3 Traditional Chinese Medicine Syndrome Differentiation and Formulas

(3) Traditional Chinese Medicine Syndrome Differentiation and Formulas

1. Liver and Gallbladder Fire: The primary symptom is intense burning and severe pain in the affected skin area, with redness and inflammation, prominent papules and vesicles, dry throat and bitter taste in the mouth, irritability, restlessness, constipation, short yellow urine, a red tongue with a yellow coating, and a tense, rapid pulse. Treatment focuses on clearing heat, reducing fire, detoxifying, and relieving pain; the formula uses Longdan Xie Gan Tang combined with Ban Lan Gen, Huai, Honeysuckle Flower, and Portulaca Oleracea.
2. Spleen and Stomach Damp Heat: The primary symptom is pale skin, clustered rashes, cloudy vesicle fluid, ulceration and exudation, or moist, inflamed rashes with abdominal distension, poor appetite, dry mouth and reluctance to drink. The tongue is pale red, with a white or yellowish greasy coating, and a slow, tense or astringent pulse. Treatment aims to strengthen the spleen, remove dampness, and relieve pain; the formula uses Zhu Shi Wei Ling Tang combined with Fresh Job’s Thistle, Plantago Major, Kikuyu, and Portulaca Oleracea.
3. Qi Stagnation and Blood Stasis: The primary symptom is severe pain in the affected area, or the rash subsides but the pain persists, restless sleep, a dark purple tongue, a thin white coating, and a fine, tense or astringent pulse. The formula uses Taohong Siwu Tang combined with Chuan Lian Zi, Yuan Hu, Dan Shen, Frankincense, and Myrrh. In the later stages of the disease, especially in elderly patients with qi and blood deficiency, it is advisable to tonify qi and blood, resolve stasis, and calm the mind; the Eight Treasure Decoction combined with Pearl Mother, Frankincense, and Myrrh can be used. (4) Traditional Chinese Medicine Resources on the Diagnosis and Treatment of This Disease Based on the severity of the condition, the disease can be classified as mild, moderate, or severe. If the rash appears within 1–2 days, the skin is red, the vesicles are small and grain-like, with burning and pain, and the tongue is red with a tense pulse, it is considered a mild case; a two-component Baidu Disinfectant Powder can be applied externally. If the disease has progressed to 3–4 days, the affected area is intensely burning and painful, the vesicles are clear and swollen in clusters, the skin is red, and the tongue is red with a tense pulse, it is considered a moderate case; the Longdan Xie Gan Tang can be taken internally, while the Baidu Disinfectant Powder is applied externally. If the rash has persisted for 5–7 days or longer, the skin is burning, red or purplish, or shows pus-filled scabs, with severe pain, high fever, irritability, yellow urine, a red tongue, and a rapid pulse, it is considered a severe case; the Longdan Xie Gan Tang combined with Wu Wei Du Xuan Decoction can be taken internally, while the Baidu Disinfectant Powder is applied externally. In recent years, various physicians have developed their own proprietary formulas for treating this disease, such as Jin Shao Yiguan Jian (White Peony, Rehmannia Root, Curcuma, Shaoshan, Ophiopogon, Goji Berry, each 10–30g, Angelica Sinensis, Chuan Lian Zi, each 6–15g). Dai Xie Xiao Ran Tang (Green Indigo Powder (prepared by decoction), Fresh Sophora Flower, Cortex Phellodendri, each 10g, Whole Scorpion (ground into powder and taken orally) 5–10g, Ban Lan Gen, Coix Seed, each 