Disease symptoms
A knot in one's heart often grows on one or both sides of the neck, which grows up gradually, without pain or itching, sliding and no obvious tenderness. If the body's resistance is low, it will gradually increase, and the skin will turn purple. Finally, watery pus will erupt and yellow turbid cheese-like pus will be discharged, which is called "rat sore" in Chinese medicine. Recurrent ulcers are rare, and some patients may have symptoms of systemic poisoning such as low fever, night sweats, loss of appetite and emaciation.
Edit the paragraph on etiology and pathology.
There are two causes of lymph node tuberculosis: one is the primary focus caused by Mycobacterium tuberculosis infecting the oral cavity and nasopharynx, especially the tonsil gland, through the upper respiratory tract or with food. Posterior lymphatic vessels reach superficial and deep lymph nodes in the neck. Most sites are unilateral lymph nodes. Affected pharynx. After absorption after severe illness, the affected lymph nodes continue to develop into cold abscess or ulcer.
The other is that after primary tuberculosis infection, mycobacterium tuberculosis in the blood enters the medial cervical lymph nodes with the blood, causing cervical lymph node tuberculosis; It can also spread from waist and abdomen lymph nodes to deep lymph nodes for secondary infection, which is more common in the pathogenesis of cervical lymph node tuberculosis.
Edit this lymph node nuclear typing.
Classification of tuberculosis in lymph nodes: caseous tuberculosis, proliferative tuberculosis, mixed tuberculosis and unresponsive tuberculosis.
Disease classification
Tuberculosis is generally named according to the location and organs of the disease. According to the location of the disease, there are mainly the following types:
Cervical lymph node nucleus
This is the most common lymph node tuberculosis, with more women than men. According to Japanese statistics, the age group of men is 30 years old and that of women is 50 years old. The most common part is the right side. Western medicine believes that this disease is mostly due to the invasion of mycobacterium tuberculosis through the oral cavity (dental caries or tonsils), from lymphatic vessels to submandibular or submental lymph nodes; It can also be caused by pulmonary tuberculosis and intestinal tuberculosis through blood transmission. Traditional Chinese medicine believes that this disease is caused by emotional injury, stagnation of liver qi, spleen deficiency and phlegm production. Liver depression turns into heat, phlegm and heat contend, and neck pulse is respected. It is also weak body, deficiency of lung and kidney yin, which leads to yin deficiency and fire flourishing, and phlegm-fire condenses into scrofula.
Axillary lymph node nucleus
This disease is rare in clinic. Patients often complain of axillary lymph node swelling and pain; There is also calcification in armpit or upper chest wall during chest X-ray examination.
Nodules of inguinal lymph nodes
Enlargement of inguinal lymph nodes is mostly caused by trauma of lower limbs or vulva. However, tuberculosis will spread throughout the body and occasionally occur. At first, it can be swelling, with only slight pain. If it is not actively treated, it can collapse on its own.
Abdominal lymph node nucleus
Generally, due to systemic spread or on the basis of intestinal tuberculosis, abdominal lymphadenopathy appears one after another. In the chief complaint, there may be no digestive system symptoms in the past, and no lung lesions are common. Others have symptoms of intestinal tuberculosis in the past, or have received chemotherapy to treat tuberculosis.
Hilar lymph node nucleus
When the body has not produced allergic reaction, tuberculosis in the primary focus of the initial lung infection invades its lymph nodes through lymphatic flow. There are many lymph nodes from hilum to mediastinum. When the disease progresses, mediastinal lymph nodes are also attacked one after another, forming different degrees of caseation, which flows from pulmonary lymph nodes to hilar mediastinal lymph nodes and finally into pulmonary veins from right venous angle lymph nodes, so tuberculosis can easily flow into the blood stream. Therefore, hilar lymph node nuclei are prone to potential bacteremia.
Edit this disease diagnosis
According to the contact history and local signs of tuberculosis, a definite diagnosis can be made, especially if a cold abscess or sinus or ulcer has been formed for a long time. Chest X-ray can be done if necessary to determine whether there is tuberculosis. Tuberculin test is helpful for diagnosis.
