2 English reference outbreak of larynx [Chinese medicine terminology examination and approval Committee. Terminology of traditional Chinese medicine (20 13)]
3. To sum up, larynx wind is the name of the disease [1]. Laryngeal wind [1]. Also known as acute larynx [2]. Finger throat wind [3][ 1] is characterized by tight throat, difficulty in breathing and difficulty in getting soup. If there are critical symptoms such as closed teeth and locked mouth, it is called throat lock wind [2].
Acute larynx is equivalent to laryngeal edema and dyspnea caused by acute inflammation of throat and neck in western medicine.
Acute larynx belongs to the scope of acute laryngeal obstruction [2].
According to western medicine, throat tightness includes abscess of posterior pharyngeal wall, abscess around tonsil and laryngeal edema [1].
4 Etiology and pathogenesis of throat-tightening wind: The throat-tightening wind is mostly caused by the strong smell of plaster and excessive alcohol, or the accumulation of heat in the lung and stomach, the resumption of wind and heat, the fire moving and phlegm turbidity, and the phlegm-fire poisoning choking the throat [1].
Acute laryngitis can be caused by the development of laryngeal carbuncle and various acute throat diseases, usually combined with acute laryngeal carbuncle and laryngeal diphtheria in children. This is a disease that accumulates in the throat due to excessive phlegm, saliva, fire poison or plague, leading to blood coagulation, vein stasis, excessive phlegm and saliva, and airway obstruction [2].
Patients with acute laryngitis can develop into acute laryngitis if the pathogenic heat is strong, the burning fluid is phlegm or phlegm heat, and the phlegm heat accumulates in the throat and the airway is blocked. Children suffer from this disease, because the viscera are delicate and the throat cavity is narrow, which is particularly easy to cause acute larynx wind.
In addition, there is still blood coagulation in the throat after laryngeal trauma; Or liver stagnation and qi stagnation, coagulation phlegm aggregated into laryngeal bacteria; Or foreign body blocking the throat cavity. , will lead to airway obstruction or stenosis and become a disease [2].
5 Symptoms of Laryngeal Wind Tightness "Medical Zong Jin Jian" Volume 66: "Laryngeal wind tightens the paste bundle, which is caused by wind and fire, and the sore throat is difficult to occur, such as sawing phlegm, and the acupoints are becoming less and less business."
At first, the throat swelled quickly, which was unfavorable for swallowing. Then, the whole throat is red and swollen, the sputum is congested, the throat is tight, the sputum is short of breath, it is difficult to breathe, the voice is hoarse, and even the throat is swollen, it is difficult to drink soup, or it can suffocate [1].
Acute laryngeal wind is acute, and the patient's throat is swollen and painful, and it is difficult to breathe, speak and drink soup. The onset is rapid and the condition is urgent [4][2].
The patient has sore throat, dysphagia, tightness in the throat and dyspnea in the throat, which is characterized by forced inhalation, sudden protrusion (suprasternal fossa), lack of basin (supraclavicular fossa) and intercostal depression. When inhaling deeply, it is called three depression, but laryngitis; You can smell wheezing when you cough; Hoarse or difficulty in speaking, full of phlegm, sound like a saw [2].
Local examination shows that the throat is red and swollen, or although the throat and pharynx are not red and swollen, the throat and vocal cords are obviously red and swollen, with excessive phlegm and saliva, or something decays [2].
The whole body may have aversion to cold and intense heat, or high fever, sweating like rain, dry mouth and thirst, constipation, short and red urine, red or crimson tongue, yellow or greasy tongue coating, and heartbroken pulse [2].
According to the severity of dyspnea, it is divided into four levels [2]:
The first degree: the patient has no dyspnea when he is quiet, laryngitis and nasal alar agitation and protrusion when he is active or crying, and mild depression when there is no basin.
Second degree: the above-mentioned dyspnea also occurs when it is quiet.
Third degree: In addition to the second degree of dyspnea, dysphoria, spontaneous sweating and depression are obvious.
Fourth degree: In addition to the third degree of dyspnea, shallow breathing, blue lips, beady forehead and sweaty body. What's more, the limbs are cold, the pulse is weak, the spirit is weak, and it is on the verge of suffocation.
6 Syndrome Analysis The larynx is the way to breathe in and out of the qi. The throat cavity is narrow due to the accumulation of fire and poison and the coagulation of qi and blood, and the airway is blocked by phlegm and saliva, making it difficult to breathe, especially the difficulty of inhaling and overexertion [2].
Because the gas passes through the narrow throat cavity, throat sounds are generated, and when coughing, the gas impacts the throat, showing a roaring roar [2].
When inhaling, air can't smoothly enter the trachea and lungs through the throat, and the lung qi is insufficient, and the negative pressure in the chest cavity increases, so there are three kinds of depressions such as protrusion, lack of basin and intercostal depression when inhaling [2].
