Chinese medicine treatment plan of a breast moth
I. Alias Western medicine: tonsillitis.
II. Western medicine disease classification code: pharyngeal diseases
Three, Chinese medicine disease classification code: Chinese medicine disease evidence
IV. Definition of disease name: tonsillitis is the inflammation of the palatine tonsils. It is a common disease of the pharynx. According to its pathological nature, it is generally divided into two categories: acute and chronic. See the specific disease introduction for details.
Five, Chinese medicine interpretation of the name: this disease is fever, sore throat, laryngeal nucleus red, swollen and swollen, shaped like a nipple or silkworm moth, or the surface has yellow-white pus, or laryngeal nucleus hypertrophy, hard, dark red, etc. as the main manifestation of the throat disease. Milk moth is mainly divided into acute milk moth, slow milk moth and stone moth.
Sixth, Chinese medicine etiology and pathogenesis: the rapid onset of the disease is mostly due to the wind-heat evil attacking outside, fire-heat evil poison fighting junction of the throat. If the disease is prolonged and weak, the internal organs are out of balance, and the evil poison stagnates in the nucleus of the throat for a long time, the disease is likely to be prolonged and recurrent.
7. Diagnostic points
1. Medical history There is often a history of cold, fatigue, exogenous disease or recurrent episodes of sore throat.
2. Clinical symptoms
Acute onset, severe sore throat, difficulty in swallowing, pain even in the ears. The whole body may be accompanied by chill, high fever, headache, poor appetite, weakness and general discomfort. Children may have high fever, convulsions, vomiting, and lethargy. If the disease is prolonged, the throat may be dry and itchy, choking and unfavorable, or sore throat and fever may recur.
3.Examination
VIII. Differential diagnosis
It can be distinguished from laryngeal paralysis, diphtheria, tonsillar tumor and other diseases.
Type and treatment
External treatment
Acupuncture and moxibustion therapy
XII. Other therapies
XIII. Western medicine treatment
The principle of anti-inflammatory treatment in the acute stage, penicillin is preferred. Chronic prolonged cases, conservative treatment is ineffective to consider the surgical removal of tonsils.
XIV. Criteria for evaluation of efficacy
Complications It can develop into focal tonsillitis and complicate heart disease, heart paralysis, skin water, triple paralysis and some other systemic diseases.
Chinese medicine treatment plan of nasal abscess
I. Alias Western medicine: Acute and chronic purulent sinusitis.
Western medicine disease classification code Rhinology disease
Chinese medicine disease classification code Chinese medicine disease evidence
Definition of Western medicine: purulent inflammation of the mucous membrane of the sinuses.
The disease is a nasal disease with the main manifestation of nasal runny nose, nasal congestion, loss of smell, dizziness and stuffiness, and pus in the nasal passage.
Western medicine etiology
7. Chinese medicine etiology and pathogenesis Most of the causes are “cold”. Nasal Abyss refers to the invasion of external evil, or the internal organs contain heat, steam burning nasal orifices, or due to the internal organs deficiency, the evil left in the sinuses.
The majority of patients are children.
9. Diagnostic criteria of traditional Chinese medicine
Traditional Chinese medicine diagnosis
1, wind-heat offensive nasal evidence: nasal congestion, a lot of snot, white or yellow mucous snot, reduced sense of smell, or head and facial pain, redness and swelling of the nasal mucosa, swelling of the middle turbinate, mucopurulent discharge from the middle nasal passage or olfactory fissure, local pressure pain or percussion pain, fever and chills, headache, cough, dry mouth, red tongue tip, thin yellow coating, floating pulse.
2, bile meridian heat evidence: yellow and turbid snot, with a foul odor, nasal congestion, headache, nasal mucosa red and swollen, especially in the middle turbinate, nasal cavity yellow and green pus, from the middle nasal tract or olfactory fissure, the affected sinus local pressure pain is obvious, fever, bitter mouth and dry throat, dizziness, red tongue, yellow moss, pulse string or slippery.