If only the cervical lymph nodes are swollen without cold abscess or ulcer, there are many swollen lymph nodes of different sizes on one or both sides of the neck, which are generally located at the front and rear edges of sternocleidomastoid muscle. Initially swollen lymph nodes are hard and painless and can be pushed. The lesion continues to develop, resulting in lymphadenitis, which makes the lymph nodes adhere to the skin and surrounding tissues. The lymph nodes can also adhere to each other and fuse into a group, forming a nodular mass that is not easy to push. Late lymph nodes appear caseous necrosis and liquefy to form cold abscess. After the abscess ruptures, it flows out like bean dregs or thin rice soup, and finally forms a lasting sinus or chronic ulcer. ; The skin at the edge of the ulcer is dark red, and the granulation tissue is pale and edema. The above-mentioned pathological changes in different stages can appear in all lymph nodes of the same patient at the same time. The patient's disease resistance is enhanced, and after proper treatment, the development and calcification of lymph node tuberculosis can be stopped.
Diagnostic basis
(1) Cervical lymph nodes are swollen, nodular and painless. More common in children and young people.
(2) At the initial stage, solitary nodules were smooth and mobile, while at the later stage, the nodules merged into blocks, which were irregular and had poor mobility. The mass can form an abscess with a sense of fluctuation, and it can form a sinus after rupture, and it will sneak with the lower part of the skin for a long time.
(3) The secretion is thin, often containing cheese-like substances, and the granulation on the wound surface is unhealthy.
(4) There may be systemic symptoms such as low fever, night sweats, fatigue and emaciation.
(5) Some patients may have a history of pulmonary tuberculosis or pathological changes.
(6) Take the diseased tissue for PCR detection, and the result can be positive.
(7) Pathological biopsy can make a definite diagnosis.
Inspection sequence
Touch the lymph nodes in the front and back of the ear (mastoid region) with two fingers. After that, the patient turned his head to the right or left, and the examiner palpated the retrooccipital lymph nodes in the suboccipital region with his right hand or left hand. The examiner holds the head with his left hand, touches the submandibular and submental lymph nodes with the fingertip of his right hand (the palm is turned over), and the left side is also examined. Touch the anterior cervical triangle with two fingers along the anterior edge of sternocleidomastoid muscle. Then palpate with two fingers in the posterior cervical triangle along the anterior edge of trapezius muscle and the posterior edge of sternocleidomastoid muscle. Finally, the fingertips of both hands touch the supraclavicular lymph nodes from shallow to deep in the supraclavicular fossa. (The order of palpation of cervical lymph nodes is pre-auricular, post-auricular, occipital, submandibular, submental, anterior cervical, posterior cervical and supraclavicular lymph nodes ***8 groups. )
Order of cervical lymph node examination-What examination should be done for cervical lymph node tuberculosis?
1. Chest X-ray or CT scan to determine whether the lung structure is damaged.
2. Indirect laryngoscope and postnasal endoscopy can sometimes find tuberculosis of larynx and nasopharynx.
3. PPD test of tuberculin (purified protein derivative) is helpful for diagnosis.
Edit the differential diagnosis of tuberculosis in this lymph node
(A) differential diagnosis of lymph node tuberculosis and lymphadenopathy caused by sexually transmitted diseases
1, chancre
It is a focal infectious disease caused by Haemophilus ducrae. The painful papules of pudenda quickly burst to form superficial ulcers with uneven edges and redness around them, which often merge with each other. The inguinal lymph nodes are swollen and tender, and stick together to form an abscess, with a sense of fluctuation. The skin above the abscess is red and shiny, which can rupture to form a sinus. It should be differentiated from abscess, lymph node tuberculosis. The diagnosis is mainly based on clinical manifestations and sexual history, which can be differentiated from lymph node tuberculosis. The bacteria of this disease are difficult to cultivate.
2, venereal lymphogranuloma
This disease is caused by immune Chlamydomonas, which is more common in tropical and subtropical regions. The initial symptoms are swollen lymph nodes in the abdomen and thigh, with tenderness on one side, which develops into a huge, tender and fluctuating mass, which adheres to deep tissues and has inflammation in the upper skin, which can form a fistula. May be accompanied by fever, headache, joint pain and other systemic symptoms. The diagnosis depends on sexual history, clinical manifestations and complement fixation test, and immunofluorescence microscopy can be used if conditions permit.
3. AIDS
There is a subtype of AIDS-related syndrome, which is characterized by stubborn systemic lymphadenopathy and lymphadenopathy, which often lasts for more than 3 months, but there is no recent history of any disease or drug treatment that can cause lymphadenopathy. Check for HIV antibodies. ① recent (3 ~ 6 months) weight loss 10% or more, persistent high fever of 38℃ 1 month or more; (2) recent (3-6 months) weight loss 10% or more, persistent diarrhea (3-5 times a day) 1 month or more; ③ Pneumocystis carinii pneumonia; ); ④ Kaposi sarcoma; ); (5) obvious mold or other conditional pathogenic bacteria infection.
