Proprietary Chinese medicines occupy an important position in the treatment of common and multiple diseases in pediatric patients, and pediatricians have been accustomed to using them as an essential treatment tool and are popular among parents. However, there are some problems in the rational application of proprietary Chinese medicines by western pediatricians, which affect the clinical efficacy of proprietary Chinese medicines. The author reviewed the literature in recent years and analyzed the problems in this area with his own clinical experience, in order to promote the rational application of proprietary Chinese medicines in pediatrics. The current problems a. Physicians do not use medicine in accordance with TCM theory. Identification of the use of drugs is the key to the effectiveness of Chinese medicine, do not identify the difference between cold, heat, deficiency, real, often wind-cold colds wrongly used pungent cold drugs, adding insult to injury. Example 1, at the beginning of the cold, there is a sore throat, but there is no nasal congestion, runny nose and other symptoms, the prescription “Qingkailing granules”, “silver forsythia antidote particles”. There was no runny nose, but after taking the medicine, the nose was runny and sneezing frequently. Example 2: A physician prescribed penicillin, ribavirin and febrifuge for a child with a cold (stuffy nose and runny nose, low fever and mild cough), and took Jinzhen Oral Liquid orally. The following day, the clinic saw a significant improvement with hemp and ginger granules. Example 3: A child with a summer damp cold at the beginning, the blood routine was normal, the doctor considered a viral infection, with anti-viral oral solution should be effective. As a result, the child not only did not improve that night but also became more and more coughing and irritable. This is related to the overuse of cold medicine, that is, parents were instructed to stop feeding the Chinese medicine, and quickly cured with Huoxiang Zhengqi oral liquid instead. The physician did not carefully read and understand the indications and precautions in the drug instructions. Qingkailing granules [Functions] Clearing heat and detoxifying, sedative and tranquilizing. Used for fever, irritability, sore throat due to external wind-heat; and upper respiratory tract infection, viral cold, acute pharyngitis with the above symptoms. Precautions】Not suitable for people with wind-cold cold, which is characterized by heavy vicious cold, light fever, no sweating, headache, nasal congestion, clear runny nose, itchy throat and cough. Patients with hypertension and heart disease should take it with caution. Patients with weak spleen and stomach and those who have been ill for a long time should take it with caution if they have diarrhea. Third, some proprietary Chinese medicine instructions are often more ambiguous and vague. Example 1, pediatric cold and flu Ning syrup [generic name] [ingredients] Jingchuosu, forsythia, dahurica, orris, honeysuckle, etc.. Characteristic】 This product is a dark brown clarified liquid; taste sweet, slightly bitter. Functions】For children with fever, sweating, nasal congestion and runny nose, cough and sore throat. Example 2, pediatric hemp and Gan granules [ingredients] ephedra, scutellaria, perilla, licorice, mulberry bark, bitter almond, ground bark, gypsum. Excipients are sucrose, dextrin. Properties】The product is light yellow or brown granules; taste sweet, slightly bitter. Functions】Calming asthma and cough, pharyngeal expectorant. Used for pediatric pneumonia and cough, pharyngeal inflammation. Not marked contraindications and precautions. Fourth, the side effects of proprietary Chinese medicines are not well understood. 7 cases of intussusception due to Qizhen Dan were reported, the sexual taste is salty, bitter, cold and cool. Most of them have the function of clearing heat and fire, detoxifying and laxative. Can promote intestinal peristalsis, such as excessive dosage or sensitive body, intestinal peristalsis is too strong, can lead to intestinal overlap. Shock after taking the six pills is caused by overdose. A 42-day-old baby boy was in deep sleep and respiratory arrest after taking a packet of babyin within 1h, and was rescued from danger. This is due to the fact that the drug contains the Chinese medicine Chuanbei, which contains beriberi alkaloids that can cause central respiratory depression and respiratory failure at high doses. Fifth, look at the text and blindly use drugs. For example, a child with fever for 2 days, body temperature 37,5~38,7 ℃, no cough, nasal congestion, runny nose, given cold and fever granules, body temperature rose to 39,6 ℃, and the appearance of bulbar conjunctival congestion, oral mucosal ulcers, check the blood picture is elevated. He was cured by giving Yin Qiao detoxification granules and antibiotics. Cold and fever clearing granules】Dispersing wind and cold, relieving surface heat. It is used for cold and flu, headache and fever, cold and body pain, runny nose and dry cough and throat. Contraindications: Not applicable to wind-heat colds. It is not advisable to take tonic Chinese medicine at the same time as the medicine. Identification of pediatric colds Wind-cold colds: characterized by light fever, heavy cold fear, clear runny nose, sneezing, coughing and no sweating. Thin white tongue coating. Wind-heat cold: characterized by heavy fever, light fear of cold, slight sweating, dry red throat and nasal congestion. Tongue coating is thin yellow. Summer dampness cold: Mostly occurs in summer, when the summer dampness evil, but also because of the like of cold and drinking cold, so that the body of summer dampness for wind and cold to contain, drainage is blocked, and therefore the onset. Characterized by fever, body