The Chinese Association of Traditional Chinese Medicine released a TCM prevention and treatment plan for respiratory tract infections in children

Recently, there has been a high incidence of respiratory diseases, and children may be co-infected with multiple viruses. For example, influenza virus combined with adenovirus, respiratory syncytial virus, etc., leads to cough, fever, runny nose and other symptoms.

Respiratory tract infections in children fall under the category of "cold", "cough" and "pneumonia and wheezing" in traditional Chinese medicine. In order to further standardize the prevention and treatment of respiratory tract infections in children in mainland China, give full play to the advantages of traditional Chinese medicine in prevention, treatment and rehabilitation, and combine the clinical characteristics of the current round of respiratory tract infections in children, the Pediatric Branch of the China Association of Traditional Chinese Medicine organized experts to study and draft and issued the "National Traditional Chinese Medicine Prevention and Treatment Program for Respiratory Tract Infections in Children".

The "Plan" points out that the causes are divided into two categories: external causes and internal causes, the external causes are responsible for wind, cold and heat, etc., and the internal causes are responsible for the deficiency of the lungs and spleen qi and the lack of solidity of the external body. The disease is mainly located in the lungs. In terms of governing the law, the initial and extreme periods are mainly used to dispel evil spirits, and the recovery period is mainly to uphold righteousness. It is proved that the methods of spicy and warm sweating, pungent and cool to relieve the surface, clear heat and promote the lungs, dissolve phlegm and relieve cough, clear the intestines and relieve heat, and nourish qi and nourish yin.

In addition to traditional Chinese medicine, Chinese patent medicine and traditional Chinese medicine characteristic therapy, the program also gives guidance on home rehabilitation, for children who are discharged from the hospital or outpatient drug treatment and still occasionally have nasal congestion and runny nose, dry throat and itchy throat, intermittent light cough, loss of appetite and irregular stool, some traditional Chinese medicine methods are used for home rehabilitation treatment, which also helps to consolidate the curative effect and prevent recovery after illness.

National Traditional Chinese Medicine Prevention and Treatment Program for Respiratory Tract Infections in Children

Respiratory tract infections in children fall under the category of "cold", "cough" and "pneumonia and wheezing" in traditional Chinese medicine. In order to further standardize the prevention and treatment of respiratory tract infections in children in mainland China, give full play to the advantages of traditional Chinese medicine in prevention, treatment and rehabilitation, and combine the clinical characteristics of the incidence of respiratory tract infections in children in this round, this plan is formulated for clinical reference.

Part I Prevention Programmes

1. General prevention

Avoid the cold and keep warm, add clothes in a timely manner, avoid sweating when the wind blows, eat reasonably, should be light, avoid greasy, ensure adequate nutrition, regular work and rest, appropriate activities, reduce gatherings, and open windows frequently for ventilation.

2. Dietary therapy and prevention

According to the different constitutions of children, under the guidance of doctors, traditional Chinese medicine with the same origin of medicine and food can be used to assist in prevention.

For children who are prone to food accumulation, have bad breath, abdominal distention, sour or constipated stools, or have food residues, they can eat hawthorn, malt, tangerine peel, sulforaphane and other food stagnation to dispel and induce food stagnation;

For phlegm and dampness children who are fat, do not like to move, sweat a lot and sticky, and have stools that are not easy to form, you can eat tangerine peel, poria cocos, raw coix seeds, red adzuki beans, etc. to dissolve phlegm and dampness;

For children with qi deficiency who are usually prone to colds, yellowish complexion, and loose sweating and stools, they can eat astragalus, codonopsis, yams, jujubes and other spleen and qi supplements;

For children with yin deficiency who are thin, irritable, hot hands and feet, and have dry night sweats and stools, they can eat American ginseng, jade bamboo, dendrobium, lily, etc. to nourish yin and nourish yin.

Note: The preventive time of dietary therapy is recommended to be 3~5 days.

3. Prevention with traditional Chinese medicine characteristic therapies

(1) Pediatric massage

Adaptation to physical fitness: qi deficiency, phlegm dampness, food stagnation.

Recommended acupuncture points: abdomen, foot sanli, spine, etc.

Efficacy: Reconciles viscera, spleen and stomach.

Operation method: rub the abdomen 100~300 times, knead the foot 30~50 times, and pinch the spine 5~7 times. Dry stool plus clear lung meridian and large intestine meridian, belly and abdomen full plus kneading the plate door, sweat more plus spleen meridian.