20g, Silkworm Sand (prepared by decoction), Grassa, Kikuyu, each 20g). Tu Fu Ling Da Huang Tang (Tu Fu Ling 120g, Da Huang, Honeysuckle Flower, Forsythia, each 30g, Phellodendron Amurense, Coptis Chinensis, Rehmannia Root, each 10g). Ma Chi Xuan Decoction (Portulaca Oleracea, Big Green Leaf, Purple Herb, Badger Grass, Honeysuckle Flower, Sour Date Kernel, Calcined Dragon Bone or Magnet Stone). Long Yan Tang (Big Green Leaf, Pinellia, Ban Lan Gen, Scutellaria, Fagot, Bai Zhi, Purple Herb, Honeysuckle Flower, Codonopsis Pilosula, White Skin Bark, Licorice). San Zi Tang (Purple Herb, Wood Vine, Yuan Hu, Big Green Leaf or Ban Lan Gen) and other formulas are all prepared by boiling in water twice daily. (Chinese Medicine Magazine, May 1987) In terms of external applications, there are many different options available, including Da Huang Wu Bei Jiao Paste (2 parts Raw Da Huang, 2 parts Phellodendron Amurense, 1 part Wu Bei Jiao, 1 part Mangxiao, finely ground and mixed with petroleum jelly to create a 30% ointment), or San Huang Paste (15g of Realgar, 15g of Da Huang, 50g of Cypress Branch, 3g of Camphor, mixed with an appropriate amount of sesame oil). Alternatively, there are Chuan Xiong Powder (60g of Gentian Grass, 30g of Realgar, 10g of Camphor, finely ground and mixed with vinegar for external application), or Pore Xuan Powder (15g of Asarum, 15g of Mint, 30g of Ban Lan Gen, finely ground and mixed with green indigo, applied externally), all of which have shown good therapeutic effects. (Sichuan Chinese Medicine, December 199.12) For treating post-herpetic neuralgia, combining Clove and Curcuma is effective. Japan has used Yue Bi Jia Shu Tang for treatment. (Sichuan Chinese Medicine, February 1992) Liang Jielì treated 68 cases of herpes zoster using a self-made Decoction for Detoxification and Circulation Activation combined with conventional Western medicine treatments, comparing them with a control group of 66 cases treated solely with Western medicine. The treatment group took traditional Chinese medicine (Decoction for Detoxification and Circulation Activation) with 30g of Ban Lan Gen, 15g of Big Green Leaf, 45g of Honeysuckle Vine, 2g of Clams, 4g of Whole Scorpion, 10g of Yuan Hu, 10g of Red Flower, 10g of Zhike, 12g of Lulu Tong, 15g of Soak Angles, 10g of Keshan, 12g of Gentian Grass. Conventional Western medicine included Vitamin B₁ 100mg, Vitamin B₅ 500µg, administered intramuscularly once daily; oral administration of Virus Ling 0.2g, Glucoside 20mg, Pain Relief Tablets 0.5g, three times daily. If the rash broke open and became deeply infected, -u6, number HI eight, L knife Pain duration 2–4 days, pain relief time 2.5–5 days; the rash began to dry and scab over in the preparation of zinc cream. Results: The combined Chinese and Western medicine treatment group saw mouth + white t T work book work 2.5–6 days, with a cure rate of 4–12 days, averaging 5.6 days, and a total treatment duration of 6–18 days, averaging 8 days. Compared to the control group, there were significant differences in pain relief time, the time for the rash to begin to scab, and the number of cures (p < 0.01). (Medical Theory and Practice, 2024) Liu Guanghan treated 190 patients with traditional Chinese medicine, using Qing Huang Powder for external application, all of whom were cured in a short period, with no cases experiencing post-herpetic neuralgia. The patients in this group Integrated Chinese and Western Medicine Practical Internal Medicine

