Infectious mononucleosis is an acute infectious disease caused by EB virus infection. It is characterized by fever, superficial lymphadenopathy, rash, hepatosplenomegaly and even myocardial damage. Most of them occur in school-age children, especially in spring and autumn. This disease belongs to the category of "febrile disease" in traditional Chinese medicine. Etiology Pathology Exogenous pathogens enter the lung and stomach through the nose and mouth, so they are manifested as fever, cough and choking, sore throat, endogenous heat toxin that causes fire to enter the stomach for a long time, dispute between good and evil, phlegm-heat interaction, qi stagnation and blood stasis leading to scrofula, blood rush, burning collaterals, blood extravasation, rash, purpura and hematuria. Insufficient qi and blood, blocked operation, liver and spleen will be swollen due to congestion. Diagnostic point 1. Have a history of popularity and contact. 2. The main symptoms are irregular fever, sore throat, white rot of tonsils, swollen lymph nodes in neck and back and beside sternocleidomastoid muscle, dermatitis, hepatosplenomegaly, nosebleed, hematuria and joint pain. 3. Liver involvement may have jaundice; The nervous system can show the symptoms of aseptic meningitis; Cardiovascular system may have symptoms of myocarditis and pericarditis; Respiratory system is involved, and the chest X-ray film has patchy infiltration shadow. Most of the symptoms of infants and young children are mild, only showing symptoms of upper respiratory tract infection. 4. Laboratory examination showed that white blood cell count increased and monocytes increased, among which abnormal lymphocytes accounted for more than 10% ~ 25%. Heterophilic agglutination test showed that the titer was above 1: 56, which was of diagnostic significance. Dialectical classification 1. Symptoms of exogenous cold: cough, runny nose, sore throat, moth-eaten, white face, body heat fluctuation, nausea, abdominal discomfort, white tongue coating and floating pulse. Syndrome analysis: exogenous pathogenic toxin, lung attack first, lung failure to publicize, so cough and runny nose. Pathogenic heat is smoked along meridians, so moths are swollen and have chyme on their faces. Evil is contending, camp and health are at odds, and body heat fluctuates. Then the evil poison invades the stomach, which causes nausea and abdominal discomfort. White fur and floating pulse indicate that evil is still in the exterior. 2. Symptoms of hyperactivity of fire due to yin deficiency: refractory body heat, thirst, loss of appetite, low fever, night sweats, hepatosplenomegaly, dark red tongue, thin and white fur, and thready pulse. Syndrome analysis: evil toxin is abundant in the interior, which hurts yin, so the body heat is indissoluble and thirst leads to drinking. Yin deficiency and internal heat lead to low fever and night sweats. Heat burning blood vessels, blood stasis is not good, so see hepatosplenomegaly. 3. Symptoms of excessive toxic heat: persistent fever, thirst and irritability, subcutaneous hemorrhage, or hematuria, red tongue, yellow fur and rapid pulse. Syndrome analysis: the heat toxin is abundant, so the excess heat does not subside, and thirst leads to drinking. It disturbs the gods, so it is restless. Pathogenic heat forces blood to run wildly, spilling over the skin and infiltrating into the lower coke, leading to subcutaneous bleeding or hematuria. The tongue is red, the coating is yellow, and the pulse is the sign of excessive heat and toxin. 4. Syndrome of damp-heat accumulation: yellow complexion, nausea and vomiting, no appetite, false stool, hepatosplenomegaly, white and greasy fur, and thready pulse. Syndrome analysis: Congenital deficiency, spleen deficiency leading to dampness, exogenous pathogenic factors and reinfection of toxic substances combine to cause damp heat, which accumulates in the liver and gallbladder, leading to liver failure and bile overflow, so the eyes are yellow. Liver wood invades the spleen, so nausea and vomiting, eating less fruit, and false stool. Damp heat consumes yin and blood, and if blood stasis fails, hepatosplenomegaly will occur. The fur is white and greasy, and the pulse is Confucian, which is the image of damp heat. Typing therapy 1. Treatment principle of exogenous cold: dispelling wind, clearing heat and relieving sore throat. Main prescription: Yinqiao powder is modified. Addition and subtraction: moth white spot, plus Belamcanda 10g, puffball 6g; Body heat fluctuation, adding Cynanchum atratum 10g, Anemarrhena asphodeloides 10g. Principal analysis: this syndrome belongs to exogenous heat toxin, and the disease is still in the exterior. Yinqiao powder can dispel wind, clear away heat and relieve sore throat, thus