(1) Common cases.
1. General treatment: Pay attention to isolation and avoid cross-infection. Get proper rest, eat a light diet, and take good oral and skin care.
2. Symptomatic treatment: Fever and other symptoms are treated with a combination of traditional Chinese and Western medicine.
(2) Severe cases.
1. Treatment of nervous system involvement.
(1) Control intracranial hypertension: limit the amount, and actively give mannitol to lower intracranial pressure, 0.5-1.0g/kg each time, once every 4-8 hours, 20-30 minutes rapid intravenous injection. Adjust the dosing interval and dosage according to the condition. Add furosemide if necessary.
(2) Apply glucocorticoid treatment as appropriate, reference dosage: methylprednisolone 1mg-2mg/kg·d; hydrocortisone 3mg-5mg/kg·d; dexamethasone 0.2 mg-0.5 mg/kg·d. After the condition stabilizes, reduce the dose or stop using it as soon as possible. If individual cases progress rapidly and the condition is severe, an increase in dose may be considered. For example, methylprednisolone 10mg-20mg/kg·d (maximum single dose not exceeding 1g) or dexamethasone 0.5mg-1.0 should be given within 2-3 days. mg/kg·d.
(3) Intravenous immune globulin should be administered as appropriate, with a total dose of 2g/kg and given in 2-5 days.
(4) Other symptomatic treatments: cooling, sedation, and arresting convulsions.
(5) Closely observe changes in condition and monitor closely.
2. Treatment of respiratory and circulatory failure.
(1) Keep the respiratory tract open and inhale oxygen.
(2) Ensure that the two venous channels are unobstructed and monitor respiration, heart rate, blood pressure and blood oxygen saturation.
(3) When respiratory dysfunction occurs, tracheal intubation should be performed promptly and positive pressure mechanical ventilation should be used. It is recommended that the initial adjustment parameters of the ventilator are: inspired oxygen concentration 80%-100%, PIP 20-30cmH2O, PEEP 4-8cmH2O , f 20-40 times/min, tidal volume is about 6-8ml/kg. Adjust ventilator parameters at any time based on blood gas and X-ray chest X-ray results. Give appropriate sedation and analgesia. If there are symptoms of pulmonary edema or pulmonary hemorrhage, PEEP should be increased, and nursing operations that reduce respiratory tract pressure such as frequent sputum suctioning should not be performed.
(4) While maintaining stable blood pressure, limit the amount of fluid intake (if possible, adjust the fluid amount based on central venous pressure, cardiac function, and invasive arterial pressure monitoring).
(5) Elevate the head and shoulders 15-30 degrees and maintain a neutral position; leave an indwelling gastric tube, catheter
, and urinary catheter.
(6) Drug application: Milrinone, dopamine, dobutamine and other drugs can be used according to changes in blood pressure and circulation; diuretic drugs can be used as appropriate.
(7) Protect the functions of important organs and maintain the stability of the internal environment.
(8) Monitor blood sugar changes, and use insulin when severe hyperglycemia occurs.
(9) Inhibit gastric acid secretion: gastric mucosal protective agents and acid suppressants can be used.
(10) Give antibiotics for secondary infection.
3. Recovery period treatment.
(1) Promote the recovery of functions of various organs.
(2) Functional rehabilitation treatment
(3) Integrated traditional Chinese and Western medicine treatment.
(3) Traditional Chinese medicine treatment.
1. Common cases: lung and spleen damp-heat syndrome
Main symptoms: fever, maculopapular rash and herpes on the hands, feet and buttocks, scattered herpes on the oral mucosa, red throat, salivation, A tired look, pale or red tongue, greasy coating, rapid pulse, and red and purple fingerprints.
Treatment method: clear away heat and detoxify, remove dampness and eliminate evil
Basic prescription: Modified Manlu Disinfectant Pill
Forsythia suspensa, honeysuckle, skullcap, artemisia annua, burdock Seeds of seeds, Patchouli, Peilan, Tongcao, raw barley, talc (fried), raw licorice, Imperata cogongrass root
Usage and dosage: Determine the dosage of the drug according to the age and weight of the child. Decoct 100-150 ml of water and take it orally in 3-4 times.
