| Objective:Of the2011Chongqing Medical University Children’s Hospital,Children’s Hospital Affiliated collecting specimens for virusisolation and identification of patients with Japaneseencephalitis (JE);JE cases collected in2011and2012, from theevidence, climate the typing and TCM syndromes analysis of theclinical features of JE, to further clarify the Japaneseencephalitis card Hou characteristics and Chinese medicine named,etiology, pathogenesis, evolutionregularity and efficacy ofChinese medicine advantages, explore solutions to the problem ofJapanese encephalitis in the three main card, the formation of thetheoretical system of Chinese medicine prevention and control ofJE, evidence based medicine for the treatment of JE JE promote theprevention and treatment of Traditional Chinese Medicinetechnicalmethods and program development.Methods:(1)The acquisition of a total of145copies of Chongqing Medical University Children’s Hospital, Japanese encephalitis patientsblood and cerebrospinal fluid specimens by nested PCR, real-timefluorescence PCR, BHK-21cell cultures as well as vaccination2-3day-old suckling mice and other methods detection and separationof the Japanese encephalitis virus.(2)Study the scene: The study site medical care center inWuhanCity the Chongqing University Children’s Hospital, the SixthPeople’s Hospital of Hangzhou, ChengduInfectiousDiseasesHospital,GuiyangCity, and the Fifth People’s Hospital. Above severalhospitals is provincial infectious disease hospital, once theprovince of JE epidemic will the patient transferred to severalhospitals treatment, so to ensure the patient centralized andcomprehensiveness. Another research base in several hospitals inthe study period, with a relatively fixed data management.(3)study： Wuhan City medical treatment center, ChongqingUniversity Children’s Hospital, the Sixth People’s Hospital ofHangzhou, Chengdu Infectious Diseases Hospital, Fifth People’sHospital of Guiyang City, admitted in2011-2012diagnosed patientswith Japanese encephalitis.Inclusion criteria:(1) comply with the Ministry of Health,"Japanese encephalitis diagnostic criteria"(2009) clinicaldiagnosis.②serum or cerebrospinal fluid detected cases of JEvirus IgM antibodies.Exclusion criteria:①serum or cerebrospinal fluid to detectcases of JE virus IgM antibody negative.②not detected cases ofserum or cerebrospinal fluid.(4)Laboratory testing Serological tests, serological tests JEvaccine unvaccinated months, with viral antigen in the blood or cerebrospinal fluid of patients with early onset of immuneofluorescence or E LISA assay useful for early diagnosis. JEspecific antibodies with immunofluorescence or E LISA detection ofserum or cerebrospinal fluid, with early diagnosis. Take patientswith acute and convalescent serum antibody titer was more than fourtimes higher diagnostic significance.By the hospital laboratorywere detected.(5)Research Methods Site visits to medical treatment center inWuhan City in2011and2012, the Children’s Hospital of ChongqingUniversity, Hangzhou Sixth People’s Hospital, Chengdu InfectiousDiseases Hospital, Guiyang City Fifth People’s Hospital of Japaneseencephalitis patients. Patient cases and CRF table, fill in thecases of Japanese encephalitis questionnaire content: basicsituation of the patients, the diagnosis, admission and dischargetime, the typical symptoms, signs, TCM syndrome discharge recovery.JE onset of clinical symptoms and TCM analysis on census forms.Results:(1)In this study, CSF samples only from children JE patientsisolated from a Japanese encephalitis virus, named CQ11-66, thevirus can cause2-3day-old suckling mice died, BHK-21cells canoccur Cellcytopathic effect.(2)In2011and2012,472cases were collected cases, the onsetmostly concentrated in the three months7,8,9. Which271casesof male patients, female patients with201cases, between men andwomen, the proportion was1.05:1.225cases of children under theage of5,6-10-year-old children in173cases, more than10-year-oldpatients74cases.450patients from rural areas, the poor livingenvironment, near a pig farm or their own pig, there is no anti-mosquito measures.(3)Clinical symptoms: The JE patients the main symptom observedin2011and2012were fever in445cases (94.30%), headache in108cases (22.90%), vomiting in43cases (9.10%), seizures in157cases(33.30%) and360cases of disturbance of consciousness,(76.30%),abnormal breathing20cases (4.20%) and anorexia375cases (79.40%),fatigue in418cases (88.60%).