First, how to prevent misdiagnosis? Talk about Wang Yi's illness.
On February 27th, 2002, at 65438, Wang Yi bent over and came to ask for help with his chest in his hand. His expression is very painful, and his ribs are sick. A central hospital treated him with occult herpes for more than a month, but he didn't recover, so he was transferred to me for treatment. After listening to her story, I checked that there was no trace of rash on her affected area. I asked suspiciously, "Wang Yi, did you find any traces of rash at the beginning of your illness?" There's not even a little red dot. "Not at all," she replied. I said, "Well, the situation is clearer. You don't have herpes, but intercostal neuralgia is probably caused by overwork. " The king said anxiously, "What shall we do? Teacher Xie said it was herpes at first. Please press herpes treatment first! " I said, "Yes, if it doesn't work for half a month, then you must change to another hospital. Our medicine specializes in treating herpes and postherpetic neuralgia, but other skin diseases are ineffective, but there are no side effects after application. "In this way, I gave her medicine for half a month. During the treatment, she felt a little better, but there was no fundamental change. So I decided not to give the medicine and let her transfer to hospital for treatment. Soon, she called and said, "As Teacher Xie expected, she was diagnosed with intercostal neuralgia again. Now she is infusion every day. Please rest assured, thank you very much! "Therefore, it is very important to prevent misdiagnosis. So how to prevent misdiagnosis? It is necessary to master the characteristics and classification of herpes zoster.
(1) What are the characteristics of herpes zoster? (1) Generally, 5-7 days before the appearance of the rash, the affected area has a strange feeling (pain, itching, numbness and tightness). If it appears in the waist, it is easy to be misdiagnosed as gallstones and kidney calculi. If it appears in the chest, it is easy to be misdiagnosed as a heart or stomach disease. It was not until the rash appeared that the doctor suddenly realized. (2) There is bound to be a rash, that is, red papules or transparent blisters similar to prickly heat, which appear in clusters and bands. (3) It can occur in all parts of the body, mostly unilateral. (4) Because this disease is caused by varicella-zoster virus infection, and the main feature of this virus is nerve feeding, pain is the most important clinical feature of this disease, and 30% of patients may even have post-traumatic neuralgia for months or even years.
(2) The classification of herpes zoster? It is not enough to know the characteristics of * * *, but also to know its classification. Different herpes has different characteristics.
It falls into two categories:
The first typical herpes zoster is characterized by small-particle size blisters clustered in strips, and the blisters no longer increase.
The second type of atypical herpes zoster is divided into (1) bubble type, that is, the blisters become larger, such as soybean grains, and the largest is as big as table tennis. It can be divided into two types: one is that blisters dry and scab off, leaving no scars; The other is that it will leave scars, which is called "scar herpes". Because the scar is purplish red and protrudes outward, it is professionally called "gangrenous herpes" and it is difficult to eliminate it. (2) Concealed herpes (also known as frustrated herpes) is the most painful one, with only a few clusters of little red dot, and the skin disease is not obvious, while the virus scurfs along the deep nerve glands. (3) Generalized herpes zoster, that is, clusters of blisters appear all over the body, accompanied by high fever is the most serious type of herpes, which is very rare. (4) Herpes capitis usually occurs on one side of the face, which can damage the trigeminal nerve, and in severe cases, facial paralysis (crooked mouth) occurs. Patients with high fever will be complicated with encephalomyelitis if they are not treated properly. (5) If you have herpes in your eyes and ears, you must consult ophthalmology and ENT. Others are genital herpes, which is caused by herpes simplex virus infection. It is difficult to eliminate and easy to relapse, so it does not belong to the diagnosis and treatment of herpes zoster.
Second, is it dangerous for herpes to cross the midline?
On March 3, 20051,Aunt Wang from Douzhangzhuang Village, wuqing district came to see a doctor. She was nervous when she came. She let me have a look and said, "Teacher Xie, you see, my herpes has crossed the middle line of my waist, and my neighbor said that I died after a circle." Please help me quickly! " I said, "most people have herpes zoster only on one side, but a few people have had a midline." As long as active treatment, there is no danger at all. Don't worry! " . This treatment was effective for a week, and then it was repeated twice (out of little red dot), and finally it was fine in February.
Third, why is the curative effect of Heduo couple three times worse?
