Infantile eczema is a common allergic disease. The rash is often first seen on the cheeks and extends to other parts of the face, neck, ears, extremities, anus and trunk. The earliest clinical manifestations are redness and edema, followed by rash, blistering, oozing, crusting and flaking. Eczema is a type of allergic dermatitis, also known as allergic disease, the pathogenesis of which has genetic factors, allergenic stimulation and the most critical immune function of the perversion, abnormal. The treatment is not particularly effective in general hospitals and in books and journals for the eradication of the disease. Most of the children seen in our department come to us because of the ineffective treatment in other hospitals, and the radical treatment by improving immune function in our department is particularly effective.
I. Clinical data
In this paper, a total of 40 cases of eczema in infants and children under 3 years of age were counted. Among them, 52.5% were males and 47.5% were females. 14% of the total eczema patients under 3 years of age from 70 days to 72 years of age had eczema during the same period. 2.
2. age Minimum age 70 days, <1 year 30%, 1 year 25%, 2 years 27.5%, 3 years 17.5%.
3. duration of disease Minimum duration of disease 1 week, <1 year 48.6%, 1 year 25.7%, 2 years 20%, 3 years 5.7%.
4. age of onset <1 month 51%, 1-6 months 17%, 7 months-1 year 23%, 2 years 3%, 3 years 6%.
Allergen screening is generally not done in children under 7 years of age. In this paper, only one 3-year-old child was examined by intradermal injection, and the results were + + + + for summer and autumn pollen, and + + + for all three groups of mycobacteria; another 3-year-old child had mites + + by dot prick method.
Comorbidities In this paper, 30% of children with eczema had combined cervical lymphatic tuberculosis, 23% were susceptible to colds, 15% had bronchial asthma, 5% had allergic dermatitis, and 3% had angioedema, allergic rhinitis, and chronic tonsillitis.
Family history of allergy: 69% positive, including 44% eczema. 8.
Treatment and efficacy Our department uses treatment to improve the immune function, and the effect is sure and can be cured. Infants who are breastfed are mostly treated by their mothers through breast milk, but younger infants have difficulty receiving much treatment. The younger the baby, the easier it is to cure. Generally, only a few treatments are given and the effect is very satisfactory, usually within 1 week to 1 month, and the immune function remains normal, that is, the cure. Unlike older patients, who require more and longer treatment to improve immune function. We generally give levamisole, ching qi fuzheng punch, card slow Shu, Chinese herbal allergy decoction (Wu Wei Zi, Fang Feng, Chai Hu, Cicada, licorice, Astragalus, white moss bark, jujube), bronchitis vaccine, placental lipopolysaccharide, no tuberculosis infection dead card scratch and other options, with temporary effective non-hormonal anti-allergy drugs. Those with cervical lymphatic tuberculosis add anti-tuberculosis treatment. Do not use hormones to reduce immune function.
9. typical case Liu Yifei, male, 2 years old, mother with childhood asthma, living in Xi’an Jiaotong University. He was a Chinese American who developed eczema 2 months after birth in the United States, and his eczema developed all over his body including his face and hands. She was brought back to China by her maternal grandmother and was not cured. She had a red rash all over her body with small blisters and scabs. He was referred to our department for investigation of combined cervical lymphatic tuberculosis, and was given isoniazid, vitamin B6, vitamin C, levamisole, kartramycin, ching qi fu zheng punch and intradermal injection of bronchitis vaccine. The patient’s condition was greatly improved after one week of follow-up, and was cured after one month of follow-up.
II. Discussion
1. The pathogenesis of eczema in infants and children and immunotherapy
Eczema, like other allergic diseases, is a metaplastic disease. Metamorphosis means that the immune function is perverted and abnormal. The pathogenesis, although there is a family history of allergy genetic factors and allergenic stimulus factors, but the key is whether the immune function is normal. The disease only develops when the immune function is abnormal, but not if the immune function is normal. Therefore, if the immune function is normalized, the disease will not occur, and if it is maintained, the disease will not occur, which is the root cause. The Chinese and Western medicines to improve the immune function, intradermal injection of bronchitis vaccine, inactivated BCG vaccine scratch, etc. have the effect of non-specific improvement of immune function. Hormones reduce immune function, and topical application will pigmentation and fall down brown spots that cannot be removed again, and there is a tendency of abuse at present.
