Contents 1 Pinyin 2 English reference 3 Overview 4 Symptoms of cephalic gangrene 5 Causes and pathogenesis of cephalic gangrene 6 Diagnosis of cephalic gangrene 7 Diseases that need to be differentiated from cephalic gangrene 8 Treatment of cephalic gangrene 8.1 Syndrome differentiation treatment 8.1.1 Empirical evidence 8.1.1.1 Fire poison stagnation 8.1.1.1.1 Symptoms 8.1.1.1.2 Syndrome differentiation analysis 8.1.1.1.3 Treatment method 8.1.1.1.4 Prescription treatment 8.1.1.2 Damp heat stagnation 8.1.2 Deficiency syndrome 8.1.2.1 Yin deficiency and fire 8.1.2.1.1 Symptoms 8.1.2.1.2 Syndrome differentiation analysis 8.1.2.1.3 Treatment method 8.1.2.2 Qi deficiency and poison stagnation 8.1.2.2.1 Symptoms 8.1.2.2.2 Syndrome differentiation analysis 8.1.2.2 .3 Treatment method 8.1.2.2.4 Prescription treatment 8.2 External treatment method 8.3 Treatment of complications 9 Daily health care of patients with cephalic gangrene 10 About syndrome 11 References attached: 1 Prescriptions for treating cephalic gangrene 2 Acupoints for treating cephalic gangrene 3 Chinese patent medicines for the treatment of head gangrene 4 Head gangrene related drugs 5 Head gangrene in ancient books 1 Pinyin
yǒu tóu jū 2 English reference
carbuncle [Traditional Chinese Medicine Terminology Approval Committee] . Traditional Chinese Medicine Terms (2004)]
(headed) carbuncle [Traditional Chinese Medicine Terms Approval Committee. Traditional Chinese Medicine Terms (2013)]
deep carbuncle [21st Century Bilingual Science and Technology Dictionary] < /p>
carbuncle [Xiangya Medical Professional Dictionary]
3 Overview
Carbuncle (headed) is the name of the disease [1]. It refers to an acute suppurative disease that grows between the skin and is characterized by the initial appearance of miliary pus heads on the skin, redness, swelling, heat and pain, which easily spreads to the deep and surrounding areas, the number of pus heads one after another, and the appearance of a lotus pod after ulceration [2 ]. It is named because there are single or multiple white corn-like sores on the affected area at the beginning [1]. It is characterized by the presence of miliary-like pus heads on the local skin at the beginning, which is hot, red, swollen and painful, and easily spreads to the deep and surrounding areas. The pus heads also increase one after another and look like honeycombs after ulceration. It is more common in middle-aged and elderly patients, especially in patients with diabetes, and is prone to invagination. "Surgical Cases·Three Names of Sores" says: "For gangrene, when the first white grains appear, like corn, you will feel itching and pain, and the pain will be felt in the heart when you touch it. This is the sign of the beginning of gangrene..." This disease varies according to the location of the disease. There are different names for the disease. For example, if it occurs on the neck, it is called brain gangrene, mouth gangrene, and head gangrene; if it occurs on the back, it is called hair back or hand gangrene; if it occurs on the chest, it is called tanzhong gangrene; if it occurs on the chest, it is called tanzhong gangrene; If the abdomen is small, it is called abdominal gangrene. However, their causes, symptoms, and treatments are basically the same, so they are discussed together.
Due to different shapes and locations of onset, gangrene has different names, such as honeycomb gangrene, cell gangrene, lotus hair, back gangrene, hand gangrene, back gangrene, brain gangrene, hair on the back of the head, etc.[1] .
Head gangrene is more likely to occur in middle-aged and elderly people, and it mostly occurs in the back of the neck and back. It is equivalent to carbuncle in Western medicine [2]. 4 There are symptoms of head gangrene
Positive sores that occur on the body surface and between soft tissues [1]. 5 Causes and Pathogenesis of Head Gangrene
Head gangrene is often caused by exogenous rheumatism and fire poison, or overeating thick and flavorful oats, which contains damp heat and fire poison, causing heat accumulation in the internal organs, discord between the Ying and Wei, and evil obstruction. Made of skin[1].
