Pediatric ointment formula is mainly for chronic diseases in remission and physical adjustment, and the combination of medicine “tonic in treatment, treatment in tonic”. In the process of development and regression of pediatric diseases, it also has the aspect of clear qi, vigor and quick response. After the disease is treated and adjusted reasonably, the disease will improve and recover quickly, and there will be few sequelae, and the disease will be treated as it is drawn.
Physiology and common disease characteristics of pediatric diseases
The respiratory, digestive, cardiovascular and urinary systems of children are not yet fully developed, and their anatomical structure, physiology, pathology, nutrition and metabolism, immunity and biochemistry are different from those of adults from birth to adulthood.
Due to the lack of maturity of pediatric development, the response to different causes is often very different from that of adults, and different pathological changes can occur. The onset of the disease in children is rapid, aggressive and fast-changing, but if the diagnosis and treatment are timely and appropriate, the recovery can be fast. In addition, the repair ability of pediatric organs and tissues is stronger, and the sequelae are generally less than those of adults.
Chinese medicine theory believes that children’s internal organs are delicate and not yet full of vital energy, among which the lungs, spleen and kidneys are the most prominent. The lung is the main organ of the body and the outer skin and hair, so if the lung is weak, the external function of the guard is not solid, therefore, the children have the most external diseases; the spleen is the origin of the later life, the main division of transportation and nutrition, the children have a large demand for nutrients, but the spleen and stomach function is not yet robust, so the spleen and stomach are easily damaged; the kidney is the origin of the first life, the main bone and marrow, when the children are born, the kidney is not yet healthy, so they are prone to growth and development disorders. The ancient medical practitioners summarized this delicate state of children as “infantile yin and yang”, therefore, the regulation of the cream formula is also mainly aimed at these three aspects.
Another important physiological characteristic of children is their vigorous and rapid development. This vigorous state of vitality is summarized as “pure yang”. Therefore, the formula should avoid damaging the “pure yang” body, avoiding big cold and big heat, avoiding precocious maturity and affecting development.
The pathology of children is characterized by easy onset, rapid transmission, the shape of Qi is not full, the internal organs are not firm, the couples are loose, the surface guard is not solid, cold and warmth can not be self-regulated, milk and food do not know how to regulate themselves, once the regulation is not appropriate, it is easy to be invaded by the six sexes externally, easy to be injured by food internally, the most common evidence of external evil and the two organs of the lung and spleen, and rapid changes after the disease, “easy to deficiency, easy to real, easy to cold, easy to heat “.
Characteristics and purpose of paediatric poultices
Because of its function of “nourishing the dry and weak of the five organs and six bowels” and “containing the meaning of saving the bias but not the disease” (Qin Bo Wei’s words), it is a common choice to regulate children’s physique.
The paste formula is sweet in taste and reduces the pungent and bitter smell of Chinese medicine, which makes it easy to be accepted by children, increases compliance with treatment, and facilitates long-term use. It is viscous in nature and can be diluted by water. After being swallowed orally, it hangs on the throat, stomach wall and intestinal wall and is slowly transmitted and absorbed by the digestive tract, which has the effect of calming the mucosal reaction and slow absorption. Pediatric poultices are commonly used to be rich in animal gums, pectin, sugar, starch-based drugs or medicinal food products, rich in nutrients and calories, which can be consumed in autumn and winter to replenish nutrients and strengthen the role of cold. Although poultices can benefit the lungs, spleen and kidneys, targeting states or constitutions such as recurrent respiratory infections, digestive disorders or developmental delays, it is advisable to choose dosage forms such as soup and powder for acute illnesses and acute attacks of chronic diseases.
Tonic for deficiency is based on plain tonic, not warm tonic, to avoid causing precocious sexual maturity, cautiously use ginseng, deer antler, cistanches, bacopa monniera, mealybug, bone marrow, etc. or drugs that disrupt sex hormones.
To dispel the evil on the basis of regulating the spleen and lung, so that the lift is moderate, the phlegm is clear and the qi is smooth, and the symptoms are smooth, avoiding big grams and big cuts that hurt the qi and damage other organs. The combination of both tonics and treatment.