The evil guest gives the throat cavity, and the glottis are not easy to open and close, so the voice is hoarse or the language is difficult to come out [2].
Sputum is full of saliva, blocked in the airway, and moves up and down with the qi, so there is a sputum sound, which is quite like a seesaw [2].
Because of sore throat, dyspnea, dysphagia, and even difficulty in water slurry [2].
Bluish lips, sweating like oil, sweating like rain, cold limbs, coma and weak pulse are the dangers of suffocation and separation of Yin and Yang [2].
Because the disease is mainly located in the throat, local examination shows that the throat and vocal cords are obviously red and swollen, while the throat and pharynx may or may not be red and swollen [2].
7 Diagnosis of acute larynx wind The diagnosis of acute larynx wind is mainly based on the characteristics of clinical symptoms, especially laryngeal dyspnea, excessive phlegm and saliva, difficulty in speaking and difficulty in drinking soup [2]. If the acute throat disease develops and the above symptoms appear, the diagnosis will be more clear [2].
8. Syndrome Differentiation of Acute Laryngeal Wind 8. 1 Syndrome of Wind-heat Offence Acute Laryngeal Wind is mainly caused by wind-heat invasion, which refers to wind-heat aggression. It is characterized by dyspnea, sore throat, tight swallowing, difficulty in drinking soup, excessive phlegm and saliva, bright red or purple throat mucosa, obvious redness and swelling in glottis area, accompanied by bad wind.
8.2 Acute laryngeal wind with phlegm stagnation syndrome has a pattern and aggregation, which refers to phlegm coagulation, sudden choking cough, dyspnea, low voice, which is not suitable for swallowing. The throat is not red and swollen, and the epiglottis can be obviously swollen or even spherical. Glottic mucosa is pale and edematous, glottis is not easy to open and close, accompanied by aversion to cold, fever, headache, anhidrosis, dry mouth and tongue, white tongue coating, pulse floating, etc., which are common symptoms of acute larynx [3].
8.3 Toxic Fumigation Syndrome Acute larynx wind with toxic heat syndrome refers to toxic heat fumigation, characterized by sudden swelling of the throat, unbearable pain, difficulty in inhaling, phlegm in the throat, hoarseness, or difficulty in speaking, extreme swelling of the throat, epiglottis or glottis, excessive phlegm or corruption, and irritating sensation in the nose. Sudden protrusion, lack of basin, depression between ribs and upper abdomen when inhaling, accompanied by aversion to cold and intense heat, or high fever and upset, sweating like rain, dry mouth and thirst, constipation, short and red urine, crimson tongue, yellow or greasy fur, rapid pulse or heartbroken are common symptoms of acute larynx [3].
In the treatment of acute larynx, attention should be paid to the dyspnea of patients with acute larynx, and the symptoms of dyspnea should be alleviated according to the cause. If you have difficulty breathing in the third or fourth degree, you should immediately perform tracheotomy, remove sputum and saliva through tracheal intubation, keep the respiratory tract unobstructed and keep breathing [2].
9. 1 prescription therapy 9. 1. 1 prescription19.1.1therapy for clearing away heat and toxic materials, resolving phlegm and inducing resuscitation [2].
9. 1. 1.2 Prescription can be Qingwen Baidu Powder [Remarks] Qingwen Baidu Powder (epidemic eruption I): gypsum fibrosum, radix rehmanniae, rhinoceros horn, coptis chinensis, gardenia, platycodon grandiflorum, scutellaria baicalensis, rhizoma anemarrhenae, radix Paeoniae Rubra, Scrophulariae, forsythia suspensa, licorice, cortex moutan and lophatherum are the treatments.
Addition and subtraction: For patients with excessive phlegm and saliva, add Tianzhu Huang, Bulbus Fritillariae Cirrhosae, Fructus Trichosanthis, Rhizoma Osmundae, and Zhuru, and combine Liushen Pill (Schleswig) and Xiong Huang Jiedu Pill [Remarks] Xiong Huang Jiedu Pill (theory of three causes and one disease): Realgar and Yujin. Zixuedan (Taiping Huimin Mixture), Zhibaodan (Taiping Huimin Mixture) and other drugs for clearing away heat and toxic materials, resolving phlegm and inducing resuscitation [2]. For constipation patients, yellow and mirabilite can be added as appropriate [2].
9. 1.2 Formula II 9. 1.2. 1 Treat pathogenic wind, detoxify and reduce swelling; Or declare lung heat, clear stomach and reduce fire.
9. 1.2.2 Prescription: Qingyan Xiao Zhong Drink or Qingyan Lide Decoction [Remarks] Qingyan Lide Decoction (throat disease purple treasure collection): Fructus Forsythiae, Fructus Gardeniae, Scutellariae Radix, Herba Menthae, Fructus Arctii, Radix Saposhnikoviae, Herba Schizonepetae, Natrii Sulfas, Radix Scrophulariae, Flos Lonicerae and Radix et Rhizoma Rhei.
