Violet to areas with skin lesions; for skin itching, use 2% Carbonic Acid Solution or Calamine Lotion. If the blisters rupture, apply Neomycin Ointment. If the skin becomes infected or if complications such as pneumonia or sepsis develop, choose appropriate antibiotics such as sulfonamides or antibiotics. If encephalitis occurs, treat it according to the standard protocol for encephalitis B.

2. Adrenal cortical hormones should generally not be used for varicella. If varicella is complicated by severe complications, and effective antibiotics are being used, a 3–5 day course may be sufficient. However, if the patient already has a pre-existing condition that requires hormone use but subsequently develops varicella, and the hormone usage is brief, it may be discontinued, or the dosage can be reduced to approximately 1/10 to 1/5 of the original therapeutic dose as soon as possible.

3. For local external treatments, if the rashes break open and ooze fluid, sprinkle pine pollen over the affected area. If the rashes become ulcerated, apply Blue Indigo Oil Paste (60g of Indigo, 120g each of Calcined Gypsum and Talc, 30g of Phellodendron Amurense, 15g each of Camphor and Coptis Chinensis, ground into fine powders and mixed thoroughly, then applied with sesame oil).

Integrated Chinese and Western Medicine Practical Internal Medicine – Appendix: Herpes Zoster: Overview

Herpes Zoster is an acute inflammatory disease characterized by clustered vesicles appearing on the skin, accompanied by neuralgia. The rash often follows the distribution of peripheral nerves on one side of the body, forming bands.

The general population is susceptible to infection; after contracting chickenpox [------]{.underline}, individuals can develop lasting immunity. However, the high levels of antibodies in the body cannot eliminate latent viruses residing in the spinal cord nerve ganglia. Years—or even decades—later, under certain triggers such as trauma, cold exposure, fatigue, various infectious diseases, leukemia, or after immunosuppressive therapies, or due to weakened physical condition, immune function may decline, allowing latent viruses to proliferate and cause illness. Often, before the onset of symptoms, localized lymph node swelling may occur; initially, the skin may feel a sharp, dull, or burning pain along the nerve segments, accompanied by mild systemic symptoms. The skin presents with inflammation, with vesicles located deep within the epidermis, containing clear serous fluid. Within the vesicles and their margins, enlarged balloon-like cells can be observed, indicative of cell degeneration and formation of bullous cells. Free epithelial cells within the vesicles may contain eosinophilic nuclear inclusions. The most common form is intercostal herpes zoster, followed by the distribution area of the first branch of the trigeminal nerve in the head and face, as well as the neck, waist, abdomen, and limbs.

Some patients may experience only papules without vesicles, which eventually resolve; this is referred to as a subacute herpes zoster. Some vesicles may appear as large blisters or hemorrhagic lesions, or even necrotize at the center of the rash, forming dark brown scabs—these are known as gangrenous herpes zoster. Elderly patients with lymphoma or other conditions may experience widespread rash throughout the body, resembling extensive chickenpox, known as generalized herpes zoster, often accompanied by high fever and other systemic symptoms.

II. Diagnosis (1) Diagnostic Criteria

On one side of the body, clusters of chickenpox-like rashes appear, arranged in bands along the nerves, asymmetrically, generally not extending beyond the midline of the body, with distinct neuralgia.

Before the appearance of the rashes, it is easy to confuse them with angina pectoris, chest muscle pain, duodenal ulcers, biliary colic, and other conditions. However, once the rashes appear, they should be differentiated from the following diseases.

(2) Differential Diagnosis

1. Simple Herpes Most commonly found at the junctions of skin and mucous membranes, such as the corners of the face, the lips, around the nostrils, and the external genitalia. Although there are clustered vesicles, they are small and prone to rupture, with mild inflammation, itching, and a burning sensation—but usually without pain. These rashes often accompany febrile illnesses like meningitis, malaria, or lobar pneumonia.

