Hordeolum (sty) 麥粒腫

Translated and Edited by: Joe Hing Kwok Chu  按此看中文

Causes

Hordeola (styes) are usually caused by  the bacteria Staphylococcus aureus infection.

Elevated serum lipid levels may increase the risk of blockage to oil glands of the eyelids and, therefore, predispose to hordeola and chalazia (lumps on eye lids).

External washing and steaming method:

da huang 30 g, jin yin hua 30 g, gan cao  15 g,  ju hua 15 g, bo he 30 g (packed separately, and put in after water is boiling during the last stage)

Wash all herbs. Boil with water except bo he. After water is boiling drop in bo he. Turn off stove. Steam the affected eye(s) with the steam from the herbs, once a day, 5 minutes each time.

If the above method does not not solve the problem, use the following method:

huang lian 30 g. Soak in water for one hour. Heat with high heat until boiling; then simmer till small amount. Use a clean brush to apply to the affected eye(s) lid. Do not let the solution contact the eyes if the equipments are not sterilized.

Source or external treatment: Chen Junzhe

Internal treatment
!. Wind-heat syndrome:

During the nitial stage, there is a is a slightly red and swollen, itchy and pain in the eyelid locally where the infection is affected.

Headache

Fever

Discomfort in the whole body.

The fur in the tongue is white and thin.

Pulse is floating and rapid.
Treatment: address the pain and infection
Prescription：

jin yin hua 15 g. lian qiao15  g, jie geng 12 g. bo he 6 g.(put in the last minute)，dan zhu ye 10 g, gan cao 6  g, fang feng 10 g, tian hua fen 12 g. niu bang zi10 g, lu gen10 g.

Make into decoction and use as tea.

2. Wind-heat syndrome:

• Swollen and red eyelid and difficult to open eye

• Dry mouth

• Headache

• Fever

• Yellow urine

• Constipation

• Red tongue with yellow fur

• Strong and rapid pulse

Treatment: lower fever and address infection

Prescription:
chuan shan jia 12 g,  zhi zi10 g, lian qiao 15 g, huan lian 10 g, huang qin 10  g, bai zhi 10  g, tian hua fen 12  g, zao jiao ci 12  g, dang gui wei (tail)  12  g, gan cao 6  g, chi shao 12  g, jin yin hua 15  g, da huang  5  g, mang xiao 10克 .

Make into decoction and use as tea.

----------------------------------------------------------------------------------

Modern treatment

Treatment of internal hordeola is using oral antibiotics which could include dicloxacillin 250mg PO Q6H, erythromycin or tetracycline 250mg PO QID or amoxacillin 500mg PO TID for 10 days. Cold compresses will help to suppress inflammation. Hot compress will help to ripen pus after pus is formed.

Topical antibiotics are usually ineffective. Incision and drainage can be performed if pus is ripe.

Note:

TID = ter in die (three times a day)

Q6H = every 6 Hours

QID = quater in die  (Four Times a Day)

PO = by mouth (per Os) or orally

外用薰洗方：
 大黃 一兩   金銀花一 兩   甘 草五錢  菊 花 五錢 薄荷 一兩 (另包後下)

用法：
煮開之後以蒸汽薰眼睛，一日一次，每次五分鐘以上。

如果還是不行，用一兩的 黃 蓮 ，泡水一小時，大火滾後小火慢慢熬，熬到極少的 量，去渣取汁，以乾淨的毛筆沾取藥汁，塗 在眼皮外面，不是裡面的麥粒腫上， 沒事多塗幾次，不要太多汁流到眼睛，因為不是無菌處理, 要小 心。

以上外治方法來源﹕ 藥師．中醫師   陳俊哲

內治法：
!. 風熱外侵：瞼部腫物初起，局部微有紅腫痒痛，伴頭痛，發熱，全身不適等，舌苔薄白，脈浮數。
治法：疏風清熱。
處方：金銀花 15克，連 翹15克，桔 梗12克，薄 荷 6克(後煎)，淡 竹葉 10克，甘 草6克，防 風 10克，天 花粉 12克，牛 蒡子10克，蘆 根10克。
或用 中成藥：銀翹解毒丸。

2. 熱毒壅盛：眼瞼紅腫痛難睜。兼有口亁，頭痛，發燒，尿黃，便秘，舌苔黃，舌質紅，脈數有力。 治法：瀉火解毒。
方藥：穿 山甲12克，梔 子10克，連 翹15克，黃 蓮10克，黃 芩10克，白 芷

10克，天 花粉12克，皂 角 刺12 克，當 歸尾12克，甘 草6克，赤 芍12克，金 銀花 15克，大 黃  5克 ，芒 硝10克 。
或用中 成藥 ：連翹敗毒丸或牛黃解毒丸