9. 1.3 Prescription III 9. 1.3. 1 Therapeutic method for clearing away heat and toxic materials, relieving swelling and relieving sore throat [1].
9. 1.3.2 Prescriptions can be treated with Qingwen Baidu Decoction and Qingyan Li Ge Decoction. [ 1].
If the mental disturbance is unconscious, it is advisable to enlighten the mind and resolve phlegm, and use Anguan Niuhuang Pill [1].
9.2 External Treatment 9.2. 1 Blow medicine with Boron Ice Powder [Remarks] Boron Ice Powder (surgical genuine product): mirabilite, cinnabar, borax, borneol and * * * are ground into very fine powder. Huangshu powder [Remarks] Huangshu powder (empirical formula): Renzhongbai 3g, puffball powder 15 g, indigo naturalis 3g, baby tea 3g, mirabilite 1.5 g, borax 3g, mint 1.5g, and coptis chinensis/kloc-. Such as clearing away heat and toxic materials, reducing swelling and resolving phlegm, and frequently blowing the throat [2].
External blowing ice boron powder [Remarks] Ice boron powder (authentic surgery): Glauber's salt, cinnabar, borax, borneol and * * are ground into fine powder. Indigo Powder [Remarks] Indigo Powder (empirical formula): Indigo 60g, Gypsum 120g, Talcum 120g and Cortex Phellodendri 60g, all of which are ground into fine powder and mixed evenly. Rinse with throat-clearing disinfectant.
9.2.2 Flos Lonicerae, Flos Chrysanthemi, Herba Menthae, Herba Pogostemonis, Eupatorium odoratum, Welsh onion, Perillae, etc. for steam inhalation. And a proper amount of decoction, so that patients can inhale its steam to dispel wind and clear heat, reduce swelling and enlighten [2].
9.2.3 If the pharynx is red and swollen after gargling, gargle with gargle prescription to clean the local area, which has the effect of detoxification and detumescence [2].
9.3 Acupuncture Treatment 9.3. 1 Acupuncture selected Hegu, Shaoshang, Shangyang, Chise, Shaoze, Quchi, Zenith, Futu and Fenglong points. At 2 ~ 3 o'clock every time, use the purging method without leaving a needle [2]. Or take Shao Shang and Shang Yang to bleed and release heat [2].
9.3.2 Ear acupuncture at Shenmen, Pharyngeal and Pingchuan points, with needle retention 15 ~ 30 min, once a day 1 ~ 2 times [2].
9.4 snatch method snatch method is suitable for acute throat diseases with severe swelling and pain and difficulty in dripping water. Grasping can reconcile qi and blood, dredge meridians and relieve symptoms [5].
9.4. 1 unilateral capture method [5]
When operating, ask the patient to sit, raise his hand horizontally, thumb up and little finger down. If the patient's left hand is raised horizontally, the performer stands on the right side of the patient's hand. Press the patient's thenar back tightly with the left index finger, middle finger and ring finger (equivalent to Hegu point), buckle the wrist with the little finger, press the thumb opposite to the rib surface of the patient's thumb forward, press the shoulder joint on the upper edge of the clavicle with the right thumb (equivalent to acromioclavicular joint point), hold the armpit with the index finger, middle finger and ring finger, and pull it out forcefully (Figure 3). During the operation, you can ask a third party to stand in front of the patient and slowly pour out the soup or semi-liquid at this time, because the sore throat is obviously relieved and you can swallow it. This method can be used continuously.
9.4.2 Bilateral Capture Method [5]
The patient sits in a chair without a backrest, and the doctor stands behind the patient, with his hands extending from the patient's armpit to his chest, pressing the upper edge of the clavicle with his index finger, middle finger and ring finger, and pressing the patient's ribs with his elbow, and the doctor's chest is close to the patient's back. After positioning, you start to exert your strength. Pull your hands to the left and right (along the clavicle to the scapula), and press the patient's ribs and back with your elbows and chest. It is necessary to use three forces at the same time to relax the patient's throat and make it easy to swallow. The assistant will feed the prepared medicinal soup or porridge to the patient for swallowing.
Attention should be paid to the general situation of the patient during the operation, and the operator should exert proper force and not be too rude.