3.Dampness and heat steaming nasal evidence: yellow and cloudy snot, often flowing, nasal congestion, olfactory insensitivity, redness and swelling of nasal mucous membrane, a large amount of purulent or mucopurulent secretions from the middle nasal passage or olfactory fissure, dizziness and heavy swelling, body tiredness and discomfort, poor appetite and abdominal distension, red tongue, yellow or yellowish greasy coating, pulse count.
4.Qi deficiency of nasal orifice: often runny or mucousy mucus, lingering or recurrent episodes, poor nasal ventilation, poor sense of smell, dark red nasal mucosa, swollen turbinates, especially edema of middle turbinate, or polyp-like changes, dizziness, fatigue, forgetfulness, spontaneous sweating, coughing and sputum, withered or white face, light tongue, thin white fur, moist and weak pulse.
X. Diagnostic criteria in Western medicine
XI. Diagnostic basis in Western medicine
Onset of disease
Medical history
Symptoms
Signs
1.There are two types: acute and chronic. In acute cases, the disease is usually in a single sinus, while in chronic cases, it is mostly in several sinuses or all sinuses at the same time.
2. In acute cases, the onset is rapid and the duration of the disease is short. Acute onset of fever, headache, general discomfort and local pain in the affected sinuses, nasal congestion, runny nose, and impaired sense of smell.
3.Chronic cases are mainly characterized by long-term runny nose or recurrent attacks, often with nasal congestion. There may be dizziness, headache, insomnia, forgetfulness, etc.
Physical examination
In acute cases, the examination shows that the nasal mucosa is congested and swollen, and there is a large amount of purulent secretion in the nasal passage where the affected sinus opening is located, and local pressure pain in the affected sinus is obvious. In chronic cases: examination reveals dark redness and swelling of the nasal mucosa, edema of the middle turbinate, and pus in the middle tract and/or olfactory fissure.
Electrodiagnosis
Diagnostic imaging X-rays and CT scans may assist in the diagnosis.
Laboratory diagnosis 1. Postural drainage method can help to determine from which sinus the pus comes. 2. maxillary sinus aspiration is helpful to confirm the diagnosis of maxillary sinusitis
Blood Blood leukocytes may be elevated during acute attacks.
XII. Western medicine differential diagnosis
Thirteen, Chinese medicine class evidence to identify
1, sinus sputum package: localized painless expansion of the affected sinus can be seen, sinus x-ray or CT scan can confirm the diagnosis.
2.Sinus benign and malignant tumor: when there is a suspicion of diagnosis, early sinus x-ray or CT scan can help early diagnosis.
3.Nasal asphyxia: with long-term nasal congestion as the main symptom, enlarged turbinates, sometimes with a small amount of mucus or pus cloudy mucus.
XIV. Evaluation criteria for efficacy
XV. Prognosis and complications It can develop into serious intracranial complications.
XVI. Western medical treatment
Chinese medicine treatment
1. Wind-heat offending the nose: relieving symptoms and clearing heat, draining the wind and clearing the nose. Yin Qiao San combined with Cang Er Zi San plus or minus.
2, bile meridian heat evidence: clear the bile to benefit the nose. Gentian diarrhea of liver soup with addition and subtraction.
3. Damp-heat vaporizing the nose: clearing heat, resolving dampness and clearing the nose. De-humidification Tang with Cang Er Zi San, plus or minus.
4, deficiency of Qi in the nasal orifice: benefit the Qi to warm the nose. Tonic Zhong Yi Qi Tang with Cang Er Zi San, plus or minus.
XVIII. External treatment
XIX. Acupuncture and moxibustion treatment
Combination of Chinese and Western medicine treatment
1, the acute stage with broad-spectrum antibiotics, preferably in large doses, a long course of treatment. Dentinogenic with metronidazole or tinidazole.
2, nasal local medication: 1% ephedrine nasal drops, and with the application of antibacterial anti-inflammatory nasal drops. Or alternate nasal drops with compound gooseberry liquid and 50% fishy grass liquid. The nasal drops should be taken in a supine dropping or lateral head position to facilitate the drug to reach the opening of the sinuses. In chronic patients, it is not advisable to apply nasal mucosal constrictors continuously for a long time. Or blowing the nose with fish stone.