(2) Traditional Chinese medicine foot bath

Adaptation to physique: qi deficiency, phlegm and dampness.

Recommended medicines: Astragalus, Atractylodes atractylodes, Atractylodes atractylodes, Parsnip, Angelica dahurica, calamus, Huoxiang, cinnamon branches, tangerine peel, etc.

Efficacy: Replenish qi and solidify the surface, aromatize and dissolve dampness.

Operation method: add an appropriate amount of water and soak for 30 minutes, decoction, boil for 10 minutes on high heat, turn to medium and low heat for 30 minutes, take 2000 ml of soup, place it in a special foot bath, add cold water to adjust the temperature to 37 °C ~ 40 °C, the child takes a sitting position, soaks the feet in the liquid medicine, the liquid medicine is soaked in the ankles as the degree, each time the foot baths for 15~30 minutes, 1 time a day, with the head and body slightly sweating as the degree. Drugs with different efficacy can be selected for prevention according to different regions.

According to the actual situation, under the guidance of the doctor, traditional Chinese medicine characteristic therapies such as acupoint application, incense therapy, and auricular pressure beans can also be used to regulate the physique, and prevent diseases before they occur.

Part II Treatment Options

1. Etiology and pathogenesis

The etiology is divided into two categories: external causes are responsible for wind, cold and heat, etc., and internal causes are responsible for lung and spleen qi deficiency and external instability. The disease is mainly located in the lungs. The main pathogenesis is the invasion of external evils and the loss of lung sanism. If the lungs are combined with the fur and the evil qi is attacked, it will become the evidence of the evil criminal's lungs. When the external evil enters the inside, it becomes a wind-heat (cold) depression lung syndrome or an external cold and internal heat syndrome. Phlegm and heat are intertwined, heat and blood stasis, heat and poison accumulation, phlegm heat (poison) closed lung syndrome or phlegm stasis closed lung pattern. The course of the disease is prolonged, and the consumption of qi hurts yin, and the evidence of late stage of fever such as yin deficiency and lung fever, lung and spleen qi deficiency can be seen.

2. Governing the law and governing the law

The initial and extreme periods are mainly used to dispel evil spirits, and the recovery period is mainly to correct them. It is proved that the methods of spicy and warm sweating, pungent and cool to relieve the surface, clear heat and promote the lungs, dissolve phlegm and relieve cough, clear the intestines and relieve heat, and nourish qi and nourish yin. Depending on the region and season, it can be treated according to the time and place.

3. Periodization

(1) Initial stage

1. Wind chill beam manifestation

Symptoms: fever or no fever, severe chills, no sweating, nasal congestion, runny nose, head and body pain, pale mouth without thirst, cough and shortness of breath, thin white sputum, not red pharynx, pale red tongue, thin white moss, tight pulse, red fingerprints.

Treatment: Xinwen sweating.

Recommended prescriptions: Pueraria root decoction, ephedra decoction or Jing Fang Septic Powder. Commonly used medicines in kudzu root soup: 12g of kudzu root, 6g of ephedra, 6g of cinnamon branches, 9g of ginger, 6g of fried white peony, 9g of jujube, 6g of boiled licorice.

Addition and subtraction: those with severe cough add Qianhu and Qingbanxia, add tangerine peel and Qingbanxia for those with more phlegm, and add raw gypsum for those with irritability.

If there is shortness of breath and nasal agitation, etc., it can be given Huagaisan.

Commonly used Chinese patent medicines: three tablets, cold and heat clearing granules, etc.

2. External cold and internal heat

Symptoms: high fever, severe chills, no sweating, runny nose, headache, body pain, or sore throat, coughing and wheezing, irritability, thirst, poor appetite, heart pain, vomiting, constipation, red tongue, yellow greasy, pulse tightness or heavy strings, fingerprints floating red or purple stagnation.

Treatment: Solve the surface and clear the inside.

Recommended prescription: Gegen soup and Da Chai Hu Tang or Da Qing Long Tang. Commonly used medicines in Kudzu root decoction and Dachaihu decoction: Pueraria lobata 12g, burnt ephedra 6g, cinnamon branch 6g, ginger 6~15g, boiled licorice 6g, fried white peony 6g, jujube 9g, bupleurum 12g, skullcap 9g, banxia 6g, citrus aurantium 6g, raw rhubarb 3g.

Addition and subtraction: those with loose stools should be given raw rhubarb, and those with heavy stools should be added with raw gypsum.