1. The pathogenic poison caused by external wind, temperature, dampness and heat invades the skin, and the poison accumulates, causing the meridians to be blocked and the qi and blood to run abnormally.
2. The internal organs are poisoned, the emotions are internally damaged, and the qi is stagnant and turns into fire; or due to the usual ingestion of glutinous rice grains and rich alcoholic drinks, the spleen and stomach are not transported properly, and dampness, heat, and fire poisons are generated internally. Both of the above can cause the internal organs to accumulate poison.
3. Internal damage to the essence and qi is due to improper interventricular and overuse of the essence and qi, resulting in a loss of kidney water and a lack of water and fire. Yin deficiency means that the fire evil is raging, and after experiencing poisonous evil, it is often difficult to resolve the poisonous stagnation.
It is easy to occur when the body is weak, so patients with diabetes are often accompanied by this disease. For example, in a body with yin deficiency, every time the water is deficient and fire is burning, the accumulation of heat and poison will be even worse; in a body with weak qi and blood, every time the poison is stagnant, it is difficult to dissolve it, and the poison cannot be released. If the condition worsens, invagination will easily occur. 6. Diagnosis of head gangrene
It usually occurs in thick and tough skin areas such as the neck and back. Commonly seen in middle-aged and elderly people.
According to the evolution of the disease, the clinical stage can be divided into three stages
In the early stage, a lump appears in the affected area with a miliary-like pus head. The lump gradually expands to all sides, the number of pus heads increases, and the color is red and hot. , high swelling and pain. Accompanied by fever, chills, headache, and poor appetite.
In the ulcerative stage, the mass further increases, and the sore surface gradually becomes rotten and resembles a honeycomb. The mass range often exceeds 10cm or even 30cm. Accompanied by strong fever, thirst, constipation, urination, etc.
In the closing stage, the pus and rot gradually disappear, new flesh begins to grow, and gradually heals.
The entire course of the disease is about 1 month. The initial stage of the disease is in the 1st week, the ulceration stage is in the 2nd to 3rd week, and the healing stage is in the 4th week.
Auxiliary examination: The total number of white blood cells is usually 15×109/L~20×109/L, and the neutrophil count is 80%~90%. Blood sugar and urine sugar should be checked regularly. Can be used for bacterial culture of pus. 7 diseases that need to be distinguished from head gangrene
Boil: The disease is small and shallow; there are no obvious symptoms of the whole body; it is easy to pus, ulcerate, and collect.
Lipoma: There are lumps in the infected area, or there are enlarged hair follicle openings, and sebum plugs can be squeezed out; redness and swelling after exposure are mostly localized; systemic symptoms are mild; bean dregs can be seen in the pus after ulceration substance. 8 Treatment of cephalad 8.1 Syndrome differentiation treatment
The symptoms of cephalad can be divided into deficiency and excess [1]. 8.1.1 Empirical evidence
At first, the affected area is red and hot, with high and swollen root bundles, and sores like corns, ranging from one to multiple [1]. Severe pain, body heat, thirst, constipation and red urine, rapid pulse, red tongue and yellow coating are the symptoms [1]. Treatment should be to clear away heat and dispel wind, detoxify and activate blood circulation [1]. You can use Xian Fang Huo Ming Yin, Coptidis Coptidis Jiedu Decoction, etc.; apply golden ointment externally; do not use Jiuhuang Dan or Wu Wu Dan to remove the slough; if the sore is large and the slough is difficult to remove, it should be surgically removed; use Shengji Powder or Shengji Powder to remove the slough. Shengji Yuhong Cream[1]. 8.1.1.1 Fire toxin stagnation
