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Hand Foot and Mouth Disease 手足口病 (in English and Chinese 中英文)

Ttranslated by: Joe Hing Kwok Chu  興 國編譯      Click here for mobile users

The following formulae are for children. For adult, the weight should be increased according to normal usage.

Common type I

Syndrome: fever, no sweat, sores appear on hands, feet and mouth , red color of sores appear on the tongue and in the mouth, severe pain, drooling, lack of appetite, constipation, red tongue with yellow greasy looking fur.
Name of Formula: da huang huang lian xie xin tang with adjustment  《souce: Shang Han Za Bing Lun 》
Prescription:

 da huang 3 g,huang qin 6 g,huang lian 3 g,wu bie zi 6 g,bo he 6 g

Add about 100 ml of water and simmer to 50 ml. Make into 2 servings.  Take while warm

Common type II

Syndrome:  fever, no sweat, sores appear on hands,  feet and in the mouth , pain not severe, the sores in the mouth are dark red in color, bloating in abdomen, lack of appetite, normal or slightly runny stools, dark red tongue with yellow greasy looking fur or slightly greasy look.
 

Name of Formula: gan cao xie xin tang with adjustment 《souce: Shang Han Lun 》

Prescription:

 sheng gan cao10 g,ban xie 6 g,huang qin 6 g,huang lian 2 g,gan jiang 3 g,

chai hu 10 g,huo xiang 6 g

Add about 100 ml of water and simmer to 50 ml. Make into 2 servings. Take while warm

More serious (central nervous system infections):

Syndrome: fever, rash, high fever, no sweat, irritability, lethargy, irritability, easily frightened, or with body atrophy, paralysis, red tongue with greasy look or yellow greasy look.

Name of Formula: Feng Yin Tang with adjustment  《souce: Jin Gui Yao Lue 》

adjustment for more severe cases:
high fever: add ling yang jiao powder;
limb clonic, add yi yi ren, di long, xuan mu gua; constipation subtracting chi shi zhi,
diarrhea reduce da huang, reducing the amount sheng shi gao, add sheng ma, ge gen,
limbs flaccid paralysis, plus fresh di long, qin jiao, wei ling xian, si gua luo, (濕熱條辨方);
In later stage when fever is gone, reduce the mineral medicine, and to promote qi and yin, and to reduce  infection and clear meridian.

 

普通型(心脾積熱)

症狀:發熱,無汗,手足口出現疱疹,其中口舌疱疹色紅 ,疼痛劇烈,患兒流涎較多,納差,不能進食,大便秘結,舌質紅,苔黃膩。 

中醫治法:清熱解毒化濕   
方藥:大黃黃連瀉心湯加減   《方源:傷寒雜病論  》
處方:大 黃 3克,黃 芩6克,黃 蓮3克,五 倍子6克,薄 荷6克,水煎至50毫升,分2次服。   



普通型(濕熱交阻)

症狀:發熱,無汗,手足口出現疱疹,口舌疱疹色暗紅,疼痛不劇,腹脹,納差,大便正常或稍溏,舌暗紅,苔白膩或稍黃膩。
中醫治法:辛開苦降,清熱化濕解毒   

方藥:甘草瀉心湯加減   《方源:傷寒論  》


處方:生甘 草10克,半 夏6克,黃 芩6克,黃 蓮2克,乾 薑3克,柴 胡10克,藿 香6克,水煎50毫升,分2次服。  
 
 


重型(中樞神經系統感染)

症狀:發熱、皮疹,高熱,無汗,煩躁,嗜睡,煩躁,易驚,或伴肢體痿軟、癱瘓,舌紅,苔白膩或黃膩。   

中醫治法:清熱化濕,鎮肝熄風   

方藥:風引湯加減   《方源:金櫃要略  》

藥物:大 黃3克,生石膏20克,寒水石10克,滑石10克(包煎),赤石脂10克,白石脂10克,紫石英10克,生牡蠣10克,龍骨10克 ,乾 薑3克, 桂枝6克,甘草3克,水煎50毫升,分2次服。  
 

重症加減方案:熱勢較盛,加用羚羊角粉;肢體陣攣重,加用薏 苡仁、地龍、木瓜;便秘減赤石脂,腹瀉減大黃,減生石膏用量,加用升麻、葛根;肢體軟癱,加用鮮地龍、秦艽、威 靈仙、絲瓜絡(濕熱條辨方);後期熱退減石類藥物,益氣養陰清熱通絡。   

中藥方劑治療小兒手足口病本病屬中醫濕溫、時疫等范疇。病因為濕熱疫毒,多因內蘊濕熱,外受時邪,留於肺、脾、心三經而成。外邪自口鼻而入,侵襲肺、脾二 經,肺主皮毛,故初期多 見肺衛症狀,如發熱、流涕、咳嗽;脾主四肢,開竅於口,手足口受邪而為水疱,口舌生疱疹、潰瘍。目前中醫藥治療本病,主要採用辨証分型、 辨病分期、專方加減三種基該方法。可達標本兼顧,減輕症狀、縮短病程之功效。

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Last update: June 14, 2014; 1 p.m. LAH