3, acute or subacute phase can be combined with physical therapy.
4.For chronic maxillary sinusitis or acute maxillary sinusitis with controlled symptoms of infection, maxillary sinus puncture and irrigation is feasible.
5.Negative pressure replacement therapy is suitable for patients with chronic inflammation of multiple sinuses at the same time.
6, often take rhinitis tablets with tonics, or take huo bile pill.
7.Acupoint injection therapy: take Yingxiang and Hegu, 1 point/time, and inject with compound vitamin B injection 0.2~0.5m acupoint, once every other day.
8.Surgical treatment: If the conservative treatment is ineffective, surgical treatment should be performed according to the condition if necessary.
Chinese medicine treatment plan for tinnitus and deafness
Treatment plan for tonic deafness
Tyrannical deafness is a sudden and obvious hearing loss, called tyrannical deafness, also known as stroke deafness, wind deafness, fire deafness and syncope deafness. This disease is a rapid onset of sensorineural deafness, or accompanied by tinnitus and vertigo, which is equivalent to sudden deafness in modern medicine, and is one of the common and frequent diseases in otorhinolaryngology.
I. Diagnosis
The diagnosis of TCM is based on the Diagnostic and Efficacy Criteria of TCM Otolaryngology (ZY/T001.6-94) and the diagnosis of the National Eleventh Five-Year Plan for the Treatment of Deafness; the diagnosis of Western medicine is based on the Diagnostic and Efficacy Criteria of Otolaryngology of the Chinese Medical Association. The diagnosis was made according to the “Guidelines for the diagnosis and treatment of sudden deafness” formulated by the Chinese Medical Association of Otolaryngology, Head and Neck Surgery Branch in 2005.
1.Diagnosis based on.
(1) Sudden onset of hearing loss, which can occur within minutes, hours or 3 days.
(2) Non-fluctuating sensorineural hearing loss, which can be mild, moderate or severe, or even total deafness. Hearing loss of at least 20 dBHL or more in at least two connected frequencies. Mostly unilateral, occasionally bilateral occurring simultaneously or sequentially.
(3) The etiology is unknown (no clear cause including systemic or local factors is found).
(4) It may be accompanied by tinnitus and a feeling of ear blockage.
(5) It may be accompanied by vertigo, nausea and vomiting, but not recurrent.
(6) No other symptoms of cranial nerve damage except for the eighth cranial nerve.
2.Typing
(1) Windy external offense certificate
Symptoms: Sudden onset of deafness with nasal congestion and runny nose, headache, ear swelling and stuffiness, or cold, fever and body pain. Examination:The eardrum mostly has no obvious changes, or there is mild flushing, and the hearing examination shows unilateral or bilateral sensorineural deafness. The tongue is red, with thin white coating and floating pulse.
(2) Blood stasis in the ears and orifices evidence
Symptoms:Deafness occurs suddenly and develops rapidly, often accompanied by a feeling of ear swelling and stuffiness or ear pain, tinnitus without rest, or vertigo. Examination:The eardrum mostly has no obvious changes, or there is mild flushing. Hearing examination shows unilateral or bilateral sensorineural deafness. The tongue is dark red and the pulse is astringent.
Chinese medicine treatment plan
1.Wind Evil
(1) Treatment: Decongest the lung and relieve the symptoms, disperse the evil and open the orifices.
(2) Recommended formula: Xuanlung Tongkou Tang
Ephedra, almonds, antiphlogistic, Chuanxiong, Stibucus, Chai Hu, Lutong, Acorus calamus, Cang Er Zi, Xiang Shen, Licorice. 1 dose daily, divided into two doses, and add or subtract according to the changing condition.
In case of wind-heat, remove Chuanxiong rhizome and add Jinyinhua, Lianxiao, Cicada, and Peppermint (later) to remove wind and clear heat.
In case of wind-cold, add Thornbush and Osmanthus to dispel wind-cold.