If the weight loss, fever, diarrhea and other symptoms of HIV-positive people are close to the above standards and have any of the following, they can be experimentally diagnosed as AIDS patients: ①CD4+/CD8 lymphocyte count ratio.
Although there is systemic lymphadenopathy, it is not difficult to distinguish lymph node tuberculosis according to the medical history (history of selling blood or accepting blood products, history of intravenous drug use, sexual promiscuity, etc.). ), the above clinical manifestations and laboratory tests. Biopsy of reactive hyperplasia of lymph nodes. [2]
(2) Differential diagnosis of lymphadenopathy, connective tissue disease and rheumatic lymphadenopathy.
1, allergic hyposepsis
Children are more common than adults, and the clinical manifestations are as follows: ① long-term repeated fever; ② Recurrent and transient polymorphic rash and joint pain; ③ Lymph nodes, hepatosplenomegaly; ④ Blood and bone marrow cultures were negative; ⑤ Antibiotic therapy is ineffective, while adrenocortical hormone is effective.
2. Carcinomatosis
This is a multi-system granulomatous disease with unknown causes. It can cause superficial lymphadenopathy, such as cervical, trochlear and axillary lymphadenopathy, sometimes reaching the size of walnut, hard and never softening, and does not adhere to the skin. Diagnostic basis: ① Clinical manifestations of multiple organ damage; ②X-ray examination showed nodular alveolitis and pulmonary infiltration, which may be accompanied by hilar and mediastinal lymphadenopathy; ③ Pathological examination showed epithelioid cell granuloma without caseation; ④ The skin Kviem test was positive and the tuberculin skin test was negative.
3. Lupus erythematosus
Some patients with systemic lupus erythematosus may have local or systemic lymphadenopathy, but lymphadenopathy is not a diagnostic clue of SLE. When patients, especially young women, have fever, accompanied by skin erythema, polyarthritis, kidney damage, intermittent pleurisy pain, leukopenia, hyperglobulinemia, anti-DNA antibody positive and so on. The diagnosis is not difficult. It is difficult to distinguish SLE from other connective tissue diseases in the early stage. According to the medical history, tuberculin test, puncture or pathological examination, it is not difficult to distinguish it from lymph node tuberculosis. [3]
(3) Differential diagnosis between lymphadenopathy and lymphadenopathy caused by tumor.
1, malignant lymphoma
Malignant lymphoma can be divided into Hodgkin's disease and non-Hodgkin's lymphoma, both of which are characterized by painless progressive lymphadenopathy, no adhesion in the early stage and mobility. They are common in the neck, mediastinum and retroperitoneal lymph nodes, with medium texture and hard as rubber. With the development of the disease, the invasion range is extremely wide, and it quickly merges into pieces, and there is no mobility. At this time, palpation has a sense of cartilage. Hodgkin's disease patients may be accompanied by periodic fever, night sweats, skin itching and other systemic symptoms and obvious hepatomegaly. Enlarged lymph nodes may cause corresponding compression symptoms, such as hoarseness, dyspnea and Horner syndrome. Pathological examination of peripheral blood and lymph nodes found that R-S cells were the main diagnostic basis. Non-Hodgkin's lymphoma is mainly painless lymphadenopathy, which mostly occurs in cervical lymph nodes, followed by axillary and inguinal lymph nodes. If the disease starts from extra-nodal lymphoid tissue (gastrointestinal tract, tonsil, nasopharynx, lung, spleen, liver, bone, skin, etc. ), it is easy to be misdiagnosed in the early stage. When deep lymph nodes are enlarged, corresponding compression symptoms can also appear early. About13 patients are accompanied by fever, night sweats, weight loss, anemia and other systemic symptoms. Lymphoma can invade bone marrow, liver, skin and even central nervous system in the late stage and cause corresponding clinical manifestations. Pathological biopsy is the main basis for the diagnosis of lymphoma. Only when the mediastinal lymph nodes and abdominal lymph nodes are enlarged, we can rely on CT or ultrasound-guided puncture biopsy, and if necessary, we can explore the thoracic cavity and abdominal cavity (see Chapter 8, Differential diagnosis of disseminated pulmonary tuberculosis).
