3. Integrated Chinese and Western Medicine Treatments

3. Integrated Chinese and Western Medicine Treatments Deng Hua used Qing Kai Ling injection, fishy herb injection, and Astragalus injection, combined with Western medicine like Ribavirin for intravenous infusion, while simultaneously administering the traditional Chinese medicine formula Wu Wei Du Xuan Decoction along with anti-inflammatory and anti-itch medications. After treatment with these combinations of Chinese and Western medicines, along with Ribavirin intravenous infusions, the patients were treated for 8 hours¹² cases; the rash subsided in 2–3 days¹² cases, 4–5 days²⁵ cases, and 6–7 days⁹ cases; the entire treatment process lasted a minimum of 3 days¹, with 6 hours²⁴ cases.

The children’s mental state was relatively good, with no particular discomfort. Tang Yu used intravenous acyclovir infusions combined with fishy herb injections for intramuscular administration, and the treatment duration was shorter compared to the control group, with the rash resolving faster and the itching alleviating more quickly, as well as the skin scabbing and the overall course of the disease being better in the treatment group.

Second Article: Infectious Diseases

In a study by Wei Lin’s group, 89.3% of the children were successfully treated.

4. Topical application of traditional Chinese medicine, whether through topical applications or washes, is often used as an adjunctive treatment for varicella. Huang Junyong, however, treated 66 children with varicella using a self-made Yinchuan External Wash Solution, achieving a cure rate of 46 cases, with 13 cases showing marked improvement and 7 cases remaining unresponsive, resulting in a total effectiveness rate of 89.4% (Tianjin Pharmacy, August 2006).

Zhao Rong randomly divided 76 children diagnosed with varicella into a treatment group of 42 cases and a control group of 24 cases. Based on standard treatment protocols, the treatment group received traditional Chinese medicine formulas such as Yin Qiao Jie Du Decoction (composition: Mulberry Leaves, Forsythia, Honeysuckle Flower, Coptis Chinensis, Ban Lan Gen, Purple Flowered Groundsel, Cicada Ear, Red Peony, Wood Vine, Wild Chrysanthemum), while the control group received intramuscular injections of recombinant human interferon alpha-2b, oral acyclovir tablets, and external applications of Calamine Lotion. Compared to the control group, there were no statistically significant differences in the effectiveness rate, total effectiveness rate, time to relieve itching, or time for complete skin lesion scabbing (p > 0.05). However, the treatment group’s fever duration was significantly shorter than that of the control group (p < 0.01), indicating that Yin Qiao Jie Du Decoction could help restore normal body temperature more quickly, thereby alleviating the discomfort experienced by children (Pediatric Pharmacy Journal, June 2007).

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 took the varicella decoction (composition: Honeysuckle Flower, Forsythia, Ban Lan Gen, Polygonum cuspidatum, Fangfeng, Jingjie, Poria, Scutellaria, Shengma, Coix Seed, Wood Vine, Licorice, etc.) for treatment. The treatment regimen involved two doses daily, with one dose prepared by boiling the herbs in water and taken in two separate administrations; another dose was used to prepare a herbal decoction for external steaming and topical application. The control group received intravenous acyclovir infusions. The treatment group had a cure rate of 76.0%, with 16.0% showing marked improvement and a total effectiveness rate of 92.0%; the control group had a cure rate of only 28.0%, with a total effectiveness rate of 56.0%. Statistical analysis revealed that the two groups’ efficacy was statistically significant (p < 0.01) (Journal of Hunan Normal University, Medical Edition, May 2008).

IV. Western Medicine Treatments (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 scabbed over. During the fever phase, the child should rest in bed and consume easily digestible foods while staying well-hydrated. 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 spaces clean, disinfect, and well-ventilated, utilizing ultraviolet light, sun exposure, and boiling bedding items. If care is not proper, secondary skin infections can lead to pus formation and even joint inflammation.