For nasal congestion and runny nose, add Xin Yi and Bai Zhi to ventilate the nasal passages; for cough with phlegm, add Chen Pi, Fa Xian Xia and Bei Mu to resolve phlegm and stop cough; for stuffiness in the ear, add White Mustard Seed and Lycopodium to resolve phlegm and ventilate the passages; for dry throat, sore throat and yellow phlegm, add Scutellaria and Chrysanthemum to clear heat and ventilate the passages.
(3) Traditional Chinese medicine: Recommend Ge Genistein injection, Chuanxiongzin injection, etc. for intravenous infusion.
(4) With acupuncture treatment :
Acupuncture is used to treat deafness with acupuncture, moxibustion or thermal moxibustion.
The acupuncture points are mainly localized with the whole body identification points; the main localized acupuncture points are the four acupuncture points of hearing palace, hearing meeting, cataract, and ear gate, and one to two acupuncture points can be used in rotation.
Body acupuncture: Ear Gate, Hearing Palace, Hearing Society, and Cataract for 20 minutes each time, once a day.
Ventral acupuncture:Main acupuncture points: inducing qi to return to the yuan (Zhonggui, hypochondrium, Qihai, Guangyuan), Shangqu, Yindu, and Qi points; 30 minutes each time, once a day.
Moxibustion or heat-sensitive moxibustion: to the extent of moxibustion sensation penetration, 20 minutes each time, once a day.
Identify the points:Drain the wind and relieve the surface – Hegu, Waiguan, Fengchi, Quchi.
(5) Massage therapy
①Eardrum massage
Place your fingers (or index finger) at the mouth of the external ear canal and press gently, 15-30 times on each side, 3 times a day.
②Excluding tinnitus
Sit flat and stretch one leg, bend one leg, stretch both arms horizontally, straighten both palms and push them forward like a door. Twist the head item left and right 7 times each.
(③) Yingzhi Chengguo method.
This method can not only treat tinnitus, but also serve as a preventive health care.
(6) Other treatments
According to the patient’s condition, Chinese herbal foot massage is recommended.
Chinese herbal medicine foot massage program: Chinese herbal medicine decoction (main drug composition: ginger, cow’s knee, angelica, etc.) is used for foot massage to achieve the effect of draining the wind and tranquilizing the mind, and the time is best chosen one hour before the patient goes to bed, once a day for 30 minutes. Heat the decoction of Chinese medicine (1000ml) to 70°C, pour it into the basin, and instruct the patient to put his feet on the edge of the foot basin to smoke, paying attention to prevent burns. When the temperature of the liquid is around 38-42℃, instruct the patient to put both feet into the basin, scrub both feet back and forth, and keep massaging the Yongquan points on the soles of both feet until you feel the acupuncture points are sore and swollen, for 30 minutes each time; then wipe the liquid dry.
2, blood stasis ear orifice evidence
(1) Treatment: Activate blood stasis and clear orifices.
(2) Recommended formula:Tonifying the orifice and invigorating the blood, plus or minus.
Chuanxiong, angelica, red peony, peach kernel, safflower, Chaihu, salvia, lutong, calamus, astragalus, green peel. 1 dose daily, divided into two doses, and add or subtract according to the changing condition.
In case of Qi deficiency, the symptoms include tiredness and weakness, poor appetite, abdominal distension after eating, loose stools, withered face and pale red lips, remove green peel, lutong and red peony, add Radix et Rhizoma Ginseng, Atractylodes Macrocephala, Poria, Radix et Rhizoma Gastrodiae, Fructus Schisandrae, Muxiang and Sharen (later) to strengthen the spleen, benefit Qi and raise Yang.
For those with deficiency of qi and blood, pale face, dizziness and palpitations, shortness of breath, add Radix et Rhizoma Ginseng, Atractylodes Macrocephala, Poria, Radix Polygonati, Radix et Rhizoma Polygonati, etc. to nourish blood and benefit qi.