On June 25th, 2004, He Duo and his wife came to see a doctor at the same time. His wife, Zhao, was treated in XX hospital for a month, leaving a sequela in her leg, and his uncle had just been ill for four days. As a result, at the same time, Uncle He was cured in 20 days, while Aunt Zhao took two months to cure.
The reason is that He Ye took the medicine at the early stage of the disease, and the virus was quickly eliminated, and there was no major damage to the nerve line. Aunt Zhao has been in pain for a month, and the nerve line in the affected area has been damaged by more than 60%. It takes at least three times to repair the nerve.
4. What should I do if herpes patients have systemic convulsions?
On March 3rd, 2004, 54-year-old Zhang Xuehu came to see a doctor. He has been ill for more than 20 days. In addition to pain, he also has symptoms of hand twitching. After taking the medicine for three days, the pain obviously subsided, but the feeling of sobbing did not weaken, and sometimes he even convulsed all over. This is the result of the virus invading muscles and nerves. What shall we do? I suggest that he go to a general hospital for treatment. After he went to a general hospital for a diagnosis and treatment, he took anti-shake medicine (Quantianma Pill) and sedative medicine (Serpentine), and his convulsions stopped. * * * She recovered after taking the medicine for one month.
5. What are the three possible situations of post-herpetic neuralgia?
According to my experience, the treatment of this disease will encounter the following three situations:
First, the first patient took the medicine quickly and smoothly, and recovered after taking the medicine for about one month. The second drug can also take effect quickly, but it recurs after 7~ 10 days, and the pain becomes worse in a short time (cold compress can be added after taking the drug). This is because the deep virus has transferred to the skin surface. After taking the medicine for 2~3 days, it may still recur after half a month, and it will obviously improve after taking the medicine for about 2~3 months. The third patient takes effect slowly, taking effect for 5 days or even half a month, and then it will be repeated. The reason is that the damaged nerves of these patients are all caused by deep skin, and it may take about four months to take medication, so patients must be patient.
6. Why are 5% patients with postherpetic neuralgia difficult to treat?
There are five main reasons: (1) The main cause of postherpetic neuralgia is nerve injury, which will never happen overnight; (2) The disease must be treated according to the course of treatment, generally 1~4 courses of treatment, each course of treatment is one month. Because of the long time, patients may lose patience and give up halfway; (3) Most of these patients are old and weak, even bedridden, and it is not easy to improve their immunity. (4) Patients with post-herpetic neuralgia for more than four months often feel depressed and even lose confidence in life, which makes the disease more difficult to cure. (5) Patients with allergic constitution can't use traditional Chinese medicine for external use for a long time.
7. What are the factors that affect the curative effect of herpes zoster and neuralgia after herpes zoster?
The curative effect of different patients varies greatly, ranging from 7 ~ 10 days to 4 ~ 6 months. So, what factors will affect the curative effect?
(1) Age and constitution: The older you are, the weaker your constitution will be and the longer your course of treatment will be; (2) Emotion: Patients who are easily angry and angry will have a long course of treatment if they lack confidence; (3) Sleep: Adequate sleep can improve immunity. Patients often have a long course of treatment because of pain, so they should take sleep-aid drugs; (4) Fatigue: Severe patients should stop working and rest, and moderate and mild patients should also avoid overwork, otherwise it will affect the curative effect; (5) Other diseases: patients with herpes, especially post-herpetic neuralgia, are often accompanied by diseases such as diabetes, gastropathy and heart disease, and must be treated seriously at the same time to complement each other and improve the curative effect; (6) Others: The treatment time, climate and other factors will affect the curative effect.
Eight, herpes zoster patients postoperative treatment process?
The first step: look at the symptoms first, first, for diagnosis; The second is to clarify what type it belongs to; The third is to determine serious procedures in order to be aware of them.
Step 2: The patient tells himself.
The third step: psychotherapy. First of all, we must help patients find out the external causes of diseases (fatigue, gas, cold, heat, lack of sleep, etc.). ). The second is to explain the law of the disease (self-limitation), indicating that there will be repeated symptoms (pain, little red dot, blisters) during the treatment, so as to improve the patient's belief in winning.
The fourth step: drug treatment, external treatment of traditional Chinese medicine.
Nine, the general method of external treatment of traditional Chinese medicine?
1. Wipe the 1 affected area (white) and its surroundings first.
2. Wipe the affected area of 1 again (at night) and its surroundings.
3. Rub No.2 after five minutes' rest, shake well and only rub the affected area. After the patient goes home, he should paint 1 before going to bed (at night). If he wakes up in pain at night, he can paint 1 (night) 1~2 times. Enter the normal procedure the next day. During the day 12 o'clock 1 number (white), once every two days on the 2nd, and 1~2 times at night 1 number (night).