2. Chronic lymphocytic leukemia
Leukemia can cause systemic lymphadenopathy, especially chronic lymphocytic leukemia, especially in the neck. The swollen lymph nodes are hard, inelastic and tenderness-free. In the late stage, it can adhere to each other in clusters, without activity and abscess formation. The diameter can reach 2 ~ 3 cm, often accompanied by fever, bleeding, anemia and hepatosplenomegaly. The diagnosis of leukemia is not mainly through lymph nodes, but through the examination of peripheral blood picture and bone marrow picture. Leukemia patients generally have obvious hematological abnormalities, and it is not difficult to make a diagnosis through hemogram and bone marrow examination, but its accurate classification often needs the help of histochemistry and immunohistochemical techniques.
3. Plasma cell tumor
Many plasma cell tumors may have swollen lymph nodes. There are a lot of M protein, osteolytic lesions and abnormal plasma cells in bone marrow in blood and urine of patients with multiple myeloma, so it is not difficult to establish a diagnosis. The serum IgM of primary macroglobulinemia is often >: 20g/L, and there are four different types of heavy chain diseases with different clinical manifestations, but the corresponding monoclonal heavy chain can be detected by immunoelectrophoresis, and lymph node biopsy can be distinguished from lymph node tuberculosis, lymphoma and myeloma.
4. Malignant histiocytosis
Long-term fever, mainly high fever, accompanied by progressive systemic failure, emaciation, anemia, lymph nodes, hepatosplenomegaly, and pancytopenia. Systemic lymphadenopathy mostly occurs in the late stage of the disease, and it is easy to be misdiagnosed in the early stage. The diagnosis is mainly based on the existence of abnormal histiocytes and multinucleated giant cell histiocytes in bone marrow or peripheral blood. The diagnosis can also be confirmed by pathological biopsy of lymph nodes, liver, spleen and other affected parts. In recent years, it has been confirmed by immunohistochemistry that many malignant histiocytosis diagnosed in the past are T lymphoma, and the real malignant group is only a few.
5. Langerhans histiocytosis
It is a group of diseases with unknown etiology, mainly lymphoid and histiocytosis, and the lesions often involve organs such as liver, spleen, lymph nodes, lung and bone marrow. It can be divided into three types: ① Letterer-Siwe disease: found in infants under 2 years old, with high fever, red maculopapular rash, respiratory symptoms, hepatosplenomegaly and lymphadenopathy as the main manifestations; ② Hand-Schuller-Christian disease: more common in children and young people, manifested as skull defect, exophthalmos and diabetes insipidus; ③ Eosinophilic granuloma: more common in children, with osteolytic destruction of long bones or flat bones as the main manifestation (see Chapter 8 for differential diagnosis of disseminated pulmonary tuberculosis).
6, lymph node metastasis cancer
For the elderly with unknown causes of lymphadenopathy, special attention should be paid to the metastasis of some primary tumors. Metastatic lymph nodes of cancer are generally less than 3cm, with hard texture, fast growth, no tenderness, poor adhesion to the basement and uneven surface. Attention should be paid to the metastasis of nasopharyngeal carcinoma and thyroid carcinoma in painless lymphadenopathy of neck. Breast cancer often metastasizes to axillary lymph nodes first. Metastatic carcinoma of supraclavicular lymph nodes can come from stomach, bronchus, esophagus, mediastinum, pancreas and other organs. Generally speaking, right supraclavicular lymph node metastasis cancer originated from respiratory cancer for many years, while left supraclavicular lymph node metastasis cancer mostly originated from digestive system cancer. This is usually a late sign. Metastatic carcinoma of inguinal lymph nodes can be seen in urogenital carcinoma. X-ray, CT, MRI, B-ultrasound, radionuclide scanning and some serological tests, such as alpha-fetoprotein and carcinoembryonic antigen, are helpful to find the primary tumor, but the diagnosis still needs histopathological basis. [4]
(d) Differential diagnosis of lymphadenopathy caused by tuberculosis and chronic infection.
1, chronic nonspecific lymphadenitis
When tuberculosis of cervical lymph nodes is in proliferative phase (nodular type), this type is easily confused with chronic cervical lymphadenitis. Chronic lymphadenitis often involves several lymph nodes in the superficial layer of submandibular neck, which is small in size and can be found in many infected lesions, such as head lesions that can spread to retroauricular and mastoid lymph nodes; Oral and pharyngeal lesions can enlarge submandibular and submental lymph nodes. Pathological and cytological examination of lymph node biopsy or needle aspiration biopsy can confirm the diagnosis. If it is tuberculosis, there may be tuberculosis lesions. If it is nonspecific chronic lymphadenitis, neutrophil, monocyte and plasma cell infiltration can be seen.