For those with kidney deficiency, symptoms include insomnia, dizziness, weakness of the waist and knees, nocturnal urination, dry mouth and throat, add Radix Rehmanniae Praeparata, Radix et Rhizoma Polygonati, Fructus Lycii, Fructus Tortoise, Fructus Schisandrae, Radix et Rhizoma Polygonati, etc. to nourish the kidneys and fill in the marrow.
For those with qi stagnation, the symptoms include stuffiness and blockage in the ears or pain, add Radix Aromaticus and Radix et Rhizoma Polygonati to regulate qi and move it to relieve pain.
For those with liver fire, see dry mouth and bitterness, headache and dizziness, add gentian herb, scutellaria, and Xia Ku Cao to clear liver fire; for those with dizziness and tinnitus and high blood pressure, add oyster (first decoction), magnetite (first decoction), and tianshui (first decoction).
(decoction) and tianma to calm the liver and subdue yang.
For those with heart fire, add Huanglian, Temperate Bamboo Leaf and White Fructus to clear heart fire.
For those with phlegm-dampness, dizziness and heaviness, chest stuffiness and fullness, cough with phlegm, bitterness in the mouth, knotted stool and yellow urine, remove green peel and add Chen Pi, Fuxianxia, Fu Ling, Zhu Ru and Gua Gua Ren to dissolve phlegm and open the channels.
(3) Chinese patent medicine: you can choose Chinese medicine injection with the effect of activating blood circulation and removing blood stasis. Recommended: Danshen injection, Jinadu injection, Gegenin injection, Chuanxiongzin injection, Dengjianxiaoxin injection, Veilonin injection, Panax ginseng total saponin injection (blood plugging or thrombosis), etc. Intravenous drip.
(4) With acupuncture treatment:
Acupuncture is used to treat deafness with body acupuncture, ventral acupuncture, and thermosensitive moxibustion.
The acupuncture points for deafness treatment are mainly localized and combined with systemic identification points: the main localized acupuncture points are the four acupuncture points of hearing palace, hearing meeting, cataract and ear gate, and one or two points can be used in rotation.
Body acupuncture: Ear Gate, Hearing Palace, Hearing Society, and Cataract for 20 minutes each time, once a day.
Ventral acupuncture:Main acupuncture points: inducing qi to return to yuan (zhonggui, hypogastrium, qihai, guangyuan), shangqu, yindu, qi points; 30 minutes each time, once a day.
Heat-sensitive moxibustion: to the extent that the moxibustion sensation penetrates, 20 minutes each time, once a day.
Identify the points:
Clearing liver and fire – Tai Chong, Tai Xi;
Clearing phlegm and dampness–Fenglong and Dao;
Activating blood circulation and eliminating blood stasis – Diaphragm Yu, Blood Sea.
(5) Massage therapy
①Eardrum massage
Place your fingers (or index finger) at the mouth of the external ear canal and press gently, 15-30 times on each side, 3 times a day.
②Tiangu
Adjust your breathing, press the palms of both hands against both ears, press the index finger, middle finger, ring finger and pinky finger of both hands symmetrically across the occipital area on both sides, with the two middle fingers touching each other, then fold the two index fingers up on top of the middle finger, then slide the index finger down hard from the middle finger and strike the occipital area at the back of the head with a heavy blow. First 24 times with the left hand, then 24 times with the right hand, and finally 48 times with both hands. This method also has the effect of unblocking the meridians and running qi and blood.
③Eliminate tinnitus
Sit flat and stretch one leg, flex one leg, stretch both arms horizontally, straighten both palms and push them forward like a door. Twist the head item left and right 7 times each.
④Yingzhi Chengguo method.
This method can not only treat tinnitus, but also be used as a preventive health care.
(6) Other treatments
According to the patient’s symptoms, Chinese herbal foot massage is recommended.
Chinese medicine foot massage program: Chinese medicine decoction (the main drug composition: cow knee p angelica p magnetic stone, etc.) is used for foot massage to achieve the effect of activating blood circulation and tranquilizing the mind, and the time is best chosen one hour before the patient goes to bed. Heat the decoction of Chinese medicine (1000ml) to 70°C, pour it into the basin, and instruct the patient to put his feet on the edge of the foot basin to smoke, paying attention to prevent burns. When the temperature of the liquid is around 38-42℃, instruct the patient to put both feet into the basin, scrub both feet back and forth, and keep massaging the Yongquan points on the bottom of both feet until they feel sore and swollen, for 30 minutes each time; then wipe the liquid dry.