X. what are the special methods of external treatment of traditional Chinese medicine?
Atypical herpes zoster-bullous herpes zoster must take special measures as follows (divided into three types):
First, if the blister is bigger than soybean when the patient comes to the clinic, he must drain the water first, then apply 1No. (white), 1No. (night) and No.2, and finally apply Jingwanhong. (After the first night every night, add Jing Wanhong to the blistered part until the scab is fixed. )
In order to prevent bacterial infection, water must be drained carefully as follows:
(1) Sterilize with medical alcohol first.
(2) Punch a small hole in the lower part of each bubble with a sterile needle.
(3) Gently press the foam with a facial tissue to suck out the poisonous water on the facial tissue.
(4) disinfect with alcohol.
(5) Absorb water with facial tissue, repeat it for three times, and strive to suck up the poisonous water, and finally apply medicine.
The second type: If the blister is smaller than the soybean, you can apply the medicine according to the first method (adding Jingwanhong) without releasing water. After returning, the blister gradually retracts, and there is no need for a follow-up visit. Stick to applying the medicine until it is cured.
The third type: there are many viruses in the above patients, and the blisters are enlarged or even contiguous after returning home. They must come back for a follow-up visit, and then add Jing Wanhong according to the first method.
XI。 What should the patient do if he has itching?
Generally, after 1~2 courses of medication, patients will feel itchy and will recover. This is an itchy substance called "histamine" produced in the body. Generally, it can be solved by adding cold compress after Xie Huoling, which takes about 1~2 weeks. However, there are also a few patients who suffer from unbearable itching due to excessive histamine produced in the body. What should we do?
1, patients with itching can add calamine lotion (2~3 times a day) or vinegar bubble antipruritic agent.
2. If external application can't solve the problem, you can take orally the drug (Kairuitan) to prevent the production of "histamine" (take one tablet half an hour after breakfast every day, once a day, and take one tablet every two days if your stomach feels uncomfortable).
3, if not solved, it may be chronic neuritis (take VB 1 three times a day, after meals, three times a day, long-term use).
If it is not solved, you may suffer from senile itching. Ask Chinese medicine or dermatology for treatment.
Twelve, a small number of patients are allergic to the second drug?
There are two kinds of allergic reactions to drug No.2: First, if it is applied too often in one day (it should be once every two days), the applied part will be red and swollen, so you should go to the hospital to take antiallergic drugs. Secondly, the normal use of No.2 drug is also allergic, which means that touching No.2 will aggravate the pain. This patient must stop using No.2 and only use No.2 1 (white) and No.0/(late), so the curative effect will be slower.
Thirteen, patients appear repeatedly?
During the treatment of Xie's herpangolin, about 30% of patients will have minor recurrence. Repetition is a good thing, not a bad thing, so patients should not be nervous.
Why? Because repetition is the result of herpes virus transferring from deep skin to superficial skin.
There are three symptoms repeatedly: 1, and the pain is aggravated for a short time; 2. little red dot appears near the ward; 3. Small blisters appear near the ward.
The recurrence time varies from patient to patient. It usually appears one day, four days, seven days, fifteen days or even one month after application. The better the physique, the faster the recurrence time.
After relapse, patients can remain calm and insist on taking drugs. If there are blisters, apply Jing Wanhong.
The secondary cause of recurrence is the drastic change of weather, and patients will feel more pain, because the skin around the nerve has not been repaired.
Fourteen, patients appear repeatedly?
Xiepaoling has no adverse reaction. If the patient has nausea symptoms, it is likely that the patient took the western medicine "acyclovir" to treat herpes. This medicine has great side effects, and nausea is one of them. The patient must stop taking this medicine, and it's just a thank-you herpangolin.
15. Patients with dry stools?
Patients with waist herpes are likely to be accompanied by dry stool, because the virus invades the large intestine, which affects intestinal peristalsis and leads to dry stool. Generally speaking, after 4~7 days of using Xie's Herpes Ling, the stool condition improved. Before improvement, you should drink honey and take hemp soft capsules or aloe capsules.
16. What should I do if the patient stagnates during the treatment?
After using Xie's puffing spirit, most patients can take effect within 1~2 days, and take effect within 20 days. There may be stagnation after taking effect, so patients must not worry. After medication, 15 days will continue to improve.