Headed carbuncle with firetoxin amas *** ent pattern refers to the stagnation of fire toxin, which is characterized by local redness, swelling, protrusion, and burning pain. , the roots and feet are tightened, the pus is thick and yellow, and it can quickly suppurate and decompose. General fever, thirst, red urine, yellow tongue coating, and weak pulse are common symptoms of capitis [2]. 8.1.1.1.1 Symptoms
The mass is red and hot, with the base and legs bunched up, and there are millet-like pus heads on it. The sore surface is rotten, and the pus is yellow and thick; fever, thirst, constipation, and red urine; tongue Red, yellow coating, stringy and rapid pulse. 8.1.1.1.2 Syndrome analysis
Exogenous wind-warm, damp-heat and poisonous evils internally contain poisons in the internal organs, and the evil poisons accumulate on the surface of the muscles, resulting in disharmony between the body and the defense, obstruction of the meridians, and stagnation of qi and blood. Swelling and pain; the heat toxin is blazing, so the color is red, burning, and hot; the heat exceeds the rot of the flesh, so the sore surface is rotten, and the pus is yellow and thick: thirst, constipation, red urine, yellow coating, and stringy pulse are all signs of the heat toxin. Symptoms: 8.1.1.1.3 Treatment method
Clear away heat and promote dampness, harmonize Yingtuo toxin. 8.1.1.1.4 Prescription treatment
Modification and subtraction of Xianfang Huiming Drink. For constipation, add raw rhubarb and citrus aurantium to relieve heat and clear the bowels. 8.1.1.2 Damp-heat congestion
Headed carbuncle with pattern of dampnessheat congestion and stagnation refers to damp-heat stagnation. The local symptoms are the same as those of fire-toxic stagnation syndrome, and the whole body Strong fever, light in the morning and heavy in the evening, chest tightness, vomiting, greasy white or yellow tongue coating, and weak pulse are common symptoms of gangrene [2]. 8.1.2 Deficiency syndrome
Initially, the sores are flat in shape, the roots are swollen, dark in color, not very painful, the pus is late, the pus is thin, tired, eat less, dull complexion, weak pulse , a dark or light tongue is a deficiency syndrome [1]. If there is Yin deficiency, take Bamboo Leaf and Astragalus Decoction orally; if there is both Qi and blood deficiency, take Toli Disinfection Powder orally; the external treatment method is the same as that of the actual disease, and at the same time, mulberry firewood baking method can be added [1]. If the disease becomes trapped due to lack of treatment or mistreatment [1]. 8.1.2.1 Headed carbuncle with pattern of yin deficiency and fire effulgence
Headed carbuncle with pattern of yin deficiency and fire effulgence refers to yin deficiency and fire effulgence, characterized by flat swelling, loose roots and feet, and skin Purple color, severe pain, hard-to-translate pus, sparse or bloody pus, fever and irritability all over the body, thirst and excessive drinking, dry stools, short red urine, red tongue, yellow and dry tongue coating, and thready and stringy pulse are common The most common symptom is gangrene syndrome [2]. 8.1.2.1.1 Symptoms
The sore is flat in shape, with loose roots and legs, the sore is purplish in color, has severe pain, the pus is difficult to transform, and the pus is sparse or bloody; high fever throughout the body, irritability, thirst, and constipation Constipation, short red urine; red tongue, yellow coating, thready and rapid pulse. 8.1.2.1.2 Syndrome analysis
Deficiency of yin liquid leads to internal deficiency of fire, causing damp and heat poisonous evils to be felt again. Yin deficiency has no water to control the evils of fire and heat, which makes the poisonous accumulation worse, so the sores are purplish and stagnant in color. The pain is severe; the poison is dispersed, so the sores are scattered on the feet and the sores are flat; the vaginal fluid is insufficient to suppurate, so the pus is sparse; the heat poisons the human body, resulting in high fever, constipation, red urine; red tongue, yellow coating, A thin and rapid pulse is a sign of yin deficiency and burning fire. 8.1.2.1.3 Treatment method
Nourishing yin and promoting fluid production, clearing away heat and detoxifying.