Third, Chinese medicine evidence-based care
1.Wind evil outside the evidence
Emphasis on life care, patients are advised to live carefully, avoid cold wind blowing directly, appropriate increase and decrease clothing, timely drying after sweating, to prevent the recurrence of external evil. Diet is recommended to disperse the wind, such as mint porridge, gong ying porridge, sorrel porridge, ginger soup, etc. Chinese herbal soup should be taken warmly, and after taking it, increase the clothes and blankets appropriately to help the slight sweating. At the same time, we should treat cold symptoms as early as possible. If there is nasal congestion, we can give nasal drops to promote the nasal orifice and open the ear orifice; and instruct the patient to blow the nose in the correct way to prevent the snot from entering the middle ear cavity retrogradely through the eustachian tube, which may cause infection and aggravate the disease.
2. Blood stasis in the ears and orifices
Instruct the patient to massage and stimulate the ear acupuncture points to unblock the meridians and run the qi and blood. Diet can be used as a medicinal meal with Salvia miltiorrhiza, Chuanxiong and Tianqi, such as chicken with Tianqi in a pot or taking Dan Shen and Tianqi ground into powder. At the same time, attention should be paid to emotional care, explaining to the patient the effect of poor mood on the disease, avoiding depression, anxiety and other adverse emotional stimulation to prevent the blood from running.
IV. Criteria for evaluating the efficacy
According to the diagnostic criteria of Western medicine for sudden deafness (refer to the guidelines for diagnosis and treatment of sudden deafness formulated by the Editorial Committee of Chinese Journal of Otolaryngology, Head and Neck Surgery, Chinese Medical Association, Branch of Otolaryngology, Head and Neck Surgery, 2005) and the diagnostic criteria of Chinese medicine evidence (refer to the Diagnostic Efficacy Criteria of Chinese Medicine Evidence formulated by the State Administration of Traditional Chinese Medicine, June 1994 (ZY/T001.6 -94)).
1.Cured: The damaged frequency hearing threshold returns to normal, or reaches the level of healthy ear, or reaches the level before this disease.
2.Significant effect: the average hearing of the damaged frequency is improved by more than 30 dB HL.
3.Effective: The average hearing of the damaged frequency is improved by 15-30 dB HL.
4.Ineffective: the average hearing of the damaged frequency improves by less than 15 dB HL.
Diagnostic efficacy criteria for otorhinolaryngology in Chinese medicine Industry standard for Chinese medicine in the People’s Republic of China <
15.1 Diagnosis basis
15.1.1 The main symptoms are sore throat and difficulty in swallowing. Acute milk moths have fever, while slow milk moths do not have fever or have low fever.
15.1.2 Acute mastitis has an acute onset and a short duration; repeated attacks are transformed into slow mastitis, which has a longer duration.
15.1.3 Pharyngeal examination 15.1.3.l Acute mastitis: the tonsils are congested with bright red or crimson, enlarged, with pus spots on the surface, and in severe cases with small abscesses.
15.1.3.2 Slow mammary moth: swollen, dark red tonsils with congestion, or no congestion, pus spots on the surface, or a little pus overflow after squeezing.
15.1.4 The total blood leukocyte count and neutrophils are elevated in patients with acute mastitis and some slow mastitis.
15.1.5 It should be distinguished from scarlet fever and canker sore.
15.2 Classification of symptoms
15.2.1 Wind-heat invasion: Acute lactating moth with initial sore throat and mild difficulty in swallowing. With fever, chills, cough, sputum, etc. The pharyngeal mucosa and tonsils are congested and have not become pus. The tongue is thinly coated with white fur and the pulse is floating.
15.2.2 Stomach fire: Sore throat with difficulty in swallowing. Body heat, thirst, constipation. The pharynx and tonsils are congested and red, with pus spots or small abscesses on them. Red tongue, yellow coating, slippery pulse.