9.5 Scraping method Scraping method, commonly known as "scraping", is to scrape the patient's skin with the edge of a porcelain spoon soaked in oil or water until the skin is purple. It is also useful to pinch the patient's skin with two fingers to make it purple. This method can dredge the channels and collaterals, drain the evil heat in the body out of the body surface, and achieve the purpose of treatment. It is generally suitable for the initial stage of excess heat syndrome. [5]
If the throat is sore, first scrape Fengfu point, then scrape other points behind the ear, points on both sides of the arm, Quchi, ambulance, Daling and Taiyuan. The back is always scraped along the bladder meridian of Taiyang from top to bottom (from Shufei to Ganshu and Shu Wei, from Dachangshu to bladder meridian). This method is rarely used for people with weak constitution. [5]
At first, when I feel sore throat, I often take the cervical fossa (that is, the carotid artery), rub some sesame oil, and scrape it with the edge of thick copper coins. Scrape from top to bottom, don't scrape from bottom to top. The left sore throat scraped the right side, and the right sore throat scraped the left side. Mild people often recover after scraping, and severe people can also relieve symptoms. [5]
9.6 Tracheotomy If the dyspnea reaches the third or fourth degree, tracheotomy is feasible [2]. Severe dyspnea, if necessary, can also refer to this disease, tracheotomy [2].
9.7 Treatment of dyspnea Dyspnea caused by foreign body in laryngeal cavity, laryngeal trauma and laryngeal bacteria blocking airway should be treated according to the cause [2]. Severe dyspnea, if necessary, can also refer to this disease, tracheotomy [2].
9.8 Nursing Care of Patients with Acute Laryngolaryngitis The ancients said that the disease was in critical condition and changed rapidly. In severe cases, it can lead to suffocation and death instantly, so attention should be paid to nursing [2]:
(1) closely observe the changes of the disease, make full preparations and rescue at any time [2].
(2) In order to avoid aggravating dyspnea symptoms, we should rest more and exercise less [2].
(3) There is a lot of phlegm and saliva, and the semi-lying position is adopted [2].
(4) The medicine should be chewed slowly, so that the medicine can stay in the local area for a long time and play a greater role [2].
9.9 Medical Records Zhang Medical Records, Jiangbei woman Li, knocked at the door for treatment in the middle of the night. When three new people opened the door, they heard that the woman's throat was like a saw, her fingers could not move and she was short of breath. She would suffocate before dawn, so she pried open her teeth, blew the switch and dispersed the cattle. In a short time, she spit out thick and sticky phlegm like durian, half phlegm. Urgent prescription: Chen Danxing, Rhizoma Acori Calami, Rhizoma Pinelliae, Bulbus Fritillariae Cirrhosae, Semen Armeniacae Amarum, Fructus Trichosanthis, Cortex Moutan fried in San Qian, Fructus Aurantii for one and a half yuan, Rhizoma Zingiberis Recens fried in San Qian, and Folium Menthae for seven minutes. Let me take a dose, and I haven't replied for several days. Suddenly, this man accompanied another woman to check her liver and stomachache. (Excerpted from "Autonomy Series of All Diseases in TCM: Throat Diseases")
10 dietary contraindications for patients with acute laryngitis. Patients with acute laryngitis should avoid hot and dry food, so as to avoid adding fuel to the fire, breeding phlegm and dampness, and aggravating the condition [2].
1 1 prevention of acute larynx should pay attention to the early prevention and treatment of various throat diseases so as not to develop into acute larynx [2].
12 acute larynx is the name of the disease [6]. See Puji Fang, Volume 60. It is also called "Laryngeal Wind" (see) [3] and "Laryngeal Wind" (see Jin Jian Yi Zong, Volume 66) [2]. It is a throat wind [2]. Refers to the acute throat disease characterized by inspiratory dyspnea [3]. It is named because of its rapid onset and serious illness [2]. If there are critical symptoms such as closed teeth and locked mouth, it is called throat lock wind [2].
Acute larynx is equivalent to laryngeal edema and dyspnea caused by acute inflammation of throat and neck in western medicine.
Acute larynx belongs to the scope of acute laryngeal obstruction [2].
See Acute Laryngeal Wind Strip for details.
13 Laryngeal wind is the name of the disease [7]. See Essentials of Syndrome Differentiation and Treatment of Secret Recipes [7]. It refers to throat diseases characterized by sore throat and dyspnea [3]. It refers to various diseases of the throat [7].
On the volume of Heart Method of Laryngology: "Archaeology is called laryngeal disease, commonly known as laryngeal wind [7]."
In the literature over the years, there are many names of larynx with different meanings. Generally refers to a variety of diseases of the throat, including some diseases of the mouth, teeth and lips. For example, the volume of "Psychotherapy of Laryngology" says: "Archaeology is called laryngeal disease, collectively known as laryngeal wind." The Secret of Laryngology is divided into Laryngeal Wind12; The finger palm of larynx is divided into 16 symptoms. The experience of Zi Bao Ji in laryngology is divided into 18 symptoms; The jade key in Paris is divided into 36 symptoms.
See acute throat wind, tight throat wind, throat lock wind, throat wind, and dumb throat wind strips.
See throat wind strip for details.
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