Additions and subtractions:
(1) Add rhubarb for constipation;
(2) Add ginseng and isatis root for swelling and pain in the throat;
Chinese patent medicines: Lanqin Oral Liquid, Pediatric Chiaoqiao Qingre Granules, Jinlian Qingre Effervescent Tablets, Antiviral Oral Liquid, etc.
2. Common cases: damp-heat syndrome
Main symptoms: high fever, dull rash, oral ulcers,
>, lethargy, tongue Red or crimson, less fluid, yellow and greasy coating, thready and rapid pulse, dark purple fingerprints.
Treatment: Clear Qi, cool the camp, detoxify and reduce dampness
Basic prescription: Qingwen Baidu Decoction
Forsythia, Gardenia, Scutellaria baicalensis, Coptis chinensis, raw gypsum, anemarrhena, paeonol bark, red peony root, raw barley, Sichuan barley, buffalo horn
Usage and dosage: The dosage of the drug should be determined according to the age and weight of the child. One dose per day, decoct 100-150 ml in water, take orally or instill in colon in 3-4 times.
Chinese patent medicines: Zixuedan or Xinxuedan, etc.; Reduning Injection, Xiyanping Injection, Danshen Injection, etc.
3. Severe cases: toxic heat and wind syndrome
Main symptoms: high fever that does not subside, easy to startle, vomiting, muscle twitching, or weakness of limbs, or even coma. , dark red or crimson tongue, yellow greasy or yellow dry coating, stringy and thready pulse, purple and stagnant fingerprints.
Treatment method: detoxify, clear away heat, extinguish wind and calm convulsion
Basic prescription: Lingyang Uncaria Decoction with modifications
Lingyang horn powder (taken in a dilute form), Uncaria and Gastrodia elata , raw gypsum, coptis, raw gardenia, rhubarb, chrysanthemum, raw barley, whole scorpion, white silkworm, raw oyster
Usage and dosage: The dosage of the drug should be determined according to the age and weight of the child. One dose per day, decoct 100-150 ml in water, take orally or instill in colon in 3-4 times.
Chinese patent medicines: Angong Niuhuang Pills, Zixuedan or Xinxuedan, etc.; Reduning Injection, Tanreqing Injection, Xiyanping Injection
4. Critical illness Type case: Heart-yang style micro-lung qi-desire syndrome
Main symptoms: persistent heat, dizziness and shortness of breath, cold hands and feet, pale and dull complexion, cyanosis of the lips, and pink or bloody foam ( phlegm), tongue texture
dark purple, thready or slow pulse, or weak pulse, dark purple fingerprints.
Treatment method: Restore yang and save the disease
Basic prescription: Shenfu decoction with added flavor
Ginseng, Paofuzi, Cornus
Usage and dosage: The dosage of the drug is determined according to the age, weight, etc. of the child. One dose per day, thick decoction for nasogastric feeding or colonic infusion.
Chinese patent medicines: Shenmai Injection, Shenfu Injection, etc.
5. Recovery period: Insufficient Qi and Yin and lingering evils
Main symptoms: low-grade fever , fatigue, or accompanied by weakness of limbs, poor appetite, light red tongue, thin and greasy coating, and thready pulse.
Treatment: Replenish qi and nourish yin, remove dampness and dredge collaterals
Basic prescription: Shengmai Powder with flavoring
Ginseng, Schisandra chinensis, Ophiopogon japonicus, Polygonatum odorifera, Artemisia annua, papaya, clematis, angelica root, loofah, and licorice
Usage and dosage: The dosage of the drug should be determined according to the age and weight of the child. One dose per day, decoction in water and divided into 3-4 times orally.
Acupuncture and massage: People with hand, foot and mouth disease combined with flaccid paralysis should carry out acupuncture, massage and other rehabilitation treatments as soon as possible when entering the recovery period.
6. External treatment method
Oropharyngeal herpes: Qingdai Powder, Shuanglihuofeng Powder, Bingbo Powder, etc. can be used, 2-3 times a day.