17. Is the patient infected in the ward?
Patients with bullous type can be infected by bacteria if they rupture carelessly when draining water or after scabbing, showing pain and pus discharge. What shall we do? After thorough disinfection with medical alcohol, apply Baiduobang ointment, 1~2 days, until the scab skin is fixed and the outside is protected with gauze. After scabbing and fixation, it is confirmed that there is no pus, then the infected site will continue to use "Herpes Ling".
Eighteen, the patient has a fever?
Because the patient can't eat and sleep well for many days, the internal fire is very strong, and he may have a fever during the treatment. Generally, the fever is about 38℃, and compound aspirin can be used once every 4 hours, 4 times a day. Patients with high fever must be hospitalized.
Nineteen. Why do patients with herpes zoster leave sequelae? What should we do?
According to statistics, under the current medical conditions in China, at least 30% of patients with herpes zoster have left sequela, which is called "posthumous neuralgia" in medicine and is also a major problem in the world medical field.
The main cause of post-herpetic neuralgia is that the crude fibers of the neurofilament skin are destroyed by herpes virus, followed by the residual virus at irregular intervals.
Why do some people leave sequelae and others don't? This is related to the following factors.
1. Herpes type: herpes zoster with large blisters and many scars, which is easy to leave sequelae.
2. Age and constitution: Patients over 60 years old who are sick and have low immunity are prone to leave sequelae.
Third, the treatment method and time: people who use conventional methods without timely treatment are likely to leave sequelae, while those who use Xie's Herpes Ling for timely treatment will not leave sequelae.
So what should I do after the sequelae?
Two methods should be adopted:
(a) psychotherapy is divided into supportive therapy (that is, encouraging patients to build confidence, because this is a self-limiting disease, mainly patience); There is also puzzle-solving therapy (that is, to find out the external causes of the patient's illness and explain in detail the problems and countermeasures that will be encountered during the treatment).
(2) External treatment of traditional Chinese medicine, that is, rubbing Xie's Herpes Ling 2-4 times a day, usually takes effect in 1-2 days. One course of treatment (20 days) is effective, and the second course is consolidated. A few patients may need four courses of treatment.
At present, the popular medical opinion that there is no specific medicine for this disease is very wrong and harmful!
20. Why is the patient swollen locally? What should we do?
Herpes zoster virus has the characteristic of "wandering". When it swims, it is likely to stimulate nearby cells, and then the cells will increase, so edema will occur, especially in the head and arms. The patient need not panic. After taking No.2 medicine, the edema subsided in 3~5 days.
Twenty-one, a few patients have the uncomfortable feeling of strangulation, why?
This is a rare discomfort in patients with postherpetic neuralgia, and the symptoms mainly occur in the anterior lumbar region. The reason is that the internal intestinal nerve injury is too serious, so it takes about six courses of treatment (12 group) to solve it. Patients must be patient.
22. Why can't some patients touch clothes when they are in pain?
This is because a small number of patients' skin nerve endings have been eaten by the virus, so clothes can't be touched, and it hurts when touched, even when coated with medicine. Patients must be patient, otherwise they can't be cured.
23. Why is the second medicine rubbed once every two days?
The main function of "Xie's Herpes Ling" No.2 is to pull out the deep-seated virus in the body, followed by detumescence, pain relief and dryness. If you use too much, the virus will move out too much and too fast, and the patient will feel pain, so you can wipe it once every two days. Only patients with severe itching or edema can apply it once a day, but it should be used after the first day (white) and not at night. Some patients are even allergic to the second medicine (it hurts when rubbed). Such patients can stop using the second medicine and only use the first medicine (white) (late stage), which will prolong the treatment time.
Twenty-four, why use Jing Wanhong?
Patients with blisters (small bubbles do not drain, big bubbles need to drain) need to apply Jingwanhong. The reasons are as follows: ① Jing Wanhong can prevent bacterial infection; (2) relieving pain and scars; ③ suppuration and granulation.
Twenty-five, cancer patients come for help, what should I do?
Herpes zoster is induced by the sharp decline of immunity in cancer patients during chemotherapy. The oncologist was at a loss, and the patient's family came for help. What should I do? I have been diagnosed and treated, and patients with intestinal cancer, bone cancer, breast cancer and lung cancer are all cured with Xie's herpangolin, which relieves their pain.
Twenty-six, how to diagnose patients with herpes zoster before onset?
