| Objective:meibomian gland cyst in infants is a common and frequently occurring disease in ophthalmologic clinic,and for some children the condition develops rapidly,which can rapidly form granuloma,which is associated with infection,and the wound surface increases to more than 6mm or even ulcerates.At this time,the main treatment method of western medicine is incision and curettage,but because the cyst is larger or even burst,the scar after the operation is obvious,and the possibility of recurrence and recurrence is high.For patients with infants and young children,the operation requires general anesthesia or local anesthesia,the degree of cooperation with infants and young children is low,many parents do not want to accept this therapy.For meibomian gland cyst,professor Qi Baoyu of our department has the treatment plan of internal medicine and external application of traditional Chinese medicine plus mayinglong babao eye ointment,which has reliable curative effect.Professor QiBaoYu outpatient contact for children with a large number of meibomian gland cyst after professor QiBaoYu long-term observation after treatment,found that there are a number of infants and young children meibomian gland cyst disease belong to merge infection,and will be or has been through the eyelid skin and granuloma formation,illness development is rapid,professor QiBaoYu called"Angle of granulomatous type chalazion",has its regular course and good location,the"Angle of granulomatous type chalazion"children of outpatient infant meibomian gland cyst with 50%or more.After the treatment,there was a small scar left,and no special discomfort during the treatment.There is little literature on the occurrence characteristics and clinical observation of such diseases in children with "keratoid granulomatous meibomian cyst".Therefore,this study intends to observe and summarize the pre occurrence site and pathogenesis of"keratoid granulomatous meibomian gland cyst"in infants and children by using the method of before and after self-comparison,and observe the clinical efficacy of professor Qi Baoyu in the treatment of such diseases.Methods:1.36 children with keratoid granulomatous meibomian gland cyst in the outpatient department of professor qi baoyu from June 2018 to September 2018 in dongfang hospital of Beijing university of traditional Chinese medicine were selected.2.Granules were given to each child according to his/her condition and age.Ingredients:Fried hawthorn 5g,Fried malt 5g,Fried divine opera 5g,honeysuckle 5g,wind prevention 5g,balloonflower 3g,saponin thorn 10g,red peony 5g,zhejiang shellfish 5g,batryticated silkworm 5g,purple flower ground 5g,bitter almond 5g.Add or subtract as appropriate according to the illness.1/4 dose twice daily;External application of traditional Chinese medicine for the hospital unified decoction of 200ml of traditional Chinese medicine,routine composition:borax 2g,fangfeng 5g,honeycomb 5g,lutong 5g,trumpet creeper 5g,pinellia 10g,prinsepix 10g,saponin thorn 10g,prunella 6g,mountain cigu 4g,red astragalus 5g,wei lingxian,white mustards,panax notoginseng,pao shan jia add or subtract as appropriate.Pan-fried good Chinese medicine medicinal broth in the institute,100ml,each use a moderate amount of heat to 40?,using sterile cotton cloth soaked in liquid,drain while hot compress on the affected15minutes each time,2 times per day;Partial application of eye cream:after each external application,partial application of mayinglong babao eye cream.After continuous treatment until the cyst healed or10 weeks after statistical treatment effect.3.Observe the size of the cyst,the color of the surrounding tissues,and the degree of burning and pain around the eyes at the first diagnosis and treatment for 2 weeks,6 weeks and10 weeks respectively;The systemic symptoms and signs and daily routine were observed.Analysis of the characteristics of the disease,treatment effect.4.Follow up to 6 months after the visit to observe the recurrence.Results:1.The symptoms and tongue pulse of the children were mostly in line with the pathogenesis characteristics of TCM of spleen and stomach discord and phlegm dampness and heat resistance;2.The most common sites of objective examination indexes before treatment were upper eyelid temporal(33.3%),upper eyelid central(36.1%)and lower eyelid temporal(30.6%),respectively.Lower eyelid cysts were large,with significant difference(p<0.05).2,because the infant body metabolism is strong,cyst easy to burst into pus.Observation of its regular disease progression;early cyst formation,if the disease develops rapidly,can grow to 8mm and above within 3 weeks,can appear granulation and will suppurate;The middle is fester,scab,or many times fester,collapse,scab process;In the later stage,the sepsis was exhausted,and the mouth was closed and healed.Eventually,a tiny scar is left.According to the inquiry of the patient's present medical history in the first visit,it can be concluded that the percentage of the children in the initial stage of the disease is30.6%,and most of the initial stage of the eye disease is within 6 weeks.The mid-term percentage was63.9%.The duration of most of the mid-term diseases was from 3 weeks to 12 weeks,and the terminal stage accounted for 5.6%,which occurred after 6 weeks.3.From the initial diagnosis to recovery,66.7%of the children experienced the stage of mid-stage fester.Qi baoyu,professor of qi qi purulent method of red astragalus is the ingenious part in the whole treatment.For children with purulent tendency,relatively large dose of red astragalus is given to facilitate the situation and accelerate the time of collapse and healing.The dosage of astragalus was the highest in the middle stage of the disease,and the difference was significant(p<0.05).4.Multiple observation points were used for comparison analysis before and after the statistical change of cyst size,and homogeneity test of variance was performed before and after treatment,p>0.05,which did not conform to the normal distribution,and Wilcoxon rank sum test was used.The mean and standard deviation of the size of the cyst in each time period were taken for comparison,and the average diameter of the cyst was reduced(p<0.05),indicating a significant difference.The infection degree decreased with the course of treatment,and the number of patients with spleen and stomach disorders decreased with the course of treatment,p<0.05,the difference was significant.According to the observation and statistics of the reduction of cyst at week 10,the overall effective rate was 88.9%.The effective rate of the upper eyelid temporal cyst was 91.7%,the effective rate of the central cyst of the upper eyelid was 92.3%,and the effective rate of the lower eyelid temporal cyst was 81.8%.5.At the follow-up of 6 months after the visit,the recurrence rate was 3.2%.Conclusion:the most common sites of"keratoid granulomatous meibomian cyst"in infants are upper eyelid temporal,lower eyelid temporal and central upper eyelid margin.Its course is regular,initial cyst is formed,can appear granulation and infection,metaphase suppurate,burst ulcerate,later collect mouth,cicatrization.Throughout the whole course of the disease,the mid-term ulceration is the key point for the improvement of the disease.If the ulceration is smooth,the disease is easier to be cured;if the ulceration is not smooth,the whole course of the disease will be lengthened.The cyst of upper eyelid is easy to break and ulcerate,easy to treat and short course of disease.Lower eyelid cyst is not easy to collapse and the course of the disease lasts for a long time.In the treatment,to harmonize the spleen and stomach,clearing away heat as the treatment principle,and professor qi baoyu in the process of this treatment to make good use of red qi qi suppurative,red qi qi suppurative method will become the process of ingenious treatment.Qi baoyu trigeminal therapy for the treatment of meibomian gland cyst in infants avoids the surgical process,leaving little scar after the treatment of large cyst,easy to cooperate with the treatment process,mild treatment,reliable curative effect,low recurrence rate,has its incomparable advantages. |
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