english
Overview:
A boil is an acute purulent inflammation of multiple adjacent hair follicles, sebaceous glands, or sweat glands caused by Staphylococcus aureus. In the initial stages, it presents as a diffusely infiltrated hard mass, which is purple-red on the surface, tense and shiny. It then becomes purulent, with tissue necrosis, and multiple abscesses may appear, with pus draining from the hair follicle openings, forming a honeycomb-like structure with pus heads. Necrotic pus plugs may be present, and lymphadenitis, lymphangitis, and phlebitis are common complications. The affected area is extremely painful, often accompanied by systemic symptoms such as fever and chills. The white blood cell count is typically elevated, with neutrophils predominating. Boils are commonly seen in the dense subcutaneous tissues of areas like the back and neck.
Etiology and Pathogenesis:
This disease falls under the category of “head abscess” in traditional Chinese medicine (TCM). TCM attributes the condition to an external invasion of toxic wind-heat or a combination of damp-heat. This leads to the stagnation of Qi and blood, causing the toxic substances to accumulate in the skin and flesh. When originating internally, it may result from emotional distress (such as anger), which generates internal heat, or from a weakened body due to excessive physical exertion, leading to kidney deficiency and imbalances in water and fire. It can also be caused by improper diet, leading to spleen and stomach dysfunction, internal damp-heat, and toxin accumulation. Based on clinical presentation, this condition can be divided into two main categories: excess syndrome and deficiency syndrome, with excess syndrome being more common. Therefore, the primary treatment approach involves regulating the Qi and expelling toxins, clearing heat, and promoting diuresis.
Differentiation and Treatment:
Excess Syndrome:
Symptoms: Early stages show small, grain-like pus heads on the skin, which are itchy and painful. Pus spots spread outward, becoming increasingly numerous, with redness, swelling, burning pain, and the ulcerated surface becoming necrotic. After the pus is discharged, the wound resembles a honeycomb and is often accompanied by chills, fever, headache, constipation, and dark, scanty urine. The tongue coating is thin, white or yellow, and the pulse is rapid and strong. This corresponds to the purulent stage.
Treatment Method: Harmonize the Qi, expel toxins, clear heat, and promote diuresis.
Prescription: Modified Xianfang Huo Ming Yin (a traditional formula).
Herbs:
10g Angelica
15g Honeysuckle
12g Forsythia
15g Viola
10g Dried tangerine peel
15g Red peony root
10g Fritillaria
15g Soapberry
10g White angelica root
6g Frankincense
6g Myrrh
15g Tianhua Fen
10g Licorice root
Modifications: If there are chills and fever, add 12g Schizonepeta, 10g Saposhnikovia. If there is constipation, add 10g Rhubarb, 15g Immature bitter orange. If there is dark urine, add 10g Mutong, 15g Alisma, 30g Plantago seed.
Deficiency Syndrome (commonly seen in elderly or diabetic, anemic patients):
(1) Healing Phase: As the abscess begins to heal, pus and necrotic tissue gradually recede, and new tissue begins to grow. Generally, no oral medication is required.
**(2) If both Qi and blood are deficient, healing is slow, with the wound appearing flat and dull, and pus discharge is slow. The necrotic tissue is difficult to expel, and the pus is thin and grayish-green. Swelling and pain are not obvious, with symptoms of fatigue, pale complexion, loose stools, frequent urination, thirst without a desire to drink, and pale tongue with a thin coating and fine pulse.
Treatment Method: Tonify Qi and blood, support the body’s defenses, and expel toxins.
Prescription: Modified Tuo Li Xiao Du San (a traditional formula).
Herbs:
15g Codonopsis
15g Astragalus
10g Angelica
10g White peony root
10g Atractylodes
15g Poria
10g Tangerine peel
30g Fragrant grain bud
6g Roasted Licorice
20g White ginger
15g Honeysuckle
10g Platycodon
**(3) If there is insufficient Yin fluid and excessive fire toxicity, the abscess appears flat, the edges spread, and the skin is purple and congested. Pus discharge is slow, and the necrotic tissue is difficult to expel. The pus is scanty and may be blood-tinged, with severe pain and high fever, dry lips, dry mouth, constipation, short and dark urine, little appetite, and a red tongue with yellow coating and fine, rapid pulse.
Treatment Method: Nourish Yin, generate body fluids, clear heat, and expel toxins.