Patients are often misdiagnosed because there are no red spots or blisters before rash, such as heart disease in the chest and stones in the waist, which delays the treatment opportunity. So, how to confirm the rash before it breaks out?
① Pain is on one side of the body; ② Pain is a throbbing sting; ③ The pain site is not fixed; (4) fever in the painful part; ⑤ Herpes virus is "time-sensitive" if the pain intensifies between 12 pm and 3 am. Those who meet the above five conditions can generally be diagnosed as occult herpes zoster, and those who have a rash and relieve pain after taking the medicine are more proved to be the disease. If there is no rash or pain relief at all, you should go to the hospital for examination and diagnosis.
Twenty-seven, why did the three drugs rise at the same time when they were first diagnosed?
When the patient is treated for the first time, the three medicines should be taken together. The first medicine (white) should be applied first > the first medicine (night)-> the second medicine should be applied within five minutes. The reason is that this can make patients take effect on the same day, and some even take effect after 20 minutes, which can relieve patients' pain, greatly increase their confidence, and have more trust in Xie's herpangolin, which is of great significance for future treatment. Because the first (white) main tube stops bleeding, cools blood and repairs nerves; 1 (night watch) relieves pain and itching and kills viruses; No.2 supervisor detoxifies and detumescence. The effects of the three drugs are remarkable, and patients feel amazing, and they will be transferred to the normal medication program in the future. For patients with no obvious effect, one (night) can be added after one (white).
28. What measures should mail-order patients take before receiving medicine?
We should take Virulin orally (moroxydine tablets); 2 You can use cold compress when it hurts (put a plastic bag on the cold towel); ③ Apply Jingwanhong to the affected area for those with blisters (twice a day); 4 Fenbid (one capsule) can be taken after meals; ⑤ Take sleeping AIDS (serpentine tablet, oryzanol tablet, VB 1 tablet) before going to bed; 6. Patients with fever should see a doctor to reduce their fever.
Twenty-nine, in order to increase the curative effect, can you add some oral medicine?
Generally, patients only need to apply 1 No.2 externally, and patients with fever can take anti-inflammatory and antipyretic drugs. Some acute patients and patients with severe pain can take Niuhuang Xiaoyan tablets (which can play an anti-inflammatory and analgesic role). In addition, you can also take five quick-acting jiuxin pills (which can promote blood circulation and relieve pain) one hour after meals.
Can herpes patients take a bath?
Yes, but it is not advisable to take a bath with hot water. It is wise to take a bath. Don't use soap on the affected area when taking a bath. Be sure to dry it and apply medicine after bathing.
What are the four characteristics of herpes zoster virus?
1. gluttony (that is, liking to eat crude fibers of nerve endings and exposing nerve lines is the root cause of neuralgia after herpes zoster); 2, wandering, leading to repeated rash may appear in other places; 3, like hot compress, the more severe the rash hot compress, it should be cold compress; 4, timely, active at night 12~3, so if you wake up when you sleep, you must add a number one (night).
32. What treatment do Secretary Li and Academician Wu ask for?
Li Zhijian, director of the State General Administration of Sports (ministerial level), went to Beijing for treatment on September 1 2006. He has been in pain for 10 months, and the methods of Beijing 30 1 and other big hospitals have all been exhausted and have not been solved. Later, I went to see him for treatment, and it worked on the same day, and it was fine after two courses of treatment.
Wu Xianzhong, an academician of China Academy of Engineering and the old dean of Tianjin Nankai Hospital, endured the pain for a year and a half. In major hospitals in Tianjin, all kinds of methods have been exhausted, and the pain has not been alleviated. On February 25th, 2008, he asked me for help. After diagnosis and treatment, it was effective at that time, and it was fine after two courses of treatment. Lao Xu, secretary of Anhui Provincial Party Committee, suffered for four months. Director Liu of Beijing Railway General Administration is a ministerial leader, and Zhang Lao, president of Tianjin Institute of Medicine, suffered for five months. Zhang Lao later turned to me and achieved satisfactory results. The old man once said to me, "the director of dermatology in the hospital didn't cure my pain." I was very angry and said, "Your skills are too bad." The director asked me, "You are the dean of medical school. You haven't developed any drugs yet. How should I treat you? " ……
To sum up, it shows that there is no specific medicine and method for treating postherpetic neuralgia in China at present. Our secret recipe can break it. (It has been confirmed by the history of diagnosis and treatment for a hundred years)