Characteristics and contraindications of paediatric ointment formula composition
Although paediatric poultices are good, they are not suitable for everyone. As the old saying goes, “Do not use medicine if you are not sick, do not use medicine indiscriminately if you are sick, and do not use tonic indiscriminately if you are not sick”. It is often used for children with recurrent respiratory infections, weakness of the spleen and stomach, developmental delays, myocarditis sequelae and other diseases during the recovery and remission period. If children are healthy, they don’t need to take poultices for indiscriminate tonic, especially for obese children, precocious children and other children are not suitable to use poultice treatment.
Case analysis
He complained of recurrent episodes of asthmatic bronchitis after suffering from laryngitis two years ago, with coughing, coughing in the throat, sticky sputum that is difficult to cough up, easy spontaneous sweating and night sweats, normal mood and diet, slightly restless sleep, slightly dry stools, urine acceptable. Dry mouth and lips. The tongue is light red with thin, dry coating, and the pulse is slender. TCM diagnosis considers deficiency of both lung and spleen.
Ointment Recipe: Radix Astragali 150 g, Radix Astragali 300 g, Radix Astragali 60 g, Radix Lycopodium 60 g, Radix Ephedra 30 g, Radix Platycodon grandis 90 g, Radix Almond 90 g, Poria 90 g, Rhizoma Atractylodis 90 g, Radix Yam 300 g, Radix Arctium lappa 60 g, Radix Salviae Miltiorrhizae 60 g, Pericarpium Citri Reticulatae 30 g, Radix Ziziphiopogonis 120 g, Radix Platycodonis 120 g, Radix Pumice 200 g, Radix Bark 60 g, Radix Gastrodiae 60 g, Radix Bupleurum 90 g, Chuanbei (powdered) 30 g, Cordyceps (powdered) 10 g, jujube 100 g, Aconite 100 g, honey 100 g, caramel 200 g. The above paste was taken for 4 months, and the child’s symptoms improved.
Case analysis Asthma remission period to lung, spleen, kidney three organs deficiency mainly, can have lung spleen qi deficiency, spleen and kidney yang deficiency, lung and kidney yin deficiency and other evidence. We should start from the deficiency of the lung, spleen and kidney, and at the same time regulate the qi and clear the phlegm and draw out the evil. For the benefit of the lung, Yu Ping Feng San is used; for strengthening the spleen, Fu Ling, Atractylodes Macrocephala, Chen Pi, Yam, etc.; for tonifying the kidney, Cordyceps sinensis is used; for clearing phlegm, Su Zi, Lycopodium and Chuan Bei; for inducing evil, roasted ephedra, almonds, orris, hooked vine and burdock; for nourishing Yin and moistening dryness, Di Bone Peel and Nan Sha Shen are used to calm night sweats and coughing and wheezing with lung heat. The three ointment medicines used for making ointment can regulate the lung, spleen and kidney: Colla Corii Asini is sweet and flat, enters the lung, heart, liver and kidney meridians, can ascend and descend, can tonify the blood, cool the blood, stop bleeding, nourish the yin and moisten the lung, regulate the qi and clear the phlegm without nourishing the evil, often used in the remission period of chronic lung diseases; syrup has the effect of moistening the lung and relieving cough; honey can “harmonize the Ying and Wei, moisten the organs, open the three jiao, and regulate the spleen and stomach Honey can “harmonize the Ying and Wei, moisten the internal organs, open the three jiao, and regulate the spleen and stomach. The combination of all the medicines can tonify the three organs, replenish the qi and blood, and support the right qi, so that the lung health is solid, the spleen qi is healthy, and the kidney qi is satisfied, so that “the right qi exists inside, and evil cannot dry up.
Anorexic child female, 11 years old, with vague pain in the stomach and epigastric region, likes warmth and rubbing, no acid reflux and belching, lean and tired, not hungry, sleepless, grinding teeth, easily irritable, good at crying, sometimes chest tightness, nasal congestion, spontaneous sweating, stool one line a day, urine can be. The tongue is light red, the fur is thin and white, and the pulse is stringent and smooth. The Chinese medicine diagnosis considers deficiency of Qi in the spleen and stomach and derangement of elevation.