15.2.3 Lung and kidney yin deficiency: dryness and burning in the pharynx with slight pain and discomfort. Dry cough with little sputum, heat in the hands and feet, mental fatigue, or low fever in the afternoon, with red cheekbones. Tonsils are dark red, swollen, or with a little pus attached to the surface. The tongue is red, the coating is thin, and the pulse is fine.
15.2.4 Weakness of the spleen qi: discomfort in the throat, slight itching or dryness, or foreign body sensation, white phlegm, little color, low voice, fatigue, little food, loose stools. Tonsils are enlarged, lightly congested or not, with a little pus when squeezed. The tongue is light and fat, the coating is white and moist, and the pulse is thin and weak.
15.3 Assessment of curative effect
15.3.1 Cured: pharyngeal symptoms disappear, tonsils are not congested, no pus spots, or are removed.
15.3.2 Improved: pharyngeal symptoms are reduced and tonsillar pus spots are eliminated.
15.3.3 Not healed: No significant improvement in symptoms and signs.
11 Diagnostic basis, classification of symptoms and assessment of efficacy of nasal abscess is a nasal disease characterized by a large amount of nasal runny nose due to the accumulation of dampness and heat in the sinuses and the formation of phlegm and turbidity. It mainly refers to acute and chronic sinusitis.
11.1 Diagnosis basis
11.1.1 The main symptoms are large amount of mucous or purulent nasal discharge, nasal congestion, headache or dizziness. Acute rhinorrhea with fever and general malaise.
11.1.2 The onset of acute rhinorrhea is rapid and the duration of the disease is short. If the treatment is not complete, it will be extended to chronic rhinorrhea with a longer course.
11.1.3 The mucous membrane of the nasal cavity is congested and swollen, and there are more mucous or purulent secretions in the nasal cavity or posterior nostril.
11.1.4 Positive x-ray sinus radiographs. The total blood leukocyte count and neutrophils are elevated in acute attacks.
11.1.5 It should be differentiated from nasal asphyxia.
11.2 Classification of symptoms
11.2.l Wind-heat of lung meridian: Mostly seen at the early stage of the disease, or acute attack of chronic nasal abscess due to external sensation. Nasal congestion, white or yellowish snot, headache, cough and sputum. The nasal mucosa is congested and the turbinates are enlarged. Thin white tongue coating and floating pulse.
11.2.2 Depressed heat in the bile meridian: Mostly seen in acute nasal abscess, or acute attack of chronic nasal abscess. Nasal congestion and headache are more severe, and the snot is yellow and cloudy. Body heat, thirst, dry stools. The nasal mucosa is obviously congested and swollen, with more purulent secretions visible in the nasal cavity. The tongue is red, the coating is yellow and greasy, and the pulse is stringent.
11.2.3 Damp-heat of the spleen and stomach: mostly seen in the late stage of acute nasal abscess. Nasal congestion with lingering runny nose. With dizziness, loss of appetite and loose stools. The nasal mucosa is congested and swollen, with more yellowish secretions in the nasal cavity. The tongue is yellow and greasy, and the pulse is moist.
11.2.4 Lung-Qi deficiency: Mostly seen in chronic rhinorrhea. Nasal congestion, dizziness, memory loss, turbid nasal discharge, sometimes more and sometimes less. The face is atrophic or white, with little energy and weakness, and loose stools. The nasal mucosa is not congested, but swollen with mucous or purulent secretions. The tongue is pale, the coating is white, and the pulse is weak.
11.3 Assessment of curative effect
11.3.1 Cured: symptoms disappear, no abnormality on X-ray sinus film.
11.3.2 Improvement: symptoms improve significantly, nasal examination shows congestion, mucous membrane swelling and other manifestations are reduced. x-ray sinus film has significantly improved.
11.3.3 Unresolved: No improvement of symptoms and signs.
4 Diagnostic basis, classification of symptoms and assessment of efficacy of tyrannical deafness Tyrannical deafness is a sensorineural deafness with rapid onset due to evil offending the ear orifices, mainly referring to idiopathic tyrannical deafness (sudden deafness).