Prescription: Modified Zhu Ye Huang Qi Tang (a traditional formula).
Herbs:
30g Rehmannia
12g Ophiopogon
12g Dendrobium
12g Bamboo leaf
10g Angelica
10g Licorice
30g Astragalus
15g Viola
15g Honeysuckle
15g Tianhua Fen
Modifications: If liver and kidney deficiency is present, use Liu Wei Di Huang Wan with additional 15g Honeysuckle and 15g Soapberry.
External Treatment:
Topical Medicine: In the early stage, use Si Huang San (a powder) or Jin Huang San (a paste) to apply to the affected area 1-2 times daily. After the abscess breaks, apply Si Huang Gao (a paste) to promote wound healing. If necrotic tissue is difficult to remove, apply Hua Fu Sheng Ji San to assist in tissue expulsion and aid in wound healing.
Surgical Treatment: In cases of large boils, surgical removal of the abscess may be considered, and skin grafting may be required during the recovery phase.
chinese
4.痈
【概述】
痈是金黄色葡萄球菌引起的多个相邻的毛囊或皮脂腺或汗腺的急性化脓性炎症。
痈 – yōng – carbuncle
金黄色葡萄球菌 – jīn huáng sè pú táo qiú jūn – Staphylococcus aureus
引起 – yǐn qǐ – cause
多个 – duō gè – multiple
相邻 – xiāng lín – adjacent
毛囊 – máo náng – hair follicle
皮脂腺 – pí zhī xiàn – sebaceous gland
汗腺 – hàn xiàn – sweat gland
急性 – jí xìng – acute
化脓性 – huà nóng xìng – suppurative
炎症 – yán zhèng – inflammation
初期为炎性弥漫性浸润硬块，表面呈紫红色，紧张发亮，继而化脓，组织坏死，甚至出现多个脓点，脓液由多个毛囊口排出，形成蜂窝状，脓头，其中有坏死脓栓，易发生淋巴结炎，淋巴管炎静脉炎，患处剧痛，伴有发热胃寒等全身症状。血象中白细胞总数常明显增高，分类见中性白细胞增加，好发于背，颈部等皮下组织致密部位。
【病因病机】
本病属于中医有头疽痈范畴，中医认为本病从外而起者，由感受毒邪风热相博，湿热交蒸。以致气血淤滞，毒邪凝聚皮肉之内而成。从内而起者或因七情内郁，气郁化火，或由房室劳伤精气，以致肾水亏损水火不济，阴虚则火邪炽盛；或由于平素膏粱厚味，以致脾胃运化失常，湿热火毒内生，脏腑蕴毒，经络阻塞营卫不和气血凝滞，根据临床辨证，可分为实证、虚证两大类。但以实证最为多见，故治以和营托毒，清热利湿为主。【辨证论治】
1.实证
症状：初起，皮肤有粟粒样脓头，作痒作痛，继向周围扩散脓点亦相继增多，发红高肿，灼热疼痛，疮面渐腐烂，溃后如蜂窝状伴有寒热，头痛，便秘溲赤，舌苔薄白或黄腻，脉象洪数者，此属化脓期。
治法：和营托毒清热利湿
方药：方取仙方活命饮加减。
处方：当归10克，银花15克，连翘12克，紫花地丁15克，陈皮10克，赤芍15克，大贝母10克，皂角刺15克，炮甲珠10克，白芷10克，乳香，没药各6克。天花粉15克，生甘草10克。
加减：如寒热者加荆芥12克，防风10克，便秘者加生大黄10克，枳实15克，溲赤者加木通10克，泽泻15克，车前子30克。2.虚证（多见于年老体质衰弱或糖尿病贫血患者）：
（1）收口期：可见患处脓腐渐退，新肉开始生长逐渐愈合，一般不需内服药。
（2）如气血两亏创口愈合迟缓，疮形平塌散漫疮色灰暗不泽，化脓迟缓，腐肉难脱，脓水稀薄，色带灰绿闷肿胀痛不显，大便溏薄小便频数口渴不欲饮，神疲乏力，面色少华，舌淡苔薄，脉细。
治法：调补气血，扶正托毒。
方药：方取托里消毒散加减。
处方：党参、黄芪各15克，当归、白芍、白术各10克，茯苓15克，陈皮10克，香谷芽30克，炙甘草6克，白笈20克，天丁15克，银花15克，桔梗10克。
（3）凡虚证阴液不足，火毒炽盛，局部出现疮形平塌，根盤散漫，疮面紫滞，不易化脓，腐肉难脱，溃出脓水稀少，或带血水，并且疼痛剧烈，出现高热唇燥口干，大便秘结，小便短赤，饮食少思，舌质红苔黄脉细数。
治法：滋阴生津，清热托毒。
方药：竹叶、黄芪汤加减。