2. Chickenpox presents with mild systemic symptoms and batches of vesicles appearing on the trunk and head, gradually spreading to the face, and finally reaching the limbs. The vesicles are itchy, without significant pain.

3. Impetigo begins with a few scattered erythematous patches or vesicles, which gradually evolve into vesicles, surrounded by redness and inflammation. The vesicle fluid is cloudy, causing burning and itching, leading to scratching and contamination, with erosion and exudation, recurring and spreading over time. The disease tends to affect exposed areas such as the head, face, and limbs, though it can also spread throughout the body.

III. Traditional Chinese Medicine Understanding and Treatment of Herpes Zoster (1) Historical Medical Views on Similar Conditions

Although the term “herpes zoster” did not exist in ancient medical texts, there were records regarding the causes, pathogenic mechanisms, and symptoms associated with this disease. For example, the Suwen · Zhi Zhen Yao Da Lun stated: “All pains, itching, and sores belong to the Heart.” The Suwen · Yin Yang Ying Xiang Da Lun noted: “The dampness and moisture of the Earth, when sensed, harm the skin, flesh, tendons, and vessels.” The Yizong Jin Jian wrote: “When dry, the skin turns red and crimson, resembling cloud-like flakes, with a tingling sensation and heat, indicating Liver Qi. The Wind and Fire of the Heart Meridian… When damp, the skin appears yellowish-white, with vesicles of varying sizes, oozing fluid, and more painful when dry, indicating Spleen and Lung Meridians—both damp and hot…” The Surgical Qixuan mentioned: “Spider-like sores appear between the skin layers, similar to water pits, pale red and painful, forming five or seven sores, or five or seven clusters, sometimes spreading outward.” All of these descriptions share similarities with this disease.

(2) Traditional Chinese Medicine Understanding of the Pathogenesis of Herpes Zoster In Traditional Chinese Medicine, this disease is known as “Snake String Rash,” “Band-Aid Fire Dampness,” “Banded Dragon,” “Spider Sores,” among other names. It is often attributed to emotional distress, leading to excess Liver and Gallbladder Fire; or due to excessive drinking, eating, and other dietary habits that cause dampness and heat to accumulate within the body, leading to external exposure to harmful pathogens.

Part Two: Infectious Diseases The body’s qi is often imbalanced, leading to dampness and heat accumulating within the body, causing stagnation and toxicity. When the body’s qi is blocked, the flow of qi becomes stagnant, and the body’s natural functions are disrupted, resulting in poor digestion, lack of appetite, and a feeling of heaviness in the stomach. The liver is overly active, but the spleen is weak, and dampness and heat accumulate within the body—this is why the body’s qi is often imbalanced, and the liver’s qi is not fully balanced. The liver’s qi is not fully harmonized, and the liver’s qi is too strong, leading to heat and toxicity, which can damage the body’s qi and disrupt the flow of qi. As a result, the body’s qi becomes stagnant, and the body’s qi is not fully balanced.

If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced. If the body’s qi is not fully restored, the body’s qi becomes imbalanced, and the body’s qi is not fully balanced.......Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Purulent or turbid fluid in the vesicles; or accompanied by sores on the mouth and tongue, swollen and painful gums, constipation, short yellow urine, a pulse that is rapid and numbing or deep and solid, a red or purplish tongue, and a yellow, dry tongue with little saliva. Treatment should focus on clearing heat and detoxifying, cooling the blood and nourishing yin. The formula should be a modified Qingying Decoction combined with Qingwei Powder; use 10g of Water Buffalo Horn, 15g of Rehmannia Root, 10g of Salvia Miltiorrhiza, 10g of Scrophularia Ningpoensis, 12g of Ophiopogon japonicus, 6g of Coptis chinensis, 15g of Honeysuckle Flower, 12g of Forsythia Suspensa, 12g of Angelica sinensis, 15g of Paeonia lactiflora. Brew the herbs in water and take one dose per day. For those with dark red rashes, add Purple Flowered Groundsel, Purple Herb, or Gardenia to clear heat and cool the blood; for severe yin and liquid depletion with dry mouth, add Pollen, Ophiopogon japonicus, and Reed Grass to nourish yin and generate fluids; for swollen and painful gums, sores on the mouth and tongue, and constipation, add Shuixiang Powder or Rhubarb, Citrus Aurantium Fruit, and other herbs to clear fire and promote bowel movements.

