Only by fully understanding the physiological and pathological characteristics different from those of adults, grasping the core pathogenesis and using various means flexibly can the best therapeutic effect be achieved.
1, the qi is not full, and the viscera are delicate: children's viscera are incomplete, all but not strong, and the viscera are weak, easy to be deficient and easy to be solid, and easy to be cold and hot. Spleen deficiency is not affected by cold and temperature, and it is easy to catch cold when it is cold, and it is easy to catch cold when it is heated, so it is difficult to recuperate itself. Causes the skin to be vulnerable to internal pathogens and external pathogens.
2. Spleen deficiency: Children need a lot of subtle substances from Shui Gu, and they flourish. However, due to their spleen deficiency, that is, their digestive system is not perfect, it is difficult to undertake the heavy responsibility of transporting and transforming Shui Gu. If breast-feeding is improper, it is easy to cause accumulation of dampness and phlegm, and then induce skin diseases, and it is difficult to cure because of the accumulation of dampness.
3, the heart is more than enough: the child is pure yang, the yang is like the morning sun, and the hair is strong. Heart and liver are the dirty of wood fire, and only the balance of spleen and soil can run in the whole body. Children with spleen deficiency are unlucky, and the fire of heart and liver is easy to go up and down, which leads to irritability and crying, while fire causes rash and itching.
4. Deficiency of kidney-qi: Children's congenital constitution is significantly affected by parents' physical condition and mother's pregnancy factors, which is called congenital endowment deficiency. Family history of hereditary diseases can affect the onset of skin diseases in children, such as eczema, atopic dermatitis, allergic dermatitis and urticaria.
The ancients called pediatrics dumb because children could not express their physical discomfort, so it was particularly important for doctors to make house calls. Through seeing a doctor, we can master the disease characteristics of children and accurately analyze dialectics.
Such as infantile eczema, rash on forehead, red color, fidgety crying, purple fingerprint stagnation, etc., it can be judged that the child is full of heart and liver caused by indigestion.
Pay attention to protecting the spleen and stomach
Try not to use bitter and cold products such as Radix Gentianae, Radix Arnebiae and Radix Sophorae Flavescentis. When choosing the prescription. First, it is difficult for children to accept bitter and cold products. Second, children often have spleen deficiency, bitter and cold stomach failure, spleen and stomach injuries, damp heat and skin diseases that are difficult to heal.
Therefore, the dosage forms are mostly improved granules, creams and other dosage forms. Try to make the soup as thick as possible, and put a little rock sugar or maltose after cooking, so that children can take the medicine smoothly.
Attach importance to the application of external treatment
For children's dermatosis, the external treatment of traditional Chinese medicine has unique advantages, which directly acts on skin meridians, takes effect quickly and safely, and avoids the pain of oral drugs. External treatments suitable for children's dermatosis include external application of traditional Chinese medicine, massage for children, acupuncture and auricular points, etc.
① External application of traditional Chinese medicine: the method of external application of traditional Chinese medicine decoction and gauze can make the medicine directly contact with the rash, with quick effect and good curative effect, which is a common method for children's dermatosis.
② Massage for children: This is also one of the commonly used methods for children's skin diseases. Its gentle manipulation, combined with children's dirty qi and light spirit, is easy to dredge meridians, with reliable curative effect and high safety, and can also enhance children's affinity and promote their mental health.
Pay attention to the role of emollients.
Because children's skin is weaker than adults, it loses water faster and dries easily, and the skin barrier function is more easily damaged than adults, so it is necessary to fully moisturize.
For children with atopic dermatitis, an important method of basic nursing is to use emollients, which is helpful to improve clinical efficacy and reduce the probability of rash recurrence.
Attach importance to parent education
The occurrence of dermatosis is related to many factors, such as environment, climate, mood, diet and living habits. The avoidance of diet, the choice of clothes and good habits of work and rest will all help children recover as soon as possible. Therefore, health education for parents is particularly important.
Typical medical record
Xu, male, 10 years old, was first diagnosed in September 2020.
Main complaints:
The rash behind the ear and bilateral elbow fossa recurred for 3 years.
Current medical history:
Parents complained that three years ago, the child had a rash behind the ear and bilateral elbow fossa, accompanied by unexplained itching and desquamation, and had a history of allergies. I was diagnosed as "atopic dermatitis" in a hospital in Shenzhen. I took anti-allergic drugs and topical hormone ointment, and my symptoms often occurred. Come to my clinic now.
Direct symptoms:
Physical emaciation, sallow complexion, good spirits, poor appetite, dry stool, yellow urine after two days, red tongue with white fur and thin and smooth pulse.
Expert inspection:
A red rash the size of a coin appeared on the skin behind the ear and elbow fossa, with a small amount of dandruff and exudation, and the whole body skin was dry.
Dialectical:
Damp-heat accumulation, blood deficiency and wind dryness
Treatment:
1, internal treatment of traditional Chinese medicine:
Tonify soil and clear heart, clear away heat and promote diuresis, nourish blood and relieve itching. Four gentlemen are in harmony and scattered.
2. External treatment:
① External application of traditional Chinese medicine: decoct with traditional Chinese medicine for clearing away heat and toxic materials, moistening skin and relieving itching, soak in emery cloth, and stick a rash for about 15 minutes.
② Massage for children: clearing the sky and regulating water, clearing the heart and nourishing the stomach, clearing the heart and cultivating the soil, and improving children's physique.
3, life conditioning:
① Keep the skin moist: reduce the number of baths in autumn and winter, use moisturizer and moisturizer, and apply the whole body and rash more than twice a day to prevent skin dehydration.
2 diet taboo: light diet, avoid spicy and irritating things.
③ Attention to clothing: It is advisable to wear pure cotton fabric to prevent the chemical fiber from irritating the skin.
After about 1 month of follow-up, the rash disappeared and the skin was smooth, and there was no recurrence after two months of follow-up.
doctor
Liu
Deputy director Chinese medicine practitioner
Pediatrics/Dermatology/Chinese Medicine
brief introduction
Deputy chief physician, graduated from College of Traditional Chinese Medicine, Xinjiang Medical University, practicing medicine for 34 years. He is currently a member of Zhongjing Society of Shenzhen Traditional Chinese Medicine Association, a member of Shenzhen Fang Jing Association, a member of Shenzhen Pediatric Massage Professional Committee and a tutor of Chinese medicine. He has published dozens of papers in national and provincial journals of traditional Chinese medicine, and is good at comprehensive treatment of dermatology, gynecology, pediatrics and internal medicine diseases with remarkable curative effect.
be adept in
Dermatology: acne, seborrheic dermatitis, acute and chronic urticaria, acute and chronic eczema, atopic dermatitis, beriberi, onychomycosis, seborrheic alopecia, alopecia areata, chloasma, lupus erythematosus, psoriasis, itching, vitiligo, neurodermatitis, etc.
Pediatrics: cold and fever, cough, anorexia, indigestion, emaciation, constipation, diarrhea, recurrent respiratory infections, allergic rhinitis, chronic rhinitis, adenoid hypertrophy, pharyngitis, tonsillitis, night crying, hyperactivity, enuresis, hyperhidrosis, slow growth, ADHD in children, etc.
Gynecology: polycystic ovary syndrome, infertility, irregular menstruation, hysteromyoma, ovarian cyst, mammary gland hyperplasia, menopausal syndrome, insomnia, depression, etc. Internal medicine: chronic gastritis, chronic colitis, constipation, chronic diarrhea, dizziness, tinnitus, headache, insomnia, anxiety, irritability, hyperhidrosis, chronic cough after a cold, etc.
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