2. Comorbid cervical lymphatic tuberculosis
There are various viruses and bacteria, including tuberculosis bacteria, in the air and in the respiratory tracts of men, women and children. When immune function is good, immune cells and factors can destroy them, but people with low immune function are invaded and multiplied by viruses and bacteria such as tuberculosis, so they are often combined with cervical lymphatic tuberculosis, easy to catch a cold, tonsillitis, etc. Various allergic diseases also strike when the immune function is low. Tuberculosis, viral and bacterial infections and allergic diseases further reduce the immune function, forming a vicious circle of mutual cause and effect. Because cervical lymphatic tuberculosis is insidious, chest X-ray is negative, tuberculin test is mostly negative when immunocompromised, blood sedimentation is normal in more than half of the cases, symptoms such as night sweats, poor appetite, cough, fatigue, thinness, sometimes epistaxis, anemia, dry stools, or thin, or alternating dry and thin, abdominal pain is often incomplete, and the diagnosis is often missed without careful examination of string lymph nodes in the neck or light pressure pain in the right lower abdomen in combined mesenteric lymphatic tuberculosis. This is a frequent and common comorbidity that often goes unnoticed by the majority of physicians. Tuberculosis infection further reduces immune function, so anti-tuberculosis treatment must be added for significant efficacy.
3. Immune function modulation by Chinese medicine
According to the research on Chinese medicine conducted by Shanghai Medical University, “Wei Qi” is similar to the role of leukocytes, phagocytes and reticuloendothelial cells in modern medicine. The “kidney” in Chinese medicine has been experimentally proven to be largely related to the pituitary-adrenocortical system, which is the key to maintaining the stability of the body’s immune function. Kidney tonics are closely related to T cells and B cells. Immunological theories and methods to explore the mechanism of action of herbal medicines are reported as follows: immune enhancers such as Wu Wei Zi, Astragalus, He Shou Wu, Radix et Rhizoma Polygonatum, Fructus Lycii, etc. have the effect of supporting the essence, benefiting the qi and tonifying the kidneys, and can enhance the immunity of the body. The crude extract of licorice increases adrenocortical function and cAMP concentration in gastric mucosa, promotes phagocytosis and digestive function of monocytes, induces interferon, and promotes lymphoblastoid transformation in cellular immunity. Ligustrum sativum has a significant increase in the phagocytosis rate of macrophages in the immune system and an increase in the formation rate of serum rose nodes, which has a significant effect on enhancing the immune function of the body. Ziziphus jujubae is a blood tonic, causing a significant increase in cAMP content in peripheral plasma and leukocytes, an increase in cAMP/ cGMP ratio, and the highest vitamin C and vitamin E content among all fruits. Radix Polygoni Multiflori promotes the transformation of human lymphoblastoid cells. Silver fungus improves the immune function of T and B lymphocytes. 4.
4. Important future of immunotherapy
The current Chinese authority on allergic reactions, Prof. Ye Shitai, suggests in the chapter of “Practical allergic reactions” that the allergist community is considering non-specific means of prevention and treatment to change the allergic constitution of patients in recent years. For example, in our ancestral medicine, the treatment of bronchial asthma and experimental anaphylaxis with “allergy decoction” has achieved good results in allergic diseases. In Western medicine, various non-specific immunotherapy such as histamine desensitization and histamine globulin injection have been used in recent years, and will open up a new path in the prevention and treatment of allergic reactions in the future.
Some scholars predict that in the 21st century, drugs regulating immune function will become an important class of drugs and replace other drugs. Chinese medicine is an important treasure for immunotherapy. The experience of this paper also confirms the above arguments.