(4) Traditional Chinese Medicine Resources on the Diagnosis and Treatment of This Disease

Wang Junhua conducted a literature review on traditional Chinese medicine formulations, patent medicines, and integrated Chinese-Western medicine treatments for varicella between 2003 and 2006 as follows:

1. Formulas for Treatment Traditional Chinese Medicine views varicella as an external infection caused by harmful external factors affecting the lungs and spleen, leading to dampness and heat, which then manifest on the skin. Treatment should focus on clearing heat, cooling the blood, and detoxifying. Since patients are often children—whose bodies are still developing and whose constitutions are still weak—there is a high risk of yin and liquid depletion during the course of the disease; therefore, it is crucial to strengthen the body’s vital energy and consolidate its foundation. Traditional Chinese medicine formulas emphasize syndrome differentiation and individualized medication adjustments based on each patient’s specific condition, ensuring that treatment is targeted and effective. Yang Longsheng treated 20 cases of varicella based on Yin Qiao San, all of whom experienced fever resolution, rash regression, skin lesion recovery, and elimination of complications such as infections, with overall health improving significantly. Zhang Hua and others used a self-made disinfectant decoction for internal administration and a “Rash Soup” for external washing, treating 57 adult cases of varicella, achieving a cure rate of 1% within 10 days. Zhao Ping et al. compared a traditional Chinese medicine formula called “Disinfection Drink” for internal use with “Virus Zol” administered via intramuscular or intravenous injections, finding that the treatment group showed significantly better efficacy than the control group. Yang Jingbo et al. used a combination of Yin Huang Detoxification and Clearing Evil Decoction for internal administration, while Ma Yinglong applied Longzhu Soft Paste to apply directly to skin lesions, treating 21 cases of varicella, with 18 cases cured, resulting in an effectiveness rate of 95.24%. Yang Xia et al. developed a silver-stone mixture for treating varicella in children, averaging a treatment duration of 4 days, with no significant adverse reactions observed. Zheng Dunfa compared a Qingre Decoction with a control group receiving intravenous acyclovir infusions; the treatment group achieved a cure rate of 35 cases, with a total effectiveness rate of 100%, outperforming the control group (94.67%).

Patent medicines offer stable quality and convenient use, and the emergence of new dosage forms has expanded the options for administration. Zhao Heying used Shuang Huang Lian powder injections diluted to 0.8% for intravenous infusion; she also applied a 3% concentration solution topically to treat varicella, with 18 cases showing marked improvement and 4 cases showing effectiveness. He Guodong et al. treated 46 cases of varicella using Ban Lan Gen decoction, all of whom were cured, with an average treatment duration of 2–5 days, up to 8 days in some cases. Cao Ning et al. used fishy herb injection for treating varicella in children, comparing intramuscular or intravenous injections of fishy herb injection with intramuscular injections of Vitamin B₂ and intramuscular or intravenous injections of Viral Zol, finding that both groups showed highly significant differences in average fever reduction time, time to stop new rashes, and time for complete skin lesion scabbing (p < 0.01). None of the treatment group experienced secondary skin rashes, and no adverse reactions occurred. Xiao Zhao Wei soaked the compound Gua Zi Jin Granules (Jin Hong Sheng) in warm water for oral administration, treating 43 cases of varicella, with 22 cases cured, 17 cases showing marked improvement, and a total effectiveness rate of 97.7%, surpassing the oral formulation of Li Ba.

Part Two: Infectious Diseases

Wei Lin’s group reported a cure rate of 89.3%.