4.1 Basis of diagnosis
4.1.1 Sudden hearing loss, with peak hearing loss within 1 to 2 days, mostly in one ear. Or with tinnitus and vertigo.
4.1.2 There are often triggers such as irritation, exertion and cold.
4.1.3 Ear examination: There are mostly no obvious changes in the tympanic membrane, or the tympanic membrane is cloudy.
4.1.4 Hearing examination shows sensorineural deafness.
4.1.5 It should be differentiated from vertigo and ear swelling.
4.2 Classification of symptoms
4.2.I Sudden onset of deafness with nasal congestion, runny nose, or headache, ear swelling and stuffiness, or vicious cold, fever, body pain. Thin white tongue coating and floating pulse.
4.2.2 Inflammation of liver fire: sudden onset of deafness after depression or irritation, with bitter and dry mouth, constipation and yellow urine, red face and red eyes. Red tongue, yellow fur, and stringy pulse.
4.2.3 Hyperactivity of liver yang: sudden onset of deafness after anger, with dizziness, headache, bitterness of the mouth, irritability. The tongue is thinly coated with white fur and the pulse is stringent.
4.2.4 Qi stagnation and blood stasis: Deafness with a feeling of distended and stuffy ears, tinnitus, or deafness due to powerful sound shock. The tongue is dark red and the pulse is astringent.
4.2.5 Qi and Blood deficiency: sudden onset of deafness due to weakness, dullness of the face; or deafness with headache and dullness of the ear eliminated after a few days, but dullness of the face, dizziness, weakness of speech, and tiredness of the limbs still exist, with pale tongue and thin coating.
4.3 Evaluation of curative effect
4.3.1 Cured: hearing returned to normal.
4.3.2 Improving: Hearing is improved by more than 10 decibels, and the discomfort in the ear is reduced.
4.3.3 Not cured: hearing improves by less than 10 decibels.
5 Diagnostic basis, classification of symptoms, and assessment of efficacy of prolonged deafness is sensorineural deafness caused by deficiency of internal organs, loss of nourishment of the ear orifices, or stagnation of Qi and blood in the meridians, and characterized by long-term hearing loss. It includes drug-induced deafness, senile deafness, etc.
5.1 Diagnostic basis
5.1.1 The main symptom is hearing loss that lasts for a long time, or is accompanied by tinnitus and mild vertigo.
5.1.2 The onset of deafness is slow, and the degree of deafness gradually increases. Some patients become chronically deaf after a long period of time without recovery.
5.1.3 The disease is often caused by the use of ototoxic drugs, old age, and malnutrition.
5.1.4 Ear examination: tympanic membrane is less lustrous, or there are signs of invagination, thickening, adhesions, calcium deposits, etc.
5.1.5 Hearing examination shows sensorineural deafness.
5.1.6 It should be differentiated from ear swelling and ear closure and auditory neuroma.
5.2 Classification of symptoms
5.2.1 Kidney essence deficiency: Deafness for a long time, tinnitus like cicada sound, dizziness, soreness and weakness of the waist and knees. Red tongue with little coating and fine pulse.
5.2.2 Qi and Blood deficiency: Deafness and tinnitus, sometimes light and sometimes heavy, aggravated by exertion, dull complexion, loss of appetite. Thin white tongue coating and weak pulse.
5.2.3 Phlegm and fire stagnation: Deafness, heavy head and dizziness, stuffiness in the ears, and fullness in the abdomen. Tongue coating is yellow and greasy, and the pulse is slippery.
5.2.4 Qi stagnation and blood stasis: Deafness either heavy or light, or with tinnitus, thickened tympanic membrane, or with adhesions and calcium deposition. The tongue is purple and dark, and the pulse is astringent.
5.3 Evaluation of curative effect
5.3.1 Cured: hearing returns to normal.
5.3.2 Improved: hearing improved by more than 10 decibels.
5.3.3 Not cured: no significant improvement of hearing.