Tablet, Vitamin B, Rash Cleanser, Dry Expansion

Growth Factor, Virus Ling, Virus Zol, Polyinosinic Acid

Commonly used (oral or external), Longdan Xie Gan Tang (pill), Zhou Lin Fen Di

Go to small m, Xiang De Sheng Snake Medicine, Nantong Snake Medicine Tablets, Acyclovir P M

Monitor root, second use of Qing Miao Powder for treatment. Qing Huang Powder is made from about ten ingredients—Astragalus, Phellodendron Amurense, Prepared Frankincense, Myrrh, Red Soybeans, and Alum—carefully refined.

Only when needed, use red mold ointment or other oils, fragrances, or refined edible oils to apply to the affected skin area, then take the Qing Huang Powder and dry it for external use, cover it with sterile gauze, secure it with adhesive tape, and change the dressing once daily after disinfecting the wound. If the rash breaks open or…

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Input: Scattered rivers use evil needles to pierce water and pustules, and after cleaning the wound surface, lightly sprinkle Qinghuang powder onto the affected area, then cover with gauze for fixation—use until the vesicles heal. Pool of pain disappears. Treatment results: 6 cases were cured after a single treatment, 15 cases were cured after two treatments, 42 cases were cured after three treatments, 42 cases were cured after four treatments, 12 cases were cured after five treatments, 8 cases were cured after six treatments, 8 cases were cured after seven treatments, 8 cases were cured after eight treatments, 3 cases each received nine and ten treatments, 2 cases each received eleven and twelve treatments, 1 case received thirteen treatments, 2 cases received fourteen and fifteen treatments, and 1 case each received twenty, twenty-one, and twenty-five treatments. The average treatment duration was 5.1 times. A total of 190 cases were treated with the above regimen, and the herpes lesions dried up and formed scabs, with the pain disappearing. Follow-up examinations showed no cases developed postherpetic neuralgia, indicating excellent long-term efficacy. (Practical Medical Technology Journal, 2003.11) Ning Tianyuan et al. used an integrated traditional Chinese and Western medicine approach to treat 48 cases of herpes zoster. The method involved taking 40 tablets of 25 mg of diphenhydramine, 10 tablets of 0.75 mg of dexamethasone acetate, 50 g of rhubarb, 50 g of phellodendron, 20 g of whole scorpion, 20 g of centipede, and 10 g of camphor, grind them into a fine powder, sift through a sieve, mix thoroughly, and store in a clean, sealed bottle for later use. Before medication, wash the herpes lesions with saline solution, then disinfect with 2% iodine alcohol. Based on the size of the herpes lesions, take an appropriate amount of the powdered medication and mix it with ginseng pearl powder to form a paste, applying it to the affected area twice or three times daily, exposing it to air until dry, then gently scraping off the excess before reapplying. Seven days constituted one course of treatment, typically lasting 1–2 courses. In this group, all 48 cases achieved complete recovery within a single course; among the 46 cases followed up, 42 were cured, resulting in a cure rate of 96%, while 2 cases showed improvement (4%). (Nursing Research, 2004.7) Liu Ping treated 86 cases of herpes zoster with traditional Chinese medicine. The treatment method involved: ① local treatment with external application of traditional Chinese medicine: prepare a formula consisting of realgar, raw rhubarb, centipede, toad venom, camphor, 70% ethanol, and other ingredients, storing the preparation as a tincture for use twice daily, applying it to unruptured herpes lesions. For areas with extensive acute inflammatory rashes, cover the lesions with a layer of sterile gauze to protect the skin and prevent the rash from breaking and causing infection. Avoid using oily ointments for external application; ② systemic treatment: according to traditional Chinese medical theory, herpes zoster is attributed to liver fire overactivity and internal damp-heat accumulation; therefore, the principle of treatment is to clear damp-heat from the liver and gallbladder. Use 3 g of gentian root, 5 g of bupleurum, 12 g of skullcap, 30 g of honeysuckle, 12 g of forsythia, 10 g of gardenia, 15 g of rehmannia, 3 g of licorice, 30 g of indigo woad, 6 g of xiangxiong, 6 g of coptis, 12 g of polygonum cuspidatum, 15 g of plantain, 12 g of polygonum cuspidatum, 12 g of polygonum cuspidatum, 10 g of alisma, and other herbal formulas, taken once daily, with one week constituting one course of treatment, using the resolution of rashes as the therapeutic criterion. Results: all 86 patients were cured, with the shortest disease course being 9 days and the longest reaching 46 days. (Chinese Practical Medicine, 2009.1) IV. Western Medical Treatment (1) Symptomatic and supportive therapy The skin around the affected area can be washed with soda water, and applied with camphor powder or peppermint powder, or by mixing realgar powder with alcohol or water. Apply 5% sulfur-copper oxide water-based powder or 3–5% gentian violet solution externally for protection, anti-inflammatory effects, and drying purposes. Alternatively, apply olive oil, sulfonamides, or gold-mycin ointment to moisturize the skin and promote scab formation. For severe pain, consider local nerve blocks with alcohol or procaine, or administer vitamin B1 and B2 intramuscularly. If conjunctivitis or iridocyclitis occur concurrently, use atropine eye drops to dilate the pupils and apply corticosteroid ointment. For elderly patients, it is advisable to increase the use of sedatives such as bromide, diazepam, or imazalil, or add analgesics like aspirin, analgesic, or diclofenac. For long-term and severe postherpetic neuralgia, if analgesics are ineffective, combine analgesics, sedatives, and hypnotics. For elderly patients, early administration of prednisone for several weeks, gradually reducing the dosage and discontinuing the medication, can reduce the occurrence of postherpetic neuralgia without causing side effects. (2) Antiviral medications