Commonly used Chinese patent medicines: Xingbei cough granules, Fengfeng Tongsheng pills, etc.

3. Evidence of wind and heat attack

Symptoms: severe fever, mild chills, sweating, sore throat, runny nose, cough, red pharynx, red tongue, thin yellow lichen, pulse floating, fingerprint floating purple.

Treatment: Xin Liang solution table.

Recommended prescription medicine: Yinqiao powder or mulberry chrysanthemum drink. Yinqiao powder commonly used medicine: honeysuckle 9g, forsythia 9g, bamboo leaf 9g, nepeta 6g, light tempeh 6g, reed root 9g, peppermint 6g, bellflower 6g, burdock 9g, licorice 6g.

Addition and subtraction: those with red, swollen and painful throat add stiff silkworm and scutellaria, add gypsum and gardenia for high fever, and add Zhejiang fritillary for coughing up phlegm.

If there is cough and shortness of breath, nasal flaring and other wind-heat closed lung syndrome, Yinqiao Sanhe Ma Xing Shi Gantang can be given.

Commonly used Chinese patent medicines: Reyanning Mixture, Lianhua Qingwen Granules, Pudilan Anti-inflammatory Oral Liquid, Qingxuan Cough Granules, Pediatric Pulmonary Fever Cough and Asthma Granules (Oral Liquid), Pediatric Baotaikang Granules, Qinxiang Qingjie Oral Liquid, etc. For those who are stagnation, give children soy warp heat-clearing granules.

(2) Extreme period

1. Phlegm, heat, and lung syndrome

Symptoms: high fever, cough and shortness of breath, phlegm in the throat, thick and yellow sputum, agitation of the nasal wings, red lips, dry mouth, short and red urine, red tongue, yellow greasy, slippery pulse, purple stagnation of fingerprints.

Treatment: clear away heat and phlegm, diarrhea and cough.

Recommended prescription: Ma Xing Shi Gan Tang and Xiao Trap Chest Soup. Commonly used medicines: 6g of ephedra, 9g of bitter almond, 15~30g of raw gypsum, 10g of whole melon, 3g of Coptis chinensis, 6g of Qingbanxia, 10g of coria seeds, 6g of jujube, 6g of licorice.

Addition and subtraction: those with thirsty mouth add smallpox pollen, those with thick phlegm add Sichuan fritillary, and those with constipation and vomiting add raw rhubarb and bamboo ru.

If there is irritability, strong heat is difficult to retreat, nostrils are dry, and there are no tears, it is a hot poison that contains poison and a closed lung syndrome, which can be combined with Coptis detoxification soup;

Commonly used Chinese patent medicines: Jin Zhen oral liquid, pediatric Xuanlung cough granules, etc.

2. Phlegm stasis and lung closure syndrome

Symptoms: high fever that does not go away, violent coughing, or coughing up blood, nasal flaring, chest high and full, mouth and shoulders raised, or cyanosis of the lips, irritability, chest pain, constipation, vomiting, heart pain, dark red tongue with petechiae and ecchymosis, yellow and thick tongue coating, astringent pulse, and purple stagnation of fingerprints.

Treatment: Clear away heat and stasis, open the lungs and intestines.

Recommended prescriptions: Qianjin Reed Stem Soup, Da Chai Hu Tang and Guizhi Poria Pills. Commonly used medicines: 15g of reed root, 9g of coix seed, 15g of winter melon seed, 9g of peach kernel, 9~15g of bupleurum chinensis, 9g of skullcap, 9g of red and white peony, 6g of Qingbanxia, 6~15g of ginger, 6g of fried citrus aurantium, 9g of jujube, 3g of rhubarb, 9~12g of cinnamon branch, 9g of Poria cocos, 6g of danpi, 6g of licorice.

Addition and subtraction: those with thick phlegm add Fritillary mother, add raw gypsum for those with heavy heat, and add Angong Niuhuang Pill or Pediatric Niuhuang Qingxinsan for those with high fever, faint speech, and convulsions of limbs. If the face is white and the breathing is not good, you can add a single ginseng decoction or Zhibaodan nasal feeding or enema.

Commonly used Chinese patent medicines: Lianhua Qingcough Tablets, Pediatric Lung Reqing Granules, etc.

(3) Recovery period

1. Yin deficiency and lung fever syndrome

Symptoms: low-grade fever, night sweats, dry cough with little or no phlegm, dry mouth and thirst, dry stools, poor appetite, flushed complexion, red tongue, little moss or flower peeling, fine pulses, purple fingerprints.