(4)Cause of syndrome characteristics: Japanese encephalitiscause of syndromes characterized by2011: toxic evil195cases,accounting for100%; the heat evil148cases, accounting for75.9%clip dampness152cases, accounting for77.9%; hiinvagination of146cases, accounting for74.9%; Light, ordinary type indicatesGuardian table light card, fever, irritability, less disturbanceof consciousness. The heavy-duty the poison trap pericardialconvulsions, drowsiness, and irritability symptoms. Japaneseencephalitis cause of syndromes characterized by2012: the toxin277cases (100%); damp256cases, accounting for92.4%; the heat evil258cases, accounting for93.1%; dampness evil213cases,accounting for76.9%; hi invagination of the216cases, accountingfor78.0%; lightweight, ordinary type of representation Guardiantable light card, fever, irritability, and less disturbance ofconsciousness.The heavy-duty the poison trap pericardialconvulsions, drowsiness,and irritability symptoms. Death overcastcases, accounting for0.4%; death yang6cases (1.4%) go to the ICUtreatment.(5)Differentiation:2011Japanese encephalitis195casestreated, the syndrome distribution: drug Yun lung and stomach in35cases, accounting for17.9%;98cases of poison damage of brain collateral, accounting for50.3%of the62cases; poison trappericardial accounted for31.8%, and no yin and yang failure, Qiand Yin injury syndromes.2012treated277cases of Japaneseencephalitis syndrome distribution: drug Yun lung and stomach in61cases, accounting for22.0%; poison damage of brain collateral115cases, accounting for41.5%; the poison trap the pericardium90cases,32.5%, yin and yang failure11cases, accounting for4.0%,and no Qi and Yin injury syndrome type.(6)Clinical efficacy:2011random control group efficacy:treatment group of54cases, of which51cases were cured, improvedin3cases, the cure rate,94.40%, improvement rate of5.60%;control group of43cases,38cases cured, improved five cases, thecure rate was88.40%,11.60%improvement rate. Cohort study grouptherapeutic effect: a total of51cases, of which45cases were cured,improved in six cases, the cure rate was88.20%, the improvementrate of11.80%; control group of47cases,35cases cured, improvedin11cases,1patient died, the cure rate74.50%, improvement ratewas23.40%, and the mortality rate was2.10%.2012randomizedcontrol group therapeutic effect: a total of119cases, of which99cases were cured,20cases improved, the cure rate was83.20%,the improvement rate of16.80%; control group of57cases,42casescured, improved in13cases, the cure rate73.70%improvement ratewas26.30%. Cohort study group efficacy: treatment group of69cases,50cases were cured,18cases improved, and1died, the cure ratewas72.50%, the improvement rate of26.10%,1.40%mortality;control group of32cases,22cases cured, improved six cases, fourcases of death, the cure rate of68.80%, the improvement rate of18.80%,12.50%mortality. (7)The three main symptoms:2011randomized control groups: the treatment group, bodytemperature dropped to normal time conscious average, averagerelieve convulsions time, average length of stay (5.12±2.20) days,(3.35±1.42) days,(3.8±2.20) days,(20±2.50) days. Controlgroup, the temperature dropped to normal time conscious average,average relieve convulsions time, the average length of stay (8.26±1.56) days,(7.58±1.39) days,(7.4±1.30) days,(26±1.86)days.2011cohort study groups: the treatment group body temperaturedropped to normal time conscious average, average relieveconvulsions time, average length of stay (5.50±1.30) days,(5.84±1.03) days,(2.23±1.19) days,(23±2.19) days. Control group,the temperature dropped to normal time, the average conscious,average relieve convulsions time, the average length of stay (8.74±1.42) days,(9.72±1.61) days,(5.47±1.39) days,(29±1.87)days.2012randomized control group: the treatment group, bodytemperature dropped to normal time conscious average, averagerelieve convulsions time, the average length of stay (5.68±1.98)days,(4.76±1.39) days,(4.19±2.18) days,(19±3.10) days.Control group, the temperature dropped to normal time, the averageconscious, average relieve convulsions time, the average length ofstay (9.26±2.29) days,(8.43±1.26) days,(8.26±1.27) days,(24±1.29) days.2012cohort study groups: the treatment group body