2. Non-tuberculosis Mycobacterium lymphadenitis
The disease mainly invades lymph nodes near submandibular and maxilla, and is mostly caused by Mycobacterium scrophulariae. It is especially common in children under 5 years old, often without tuberculosis, and often needs to be differentiated from nodular and ulcerative cervical lymph node tuberculosis. In the United States, nontuberculous mycobacterial lymphadenitis is more common than tuberculous lymphadenitis and is an important cause of cervical lymphadenitis. In the United States, nontuberculous mycobacterial lymphadenitis is 10 times that of typical tuberculous lymphadenitis.
The symptoms of this disease are slightly more acute than tuberculous lymphadenitis. The swollen lymph nodes are not red and painless, even lymph nodes larger than 3cm can move. The curative effect of anti-tuberculosis treatment is worse than that of lymph node tuberculosis, and it will not be cured after long-term treatment. The diagnosis is mainly based on bacteriological examination and bacterial classification.
3. Infectious mononucleosis
The disease usually begins with symptoms of upper respiratory tract infection, acute swelling of lymph nodes in the whole body, and common swelling of cervical lymph nodes, especially in the left cervical posterior group. The swollen lymph nodes have moderate hardness, no adhesion, no suppuration and tenderness. It can be accompanied by fever, angina pectoris and rash, with 50% ~ 90% lymphocytes and abnormal lymphocytes. The positive rate of heterophilic agglutination test is as high as 80% ~ 90%. Pathological examination can confirm the diagnosis.
4. Filariasis
Infection by Bancroft and Malayan filariasis can lead to chronic lymphangitis and superficial or deep lymphadenopathy, the most common being inguinal lymph nodes. If combined with lymphatic obstruction of lower limbs, it can cause rubber swelling of lower limbs. Eosinophils in blood increase, and microfilaria in peripheral blood is checked at night to make a diagnosis.
5. Toxoplasma gondii (protozoa)
One or a group of lymph nodes can be seen in the unilateral neck, with mild tenderness or no pain, no suppuration, general malaise, low fever or no symptoms. Diagnosis depends on pathogen examination, toxoplasmosis test and complement fixation test.
6. Leptospirosis (Leptospirosis) (differential diagnosis of disseminated blood tuberculosis)
Rats and pigs are the main sources of infection. Early (leptospirosis stage) clinical manifestations are fever; Outstanding headache, muscle pain all over the body, especially gastrocnemius. General weakness, especially leg weakness, sometimes it is difficult to walk, which makes it impossible to get out of bed; Conjunctival congestion is persistent, no secretion, photophobia; Gastrocnemius tenderness; Superficial lymph nodes of the whole body are swollen, which can appear in the early stage of the disease, mostly in groin and axillary lymph nodes, mostly like soybeans or broad beans, with tenderness, but without congestion, inflammation and suppuration. It is difficult to diagnose the disease in the early stage, and the clinical diagnosis needs the positive results of etiology or serology. The metaphase and recovery period are more complicated (see Chapter 8, Differential Diagnosis of Blood-borne Tuberculosis). Therefore, it should be combined with epidemiological history, early clinical characteristics and laboratory examination results to differentiate it from lymph node tuberculosis.
7. Mold infection
Foot fungal infection can cause chronic inguinal lymphadenopathy. Histoplasmosis is often accompanied by hilar lymphadenopathy. Sporotrichosis is a chronic deep fungal disease, and the involved tissues are papilloma-like, which can fester and fester, causing local lymphadenopathy. It is not difficult to distinguish it from lymph node tuberculosis, and it can be diagnosed by fungal smear and culture. [5]
Edit this paragraph to treat western medicine treatment
(1) Pay proper attention to nutrition and rest, and carry out systemic treatment. Oral isoniazid for 65,438+0-2 years, accompanied by systemic poisoning symptoms or tuberculosis in other parts of the body. Add sodium p-aminosalicylate or rifampicin or intramuscular injection of streptomycin.
(2) local treatment
1. Some local, large and advanceable lymph nodes can be considered for surgical resection. Be careful not to damage the accessory nerve during the operation.
2. Those who have formed cold abscess but have not been punctured can be