(2) Medication Treatments

1. For symptomatic treatment, apply 10% Gentian Violet to areas with skin lesions; for skin itching, use 2% Carbonic Acid Liquid 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 is present, treatment should follow the same protocol as for encephalitis type B.

2. Adrenal cortical hormones are generally contraindicated in cases of varicella. If varicella is complicated by severe complications, and effective antibiotics are being used, a treatment period of 3–5 days may be sufficient. However, if the patient already has a pre-existing condition that requires hormone therapy but subsequently develops varicella, and the hormone usage is brief, it may be discontinued, or the dosage can be reduced to approximately 1/10–1/5 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 on 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, finely ground 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 typically 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 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 conditions, immune function may decline, allowing latent viruses to proliferate and cause the disease to manifest. 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, large, balloon-like cells can be observed, indicative of cell degeneration and transformation into giant cells. In the vesicles, eosinophilic nuclear inclusions can sometimes be found in the free epithelial cells. 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 known as a subacute herpes zoster. Some vesicles may appear as bullous or hemorrhagic, or even show central necrosis, forming dark brown crusts—these are referred to as gangrenous herpes zoster. Elderly patients with lymphoma or other conditions may experience widespread rashes covering the entire body, resembling extensive chickenpox-like lesions, 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, and generally do not extend beyond the midline of the body surface, accompanied by distinct neuralgia.

Before the appearance of rashes, it can be easily confused with angina pectoris, chest muscle pain, duodenal ulcers, biliary colic, and other conditions. However, once rashes appear, they should be differentiated from the following diseases.

(2) Differential Diagnosis

1. Simple Herpes Most commonly occurs at the junction of skin and mucous membranes, such as the corners of the mouth, the lip margins, around the nostrils, and on 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 such as 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 ultimately reaching the limbs. The vesicles are itchy, without significant pain.

3. Impetigo begins as a few scattered red patches or vesicles, gradually progressing to vesicles, with surrounding redness and inflammation, cloudy vesicle fluid, burning and itching, causing scratching and contamination, leading to erosion and exudation, recurring and spreading over time. The disease often affects exposed areas such as the head and face, as well as the limbs, but 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 Su Wen · Zhi Zhen Yao Da Lun stated: "All pain, itching, and sores belong to the Heart." The Su Wen · Yin Yang Ying Xiang Da Lun noted: "The dampness of the Earth, when sensed, harms the skin, flesh, tendons, and veins." The Yi Zong Jin Jian wrote: "When dry, the color turns red and crimson, resembling cloud-like flakes, with a tingling sensation and heat, indicating Liver Qi. The Heart Meridian's Wind and Fire... When damp, the color turns yellow and white, with vesicles varying in size, oozing fluid, and more painful when dry, indicating the Spleen and Lung Meridians' Dampness and Heat..." The Surgical Qi Xuan stated: "Spider Wounds—these wounds appear between the skin layers, similar to water pits, pale red and painful, with five or seven lesions breaking down, five or seven clustered together, and 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 Dan," "Banded Dragon," "Spider Wound," 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 internally, leading to external exposure to harmful pathogens.

Part Two: Infectious Diseases The body’s qi is regulated, leading to dampness and turbidity accumulating internally, stagnating and transforming into heat, with damp-heat accumulating and external exposure to harmful pathogens. The body’s qi is blocked, leading to stagnation and obstruction, causing the body to struggle to expel toxins. As a result, water and qi gather, becoming stagnant and obstructed, leading to a lack of water and a deficiency in bodily functions. Excess Liver Qi leads to spleen deficiency, and dampness becomes a key factor in the development of this disease. The liver’s qi is not fully balanced, and the spleen’s qi is also deficient, causing the body to become overly warm and prone to heat-related toxins. The body’s qi is blocked, leading to heat and toxin accumulation, which can cause sudden onset, widespread rashes, high fever, headache, and even confusion or delirium.