The recipe gives Huangqi Jianzhong Tang combined with liver relaxation and tranquilizing products, 150 g of roasted astragalus, 100 g of Radix Codonopsis, 100 g of cinnamon stick, 200 g of white peony, 60 g of roasted licorice, 100 g of jujube, 300 g of syrup, 150 g of poria, 60 g of peel, 120 g of sage, 100 g of foxglove, 90 g of rose, 200 g of sour date, 200 g of cypress seed, 200 g of atractylodes, 90 g of bamboo leaf, 90 g of chrysanthemum. The above paste was refined and taken for more than 3 months, with weight gain and abdominal pain reduced.
Case analysis Anorexia is one of the common pediatric spleen and stomach disease, excluding systemic and organic diseases of the digestive tract, to appetite for a long time, the amount of food significantly reduced, and even refused to eat as the clinical manifestations of chronic appetite disorders. The main cause of the disease is the failure of the spleen and stomach to transport and transform into noma, but if it is not cured for a long time, it will cause the Qi and blood to be biochemically weak and susceptible to external evils. This formula is based on the principle of “the body of the child”. This formula combines the methods of strengthening the spleen, transporting the spleen, harmonizing the stomach, draining the liver, nourishing yin, drying dampness, and benefiting the kidneys, with Huangqi Jianzhong Tang as the main formula. Emphasis on warming the spleen and stomach to treat Qi deficiency and coldness, abdominal pain, warmth and comfort, and spontaneous sweating. The medicine is used to nourish the spleen and avoid the spleen-transporting drugs from being too pungent and dry. Here we also want to emphasize the syrup, which is a medicinal food product that can be used to regulate ointment. It has the effect of slowing down the middle, relieving pain, nourishing deficiency and moistening dryness, and all Jianzhong Tang formulas use syrup dissolved in the soup. Syrup is mainly maltose, which is easily digested and absorbed and directly converted into glycogen, thus nourishing the liver and skeletal muscles, and is an important herbal remedy for nutritional deficiencies due to weakness of the spleen and stomach.
A female child with developmental delay, 8 years old, 110 cm in height, with easy sore throat, easy fatigue, low abdominal distension, little speech, cold hands and feet, much sleep, dry stools at times and loose stools at others, urine is fine. The tongue is light red, with little coating and a sunken pulse. He was treated with levothyroxine 100 μg/d.
The Chinese medicine considered the deficiency of liver, spleen and kidney, and gave Six Flavored Dihuang Drink with Sijunzi Tang and Erxian Tang as the main ingredients, as follows: Dang Ginseng 100 g, Poria 300 g, Fried Atractylodes 300 g, Yam 300 g, Raw Licorice 60 g, Raw Dihuang 300 g, Zelig 120 g, Cornu Cervi Pantotrichum 150 g, Dampi 90 g, Radix Platycodon 120 g, Forsythia 90 g, Gui Zhi 60 g, Xianmao 90 g, Xianling Spleen 90 g. The above paste was taken continuously for 3 months and then the levothyroxine tablets were reduced to 50 μg/d.
Case analysis Hypothyroidism in children is classified as gall tumor and five delay in Chinese medicine. The main pathogenesis of this disease is a deficiency of Yang in the spleen and kidney, and a deficiency of blood in the heart and liver, which should be treated by warming the kidney and helping Yang, benefiting Qi and nourishing Blood. The use of Chinese herbal medicine can improve clinical symptoms, delay the progression of chronic complications, and reduce the dosage of thyroxine replacement therapy. The child is not congenitally hypothyroid, but has had delayed growth for the past two years, not excluding nutritional and immune factors, and her parents were instructed to take her for further systematic examination. TCM considers that cold, exertion, emotional discomfort, and improper care after external sensation may damage kidney yang, involving the heart, liver, and spleen, and produce pathological products such as heat, blood stasis, phlegm, and water-dampness on the basis of yang deficiency. The combination of Erxian Tang with blood and flesh of deer horn gum warms and tonifies kidney yang; Si Jun Zi with Liu Wei Di Huang benefits qi, strengthens the spleen, and pacifies the liver and kidneys; Radix et Rhizoma oryzaeum and forsythiae benefit qi and draw out the heat. The combination of the herbs harmonizes yin and yang.