tiredness without sweating, dizziness, head swelling, thirst for drinks, nausea and vomiting, diarrhea, short and yellow urine. The tongue is yellow and greasy. Summer fever cold (heatstroke): The important feature is the prominent heat phenomenon, which is one of the heavier types of cold symptoms in the four seasons. The evil of summer heat, heat vaporizes the muscular surface, and at the same time depletes fluid, resulting in fever, slight dislike of wind and cold, sweating but the fever does not subside, heart trouble, and thirst. Yellow tongue coating. Rational application of traditional Chinese medicine for pediatric cold and flu Wind-cold cold and flu: Wind-cold cold and flu granules Cold and flu clearing granules Hong Kong Loxin pediatric cold and flu: Pediatric Baotai Kang granules Qingkai Ling granules Pediatric pharyngeal flat granules Pediatric Jindan tablets Anti-viral oral liquid Yin Qiao detoxification granules Heat poisoning injection Heat-damp cold and flu: Traditional Chinese medicine should be used to clear the heat and relieve the symptoms and strengthen the stomach and resolve stagnation. The symptoms of summer-heat cold (heatstroke): Summer-heat cold punch, Qingliang anti-heat punch, Yinhuang oral liquid Simple identification of cough in children: Wind-cold cough (wind-cold attacking the lungs): itchy throat, heavy cough, shortness of breath, thin and white sputum, often accompanied by nasal congestion, runny nose, headache, aching limbs, chills and fever, no sweating and other superficial symptoms. The tongue coating is thin and white. Wind-heat cough (wind-heat offending the lung): coarse and high-pitched cough, dry throat and sore throat, unpleasant sputum, sticky or yellow sputum, sweating while coughing, often accompanied by yellow thick mucus, thirst, headache, bad wind, fever and other superficial symptoms. The tongue is red with a thin yellow coating. Phlegm-heat cough (phlegm-heat stagnant lung): cough with shortness of breath, or phlegm sound in the throat, phlegm is sticky, thick and yellow, unpleasant coughing and vomiting, or blood in the phlegm, chest fullness, accompanied by chest pain, red face, or fever, dry and sticky mouth, and desire to drink. The tongue is red and the tongue coating is yellow and greasy. Yin deficiency dry cough: dry cough, short cough, little sputum and sticky quality, red cheekbones in the afternoon, low fever and night sweating, dry mouth and throat. The tongue is red with little moss. Chinese patent medicines for pediatric coughs Wind-cold cough: Mackerel Cough Syrup, Jiao Xing Ning Cough Pills, Cough Pills, Tong Xuan Li Lung Pills, Almond Cough Syrup, Pediatric Ma Gan Granules, Wind-heat cough: Acute Syrup, Pediatric Lung Cough Granules, Sang Ju Cold and Flu Tablets, Pediatric Phlegm Relief Cough Punch, Chinese patent medicines for pediatric coughs, Phlegm-heat cough: Snake Gall and Chuan Bei Liquid, Compound Expectorant Spirit, Lung Power Cough Compound, Pediatric Jin Zhen Oral Liquid, Phlegm Heat Clear Injection, Yin-deficiency dry cough: Honey Refined Chuan Bei Pei Pa Koa Paste Orange Red Pear Paste Nourishing Yin and Clearing Lung Oral Liquid Lung Qi deficiency long-term dry cough: Ginseng and Atractylodes Granules Tonic Zhong Yi Qi Granules Pediatric diarrhea classification Food stagnation and internal injury diarrhea Cold and damp diarrhea Damp heat diarrhea Spleen deficiency diarrhea Spleen and kidney Yang deficiency diarrhea Pediatric diarrhea classification and selection of Chinese patent medicines Note the interaction between Chinese and Western medicines Chinese patent medicines containing ephedrine such as “Ma Gan Granules, Coughing and Coughing, Pediatric Hot Cough Oral Liquid “Combining with aminophylline can increase palpitations, insomnia, headache and other adverse reactions. Combined with cardiac glycosides, because ephedrine can excite beta receptors, strengthen myocardial contraction and increase the effect of cardiac glycosides. Ginseng also has similar cardiac glycoside effect on the heart, therefore, Chinese patent medicines containing ginseng should not be combined with Sidran, digoxin, etc. The combination of Niuhuang detoxification tablets and amoxicillin can produce cold symptoms such as chills and runny nose, but not achieve the purpose of treatment. The safety incident of V.C. silver warp tablets: V.C. silver warp tablets is a compound preparation of Chinese and Western medicines made of 13 medicines, which contains three chemical components: vitamin C, chlorpheniramine maleate (also known as paracetamol) and acetaminophen (also known as paracetamol). The harm is as follows: 1. Influenced by the old concept that Chinese medicine has no toxic side effects, many people ignore the adverse reactions of the western medicine components contained. 2. 2, easy to cause repeated use of drugs, so that the amount of western medicine contained in the composition of more than the safe dose, for example, after the normal consumption of vc silver warp tablets, and then take antipyretic and analgesic western medicine, it is easy to take poisoning phenomenon. The company’s main business is to provide a wide range of products and services to its customers. In foreign countries, such as Singapore, it is illegal to adulterate pCms with western drugs, and once convicted, the fine is 5,000 yuan and imprisonment can be up to two years. I don’t know why, but in China, it is allowed to adulterate western medicine with proprietary Chinese medicines, and it is reasonable and legal. The goal of correct and rational use of drugs The result of applying western drugs while applying pCms irrationally by western pediatricians may be: 1+1<2, or 1+1<1, or even 1+1<0 The result of applying western drugs while applying pCms rationally may be: 1+1=2, or even 1+1>2