Prescriptions
Addition and subtraction of Bamboo Leaf and Astragalus Decoction. 8.1.2.2 Qi deficiency and toxin stagnation
Headed carbuncle with pattern of qi deficiency and toxin stagnation refers to qi deficiency and toxin stagnation, characterized by flat swelling, loose roots and feet, and skin The color is gray and dull, the wood is swollen and painful, the rotten flesh does not melt, the pus is sparse, and it is easy to form a cavity, the whole body is afraid of cold and high fever or the body is not hot, frequent urination, thirsty and prefers hot drinks, listlessness, pale complexion, and tongue Light red, white or yellowish tongue coating, and weak pulse are common symptoms of gangrene [2]. 8.1.2.2.1 Symptoms
The swelling is flat, the roots and legs are loose, suppuration is slow, the skin is red and dull, the pus is sparse, the slough is difficult to remove, the sores are empty shells, and they are swollen and painful; accompanied by Aversion to cold, high fever, lethargy, pale complexion, thirsty and fond of drinking, frequent urination; pale red tongue, white and greasy coating, and weak pulse. 8.1.2.2.2 Syndrome analysis
Qi and blood are weak. Qi deficiency is unable to support toxins, and the toxins are retained, so the sores are flat and collapsed; blood deficiency cannot suppurate, so the rotten flesh is difficult to get rid of; heat and poison are retained and cannot be resolved. , so there is still fear of cold, fever, thirst and preference for drinking; deficiency of qi and blood, lack of nourishment of the body, resulting in listlessness and dull complexion; pale red tongue, white coating, and weak pulse are signs of qi deficiency. 8.1.2.2.3 Treatment method
Strengthen the body and relieve the poison. 8.1.2.2.4 Prescription treatment
Tori Disinfection Powder addition and subtraction. 8.2 External treatment method
At the beginning, use Jinhuang ointment plus Qianchu ointment for external application. During the abscess period, use golden ointment mixed with Baerdan for external application; if the pus is thin or gray-green, mix it with Qisandan instead; if the slough is blocked and the pus accumulation is difficult to come out and fluctuates, use "ten" according to the shape and size of the sore. The principle of surgery is to make a wide incision, remove necrotic tissue, and provide adequate drainage. During the wound healing period, use Baiyu ointment mixed with Shengji powder for external application; if the sore and slough cannot be bonded for a while, you can use the cotton pad method. If this is ineffective, surgical debridement should be used. 8.3 Treatment of complications
People with diabetes should choose effective Western medicine to control blood sugar based on blood sugar and urine sugar conditions. 9 Daily health care for patients with head gangrene
1. If there are boils on the neck or back, avoid squeezing. Patients with diabetes should pay special attention to personal hygiene.
2. When you have high fever, stay in bed and drink plenty of water.
3. After suffering from gangrene, avoid squeezing or bruising. Those on the head can be wrapped with four headbands; those on the upper limbs should be suspended with a triangle scarf; those on the lower limbs should elevate the affected limb to reduce activity.
4. Avoid eating fishy, ??spicy or sweet foods. 10 About trapping
Trapping is also called internal trap[3]. It means internal attack of sores and evil poisons [3]. Volume 1 of "Experiences of the Department of Ulcers": "...there are three changes in the situation, namely fire trap, dry trap, and deficiency trap. In fire traps, the qi cannot lead the blood to rot outside and turn into pus, and the fire poison will sink into the camp, gradually leading to confusion. Spasms and convulsions; dry depression, the pus and rot are not penetrated, the camp and guard have been injured, the root disk is purple and stagnant, the top of the head is dry, and the consciousness gradually becomes unhappy, with the appearance of internal closure and external detachment; in the case of deficiency and depression, although the pus and rot are detached, New flesh does not grow, the appearance is like a mirror surface, the skin is white and shiny, the temper is no longer there, the evil grain is reduced day by day, the body and mind are weakened, abdominal pain and diarrhea gradually occur, cold and heat are like signs of cowardice, all of which are incurable symptoms.
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