Professor Li Gui academic experience and the temperature and lung circulation Dingchuan the clinical study of treatment of children with bronchiolitis
|School||Beijing University of Traditional Chinese Medicine|
|Course||Chinese Academy of Pediatrics|
|Keywords||Pediatrics activating blood and resolving stasis respiratory tract infections Li Gui|
1. Application of activating blood and resolving stasis to respiratory tract infections in the pediatric areaMethod of activating blood and resolving stasis had gradually formed and grown during the time the human being struggled with the disease for two thousand years, had developed and been innovated by experienced physicians in dynasties, and now had been widely used in different departments in clinic. To various pediatric diseases, especially to chronic, refractory and easily repeated diseases, the method could be applied boldly as long as the pathogenesis matched.2. Clinical study on treating pediatric bronchiolitis with method of warming lung, resolving stasis and relieving dyspneaThe author engaged in clinical study on treating pediatric bronchiolitis with method of warming lung, resolving stasis and relieving dyspnea on the basis of inheriting and concluding professor Li’s academic experience.Objective: To observe clinical effect of treating pediatric bronchiolitis with method of warming lung, to verify the safety and effectivity of Promoting Blood Circulation and Removing Blood Stasis in pediatrics, resolving stasis and relieving dyspnea, so as to find a better way to treat pediatric bronchiolitis by integration of Chinese and Western medicine to relieve the suffering of patients, and to prevent the incidence of asthma in infants and young children.Method: according to randomized parallel-group clinical study, selected patients were randomly divided into experimental group of 30 patients and a control group of 27 patients, with basic treatment of ambroxol, budesonide suspension, and compound aerosol ipratropium bromide. Experimental group, on the basis of basic treatment, took decoction of warming lung, resolving stasis and relieving dyspnea. Ribavirin injection and procaterol hydrochloride oral solution were used as comparison to the control group.Results:The results showed that there was no significant difference between experimental group and control group from the main symptoms and signs such as fever, cough, shortness of breath, phlegm, and cumulative scores change of main symptoms, indicating that there was no significant difference in therapeutic effect between Chinese medicine and Western medicine; while when it came to the change of cough, there was a significant difference between the two groups and the experimental group of Chinese medicine was significantly better than the control group of Western medicine.Conclusion: It was proved by the experiment that the therapeutic effect on acute pediatric bronchiolitis of the formula had almost no significant difference from western medicine generally, but as to improve some of the symptoms (such as cough), group of Chinese medicine was significantly better than the control group of western medicine. Thus we could say that the treatment of activating blood and resolving stasis mainly was effective to treat pediatric respiratory tract bronchitis, and showed the advantages of Chinese medicine.Acute pediatric bronchiolitis was a group of acute lower respiratory tract diseases, which was caused by a variety of pathogens. Common pathogens were viruses (respiratory syncytial virus, parainfluenza virus, adenovirus, etc.), bacteria, mycoplasma pneumoniae, etc. For these viruses, there had been no reliable, specific antiviral medicines available by now, so there was no specific treatment to this disease. Western medicine focuses on use of adrenal corticosteroids (inhaled or systemic), bronchial smooth muscle spasmolytic and expectorant cough medicine, while the therapeutic effect is not very satisfactory.WenFei Hua Yu Ding Chu an Fang (Formula of Warming Lung, Resolving Stasis and Relieving Dyspnea) was made by professor Li by reasonable use of theories of Chinese and Western medicine and was proven to be an effective prescription after long-term clinical practice, which was mainly for children with bronchiolitis, asthmatic bronchitis and bronchial pneumonia caused by exogenous wind and cold, and accompanied with signs such as fever, aversion to cold, cough, dyspnea, shortness of breath, and phlegm stagnation. In the formula, ma huang (Herba Ephedrae, ephedra herb) was pungent-warm with dispersing effect so as to dissipate cold and release exterior combining with gu i zh I (Ramulus Cinnamomi, cassia twig), and to ventilate lung and relieve dyspnea combining with xing ren (Semen Armeniacae Amarum, almond). Xixin (Radix et Rhizoma Asari, Manchurian wild ginger), ban xi a (Rhizoma Pinelliae, pinellia rhizome) and gua lou (Fructus Trichosanthis, snakegourd fruit) were used to warm lung, dispel phlegm and resolve fluid retention, w□w e i z□(Fructus Schisandrae Chinensis, Chinese magnolivine fruit) was used to relieve dyspnea by astringing and descending lung qi, hu a ng qin (Radix Scutellariae, scutellaria root) and qing d a i (Indigo Naturalis, natural indigo), with function of clearing lung heat, were used to clear stagnation heat due to wind, cold, phlegm and fluid retention, taoren (Semen Per sicae, peach seed) and hong hu a (Flos Carthami, Safflower) were used to activate blood and resolve stasis, and aid to clear up phlegm by dredging lung collaterals, zhi gan c□o (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle, prepared liquorice root) was used to moderates the actions of other herbs. All the medicines together had function of warming lung, resolving fluid retention, dispelling stasis, resolving phlegm, and relieving cough and dyspnea.Moreover, professor Li was against the overuse of antibiotics in the clinic. Based on theories of Chinese medicine and Western medicine, syndrome differentiation and treatment of TCM was applied. It not only solved a lot of clinical problems which couldn’ t be solved by Western medicine alone, but also was a good complementary to anti-infective therapy by Western medicine.In the early stages of infection, Chinese medicine, mainly for clearing heat and removing toxin, could be used merely to treat intense heat toxin syndrome at the beginning of exterior syndrome. It not only provided a reasonable and effective treatment to a large number of child patients with no clear indication of antibiotics, but reduced the use of antibiotics and shortened the period of treatment. When it came to the digestive problems such as poor appetite, anorexia, fetid mouth odor, constipation and so on commonly seen during external contraction disease in children, and to persistent or recurrent diseases, western medicine had no good method to treat, while Chinese medicine, those could replenish qi, invigorate spleen, reinforce healthy qi and eliminate pathogen, were used by professor Li and got good effect in order to solve clinical problems.The flexible application of activating blood and resolving stasis to pediatric respiratory tract infections was different from the traditional thought of TCM. It came from years of clinical experience of professor Li’s and was a development of traditional therapeutic principles and methods, which could significantly improve the clinical effect, especially to cases of more limited infection it could accelerate the dissipation of the lesion. Of course, in actual clinical work, medicines should be appropriately adjusted according to the patient’s condition, age and complications.