治法：养阴清热，润肺化痰。

Recommended prescription medicine: Shashen Maidong soup. Commonly used medicines: 9g of Shashen, 9g of Ophiopogon vulgaris, 9g of Polygonatum japonica, 9g of smallpox pollen, 9g of mulberry leaves, 9g of fried white lentils, 6g of boiled licorice.

Addition and subtraction: those with low fever and lingering heat add Artemisia annua and Digupi; those with long-term cough add 100 and burnt aster; add scorched hawthorn and fried malt if they eat less; add floating wheat and roasted oysters for those who sweat more.

Commonly used Chinese patent medicines: Yangyin Qinglung Oral Liquid, etc.

2. Lung and spleen qi deficiency syndrome

Symptoms: long-term cough and weakness, movement is very beneficial, low-grade fever ups and downs, pale complexion, poor appetite, loose stools, fatigue, self-sweating, pale tongue, thin white moss, weak pulse, pale red fingerprints.

Treatment: Nourish the spleen and lungs, dissolve phlegm and relieve cough.

Recommended prescription: ginseng schisandra soup. Commonly used medicines: Codonopsis (Panaxopsis) 6-12g, Fried Atractylodes 9g, Poria 9g, Schisandra Chinensis 6g, Ophiopogon 9g, Citrus Citrus Peel 6g, Ginger Banxia 6g, Aster 9g, Glycyrrhiza Glabra 6g.

Addition and subtraction: Nacha plus magnolia bark and fried malt, sweat plus roasted astragalus and fried oysters, fried yam and fried white lentils in loose stools.

If the lung imaging in the later stage shows that the consolidation area is still large, the syndrome is qi deficiency and blood stasis can be combined with Guizhi Poria pills;

Commonly used Chinese patent medicines: Huanglong cough granules, etc.

Note: It is necessary to pay close attention to the changes in the child's vital signs such as body temperature, pulse, respiration, and blood pressure, and beware of the occurrence of changes such as evil trapping and detachment. The dosage of the above traditional Chinese medicine is the routine dosage of 4~7-year-old children, and can be increased or decreased according to the condition, constitution, region and different age groups. The dosage of proprietary Chinese medicine should refer to the instructions, and those who do not have the dosage for children can use it according to the dosage of adults. Please follow your doctor's advice for special decoction of medicines.

Fourth, the characteristic therapy of traditional Chinese medicine

(1) Acupoint application

1. Cold and cough patches

Indications: Wind chill beam manifestation.

Recommended medicines: ephedra, fried white nuts, fine pungent seeds, schisandra chinensis, fried white mustard seeds, etc., mix well with excipients such as vinegar (ginger vinegar).

Recommended acupuncture points: large vertebrae, double lungs, etc.

Efficacy: Xinwen relieves the surface, promotes the lungs and relieves cough.

2. Heat-clearing cough patch

Indications: Wind-heat depression lung pattern, phlegm-heat pressure lung pattern, heat-toxin closed lung pattern.

Recommended drugs: mulberry bark, digu bark, almonds, gall stars, etc., mix well with excipients such as vinegar.

Recommended acupuncture points: Tiantu, Jizhong, Shuanglung Yu, etc.

Efficacy: Clear away heat and lungs, relieve cough and reduce phlegm.

Operation: Take the medicine and stick it on the corresponding acupuncture points. 6 months to 1 year old, 1~2 hours, 1 to 4 years old, 2~4 hours, 4 years old and above (including 4 years old) 4~6 hours. If there is local redness and itching, stop the application immediately, and treat it locally if necessary.

(2) Pediatric massage

1. Wind chill beam manifestation

Recommended acupuncture points: Tianmen, Kangong, Sun, High Bone on the back of the ear, Inner Bagua, Sanguan, Jizhong, Lung Yu.

Efficacy: Dispel cold and relieve the surface, dissolve phlegm and relieve cough.

Operation method: Push open the gate of heaven, push the Kan Palace, rub the sun, pinch and rub the high bones on the back of the ear, that is, the four major techniques of the head and face, 20~30 times, 50~100 times of gossip in Shunyun, 100~200 times of pushing the three passes, and 30~50 times in the middle of the body and lungs.

2. Phlegm and heat and lung syndrome, heat poison and lung closure syndrome.

Recommended acupuncture points: lung meridian, large intestine meridian, six intestines, Tianhe water, palm small horizontal lines.