处方：生地30克，麦冬12克，石斛12克，竹叶12克，当归10克，甘草10克，黄芪30克，紫花地丁15克，银花15克，天丁15克。
如肝肾亏损，阴液不足的宜滋养肝肾，用六味地黄汤加银花15克，皂角刺15克。外治法：
外 (wài) = external/outside/outer
治 (zhì) = treat/cure/govern
法 (fǎ) = method/law/way
（1）外敷药物：早期选用四黄散（黄连30克，黄柏、大黄、黄芩各90克，
外敷 (wài fū) = external application/applying externally
药物 (yào wù) = medicine/medication
四黄散 (sì huáng sǎn) = “Four Yellow Powder”, containing:
黄连 (huáng lián) = Coptis chinensis, 30g
黄柏 (huáng bǎi) = Phellodendron bark, 90g
大黄 (dà huáng) = Rhubarb root, 90g
黄芩 (huáng qín) = Scutellaria baicalensis, 90g
共研细末）。金黄散（大黄、黄柏、姜黄、白芷各2500克，生南星、陈皮、苍术、厚朴、甘草各1000克，天花粉5000克，共研细末）蜜调为糊状，敷患处，每日1～2次。溃后用四黄膏，生肌托毒之类；腐肉难脱落的，可掺上化腐生肌散，以促进坏死组织脱落，有利于伤口愈合。
（2）病灶清除：大面积痈，可考虑手术治疗，后期须植皮。
khmer
burmese
vietnamese
indonesian
russian
Japanese
korean
Arab
Hindi
Filipino
Cantonese ,
Italian
French
German
Spanish
Turkish
Portuguese
Bengali
Malay
Tamil
Telugu
Hebrew
Persian
Urdu
Pashto
Swedish
Swahili
Laos
Shan
Hausa
Marathi
Gujarati
Norwegian
Danish
Uzbekistan
Kazakhstan
Polish
Greek
Armenian
Amharic
Xhosa
Hungarian
Tamazight
Kurds
jn – 四黄散联合间断垂直钢丝缝合加张力带对髌骨下极骨折患者膝关节活动度及骨折愈合时间的影响
四黄散 – sì huáng sǎn – Four Yellow Powder
联合 – lián hé – combine/joint
间断 – jiān duàn – intermittent/interrupted
垂直 – chuí zhí – vertical
钢丝 – gāng sī – steel wire
缝合 – féng hé – suture
张力带 – zhāng lì dài – tension band
髌骨 – bìn gǔ – patella/kneecap
下极 – xià jí – inferior pole
骨折 – gǔ zhé – fracture
患者 – huàn zhě – patient
膝关节 – xī guān jié – knee joint
活动度 – huó dòng dù – range of motion
愈合 – yù hé – healing
时间 – shí jiān – time
影响 – yǐng xiǎng – effect/influence
手术技巧：髌骨下极骨折的固定、缝合术式！
手术技巧 – shǒu shù jì qiǎo – surgical technique
髌骨 – bìn gǔ – patella/kneecap
下极 – xià jí – inferior pole
骨折 – gǔ zhé – fracture
固定 – gù dìng – fixation
缝合 – féng hé – suture
术式 – shù shì – surgical procedure/method
手术的主要目的是恢复关节面和伸膝装置
主要 – zhǔ yào – main/primary
目的 – mù dí – purpose
恢复 – huī fù – restore/recover
关节面 – guān jié miàn – articular surface
和 – hé – and
伸膝 – shēn xī – knee extension
装置 – zhuāng zhì – mechanism/apparatus
w – 金黄色葡萄球菌感染
症状 , 诊断 , 治疗 , 预防
|
其它金黄色葡萄球菌感染
症状 – zhèng zhuàng – symptoms
诊断 – zhěn duàn – diagnosis
治疗 – zhì liáo – treatment
预防 – yù fáng – prevention
其它金黄色葡萄球菌感染 – qí tā jīn huáng sè pú táo qiú jūn gǎn rǎn – other Staphylococcus aureus infections