1. Ara-A can inhibit the synthesis of varicella-zoster virus.
2. Administering Ara-A intravenously at 10 mg/kg·day, for a course of 5 days, can stop viral release, accelerate skin healing, reduce lesion spread, and shorten the duration of neuralgia; however, it cannot prevent the onset of postherpetic neuralgia.
3. Acyclovir inhibits the varicella-zoster virus and has low toxicity. Administering it intravenously at 15 mg/kg·day, for a course of 7 days, can control the spread of skin lesions and the release of the virus, effectively promoting local healing and alleviating pain.
4. Acyclovir has been reported in recent years to be administered intravenously at 500 mg once daily, along with 400 mg of cimetidine, plus 5 mg of dexamethasone, given once daily for 5–7 days, exhibiting significant analgesic effects, promoting herpes healing, and preventing postherpetic neuralgia. *3. Other treatments include dermal acupuncture: after disinfecting the lesion with 75% alcohol and marking the boundary between the lesion and healthy skin, based on the size of the lesion, first use… degree of needle, making cross-shaped punctures under the skin. Qiao Yi Chapter Two: Infectious Diseases

Qu’s medicinal cream (Gui Huo Wei)

2% procaine applied externally in appropriate amounts proved highly effective, especially for those experiencing severe pain. Qu, realgar 5:1 mixed with egg white or petroleum jelly

Add (Chu Xiaoping, Qiao Fuguo, Wu Shi) Chapter Seven: Epidemic Parotitis I. Overview

Epidemic parotitis (Mumps), often referred to as “flow mumps,” is an acute respiratory infectious disease caused by the mumps virus. Its most prominent clinical feature is non-suppurative swelling and pain in the parotid glands. The virus can infect almost every organ, so some cases present with meningitis, orchitis, oophoritis, dermatitis, mastitis, myocarditis, and other conditions. This disease is prevalent throughout China, occurring year-round, with higher incidence in spring and winter, commonly affecting children and adolescents, though adults are also frequently affected. According to previous medical surveys, the incidence has been trending upward since 1978. The mumps virus belongs to the paramyxovirus family and is RNA-based; it was first isolated in 1934 from the saliva of infected patients. It is extremely sensitive to physical factors (sunlight, ultraviolet rays, etc.) and chemical agents (1% phenol, ethanol, etc.). The virus rarely mutates; it enters the body through the oral and nasal mucosa, multiplies in epithelial tissues, then enters the bloodstream, where it further proliferates in the parotid tissue before entering the bloodstream again, causing viremia and leading to fever, loss of appetite, and parotid swelling (75% of cases involve bilateral swelling). The swelling is often accompanied by pain. Due to obstruction of the parotid ducts, salivary amylase can flow back into the blood and be excreted in the urine. It can easily cause complications such as testicular or ovarian inflammation, pancreatitis, particularly the former being quite common. White blood cell counts are usually normal, with lymphocytes slightly elevated. Serum amylase levels are mildly or moderately increased in 90% of cases. Traditional Chinese Medicine often refers to this disease as “itchy parotitis.” After contracting the disease, lifelong immunity may develop.