Efficacy: Clearing heat and detoxifying, cleansing phlegm opening and closing.

Operation method: 200~300 times of lung meridians, 100~120 times of large intestine meridians and six intestines, 300 times of Qingtian river water, and 50~100 times of small horizontal lines of the palm.

(3) Acupuncture

Indications: Fever, cough and phlegm with a lot of phlegm, such as wind-heat depression lung pattern, phlegm-heat pressure lung pattern, heat poisoning and closed lung pattern.

Recommended acupuncture points: bilateral fish acupoint, Qi Ze acupoint.

Efficacy: Clearing wind and heat, relieving cough and reducing phlegm.

Operation method: Direction and depth of acupuncture in the fish-related acupoint: take a 1-inch milli needle and puncture it in the direction of the palm Laogong acupoint, 0.5 inch acupuncture for children aged 3~6 years old, and 1 inch for children over 6 years old. The direction and depth of acupuncture at the ruler acupoint: straight into the needle, the needle is 0.3~0.5 inches. Needle retention time and laxative techniques: leave the needle for 5~10 minutes, acupuncture once in the middle, moderate twisting and insertion, flat compensation and laxative;

(4) Traditional Chinese medicine foot bath

Indications: Wind-heat depression lung pattern, phlegm-heat depression lung pattern, heat-toxin closed lung pattern.

Recommended drugs: Bupleurum chinensis, Scutellaria baicalensis, Gypsum, Daqing Leaf, Radix Radix, Pueraria Pueraria, Forsythia, Guanzhong, Dandelion, etc.

Efficacy: Clearing away heat and detoxifying, relieving muscle and reducing fever.

How to operate: Same as the operation method of the preventive part of the foot bath.

(5) Cupping

Indications: Fever, cough and phlegm with a lot of phlegm, such as wind-heat depression lung pattern, phlegm-heat pressure lung pattern, heat poisoning and closed lung pattern.

Acupuncture points: large vertebrae, lung Yu, spleen Yu.

Efficacy: Clear away heat and lungs, relieve cough and reduce phlegm.

Operation method: 8~10 minutes each time, once every other day, if the child has poor compliance and is not suitable for using a fire cup, a rubber tank or an air tank can be used.

Note: Traditional Chinese medicine, proprietary Chinese medicine and traditional Chinese medicine characteristic therapies should be used under the guidance of a doctor. According to the actual situation, under the guidance of the doctor, traditional Chinese medicine characteristic therapies such as traditional Chinese medicine collapse, traditional Chinese medicine enema, and scraping therapy can also be used for auxiliary treatment.

Part 3 Home Rehabilitation

For children who are still occasionally suffering from nasal congestion and runny nose, dry throat and itchy throat, intermittent light cough, loss of appetite and irregular stool after discharge or outpatient drug treatment, home rehabilitation treatment can be treated with traditional Chinese medicine, which can help consolidate the curative effect and prevent recovery after illness.

1. Dietary guidance

Eat a balanced diet with a variety of foods. If you have symptoms such as loss of appetite and bloating, ginger, hawthorn, chicken gold, white radish, etc. are recommended; If you have symptoms such as constipation, honey, bananas, dragon fruit, celery, etc. are recommended.

2. Acupressure massage

Children with nasal congestion, runny nose and insensitive sense of smell can rub Yingxiang acupoint and Nasal Tong acupoint after illness, and those with cough and itchy throat can rub Shaoshang and Tiantu acupoints; and those with abdominal pain and bloating and poor food intake can rub their abdomen clockwise and press and knead Banmen acupoints for 1~3 minutes each time.

3. Other methods

You can use the Five Elements Music Therapy, by listening to the music of the five tones and the five internal organs and the five wills, to encourage the qi and blood and tune the emotions. Breathing therapies such as balloon blowing, horn blowing, and abdominal breathing can also be used to enhance lung function. School-age children can learn to do breathing gymnastics, Wufowl play, and Baduanjin once a day for 30 minutes each time.

appendix

National Traditional Chinese Medicine Prevention and Treatment Program for Respiratory Tract Infections in Children

Preparation of validation expert groups

Consultants: Ding Ying, Liu Qingquan, Zhang Zhongde

Group Leader: Ren Xianqing, Yan Yongbin

Members: Ren Xianqing, Yan Yongbin, Sun Xiaoxu, Li Fugen, Yu Suping, Li Huawei

Writers: Yan Yongbin, Sun Xiaoxu

Source: China Traditional Chinese Medicine News