eliminating evil toxin. Example of prescription: honeysuckle 10g forsythia suspensa 10g isatis root, 30g Bupleurum root, 6g Scutellaria baicalensis Georgi 10g Hedyotis diffusa 15g cogongrass rhizome, 30g Paeonia Rubra 10g Paeonia suffruticosa 10g Glycyrrhiza 6g 2. Treatment of yin deficiency and fire flourishing: nourishing yin and clearing heat. Main prescription: Danggui Huang Liu Decoction. Add and subtract: night sweats, add 30 grams of oyster (fried first) and 6 grams of Schisandra chinensis; Thirst, add 30 grams of reed rhizome and 0/0 gram of Dendrobium/kloc; Hepatosplenomegaly plus turtle shell Wan Jian 10g (Baojian). Principal component analysis: this syndrome is the syndrome of heat toxin injuring yin and yin deficiency causing excessive fire. The root of this syndrome lies in clearing away heat, so the heat of Scutellaria baicalensis Georgi, Coptidis Rhizoma and Phellodendron amurense, together with Radix Rehmanniae, Radix Rehmanniae Preparata and Radix Scrophulariae, are used to nourish yin, while Angelica sinensis and Astragalus membranaceus are used to nourish blood and replenish qi, thus * * * plays the role of nourishing yin and clearing heat. Examples of prescriptions: Angelica sinensis 10g Coptis chinensis 3 g Cortex Phellodendri 10g Radix Rehmanniae 10g Fructus Schisandrae Chinensis 6 g Radix Rehmanniae 10g Radix Scutellariae 10g Radix Astragali 10g Radix Scrophulariae 10g Radix Glycyrrhizae 6g.3. Treatment of excessive heat toxicity. Main prescription: Qingying decoction is modified. Add or subtract: for subcutaneous hemorrhage, add Radix Paeoniae Rubra 10g and Cortex Moutan10g; Hematuria, increase 10g Cirsium japonicum and 30g lalang grass rhizome. Analysis of the main prescription: this prescription is that the evil heat toxin goes deep into the camp and forces the blood to rush, so Qingying Decoction is used to clear heat, cool blood and stop bleeding. Fang used rhinoceros horn and Radix Rehmanniae to clear heat and cool blood; Lonicera japonica Thunb. and Forsythia suspensa Thunb. Coptis chinensis and bamboo leaves love fire; Salvia miltiorrhiza has the functions of clearing heart fire, cooling blood, promoting blood circulation and removing blood stasis; Adding Radix Scrophulariae and Radix Ophiopogonis to nourish yin and promote fluid production. Examples of prescription: buffalo horn 30g (stir-fried first), Scrophularia10g, bamboo leaves10g, honeysuckle 6g, forsythia suspensa10g, coptis root 3g, salvia miltiorrhiza10g, Ophiopogon japonicus10g, licorice root/0g. 4. Treatment principle of damp-heat accumulation: clearing heat and promoting diuresis. Main prescription: Jiawei Ganlu Xiaodu Dan. Addition and subtraction: hepatosplenomegaly, turtle shell 15g, salvia miltiorrhiza10g; For nausea and vomiting, add 6g of Jiang Zhuru and10g of Jiang Banxia. Analysis of the main prescription: this syndrome begins with damp-heat accumulation, and can not be cured after a long illness. It is advisable to use Ganlu Disinfection Dan to clear away heat and promote diuresis and eliminate filth. The prescription uses Scutellariae Radix, Fructus Forsythiae, Rhizoma Belamcandae and Bulbus Fritillariae Cirrhosae to clear away heat and toxic materials and resolve phlegm; The aroma of Pogostemon cablin, Cardamom and Acorus gramineus becomes moist and turbid; Talc, Akebia Akebia and Herba Artemisiae Scopariae can clear away dampness and heat; Mint is cool and penetrating; Shoot Li Qing in the throat. Examples of prescriptions: Herba Artemisiae Scopariae 10g Gardenia 10g Radix Astragali 10g Rhizoma Acori Graminei 10g Rhizoma Alismatis 10g Caulis Akebiae 10g Fructus Forsythiae 10g Nutmeg (below) and Herba Agastaches/kloc-0. 2. Niuhuang Jiedu tablets 2 tablets each time, 3 times a day. 3. Banlangen Granules are taken orally three times a day, each time 1 pack. Simple prescription 1. Artemisia annua 10g, Carapax Trionycis 15g, Radix Adenophorae 10g, Radix Ophiopogonis 10g, Radix Bupleuri 10g, Rhizoma picrorhizae 6g, and Cortex Lycii 10g, decocted in water, and used for hyperactivity of fire due to yin deficiency. 2. Flos Lonicerae 65,438+05g, Fructus Forsythiae 6g, Herba Menthae 6g, Radix Puerariae 65,438+05g, Gypsum 30g, Radix Isatidis 65,438+05g, Folium Bambusae 65,438+00g, and fresh Rhizoma Phragmitis 65,438+05g, decocted in water, and used when heat and toxicity are excessive or cold is exogenous. Precautions for other therapies 1. Observe the changes of children's body temperature, breathing and heart rate, and judge whether there are multiple systems involved. 2. Stay in bed, keep your oral skin clean, have a light diet and drink plenty of water. 3. The symptoms are acute and severe, and it is appropriate to treat with integrated traditional Chinese and western medicine. /TCM/zyxx/zy/ Kerr /crb/ 1 137/