temperaturedropped to normal time conscious average, average relieveconvulsions time, the average length of stay (5.50±1.30) days, (6.72±1.17) days,(2.69±1.23) days,(28±2.76) days. Controlgroup, the temperature dropped to normal time, the averageconscious, average relieve convulsions time, the average length ofstay (7.98±1.69) days,(10.12±1.79) days,(6.47±1.29) days,(30±1.29) days.Conclusion:1This study Chongqing for the first time detected in CSFsamples from children JE patients and isolated Japaneseencephalitis virus, named CQ11-66.2From nearly three years of clinical observation, accordingto Ye Tina shin of summer from the bottom of Yang Ming, summerfebrile disease to summer evil infestation sex hot summer, dampdiseases more common hot the card; humid summer season, often thereis summer in the folder the wet of waiting; summer heat gasconsumption Shang in therefore late there Qiyin the two losses andthe like. JE pathogenesis heat the toxin invades the human body,quickly years pass gas camp two burnt the of both febrile diseasetransmission becomes common, has its own evolution particularity.Preliminary refining the Japanese encephalitis core pathogenesis.3Japanese encephalitis TCM Syndromes, Drug Yun lung andstomach mainly micro chills, fever, headache, conscious,accompanied by nausea, thirst hi drink less and convulsionssyndrome; Poison damaged brain collaterals mainly high fever,headache, lethargy darkened, occasional seizure syndromes; Thepoison trap pericardial mainly for rapid-onset, severe headache,restlessness or mania, coma, repeated convulsions and othersymptoms; Yin and Yang exhausted disease potential dangerous,mainly fever, body burnt charcoal, quickly fell into a deep coma, stubborn, continuous convulsions, rough breathing or shortness ofbreath, weakness, irregular breathing, acute death overcast deathyang symptoms, such as facial pale dull lips The cyanosis, sweatmore, such as oil, hand-foot Jueleng syndrome.4. Clinical classification, medicine, prevention and treatmentof epidemic encephalitis laws of clinical and treatment programsin the pharmaceutical industry, special in2009,"the researchgroup to develop the Chinese plan, basically established the JEtoxic Yun lung and stomach poison brain collateral damage, poisontrap pericardium and yin and yang failure. From nearly2years ofclinical observation and analysis, the poison trap pericardialproportion, followed by drug damage of brain collateral, Yun-lungand stomach poison. High fever, convulsions and unconsciousness arestill three Japanese encephalitis master card, Yidu damage of braincollateral poison trap pericardial more common type; Fever arecommon symptoms of epidemic encephalitis, convulsions in drug Yunlung and stomach poison damage brain collateral attack less, isrelatively common in the poison trap pericardial card type. Thehigher the patient’s temperature, the more the number of seizure,and the longer the duration of the disturbance of consciousness.5.Japanese encephalitis pathogenesis and mass changecharacteristics, the poison in the summer heat, constant dampnessand retraction, and easy to move wind hurt Qiyin death of yin andyang. Toxic evil throughout the process of the incidence of Japaneseencephalitis, which lay the foundation for the establishment ofJapanese encephalitis treatment principle. The furtherunderstanding JE disease mass change in line with the Wei Qi YingXue the triple burner EVOLUTION, but not stickle Wei Qi Ying Xue and the triple burner Biography change the law.6Treatment on the basis of conventional treatment, andactively strengthen TCM treatment, light treatment (poisonobstruct the lung and stomach) Yawing should not reuse gypsum,therefore should Xinhua Qing gas, the white tiger soup andYinqiaosan plus less; Common type (toxic damage of brain collateral)detoxify, cool camp refreshing Qingyingtang addition andsubtraction. The heavy(the poison trap pericardium) detoxification,cooling Fifing, application Wingmen Baidu Decoction ZhejiangDecoction. Heavy (yin and yang failure) to death of yin applicationfrom collapse Tonga Shengmai the injection; death of Appliedtongmai Sini Tonga Shenfu injection;While Angongniuhuang, thetreasure of Dan, Dixie high fever, coma, played an important rolein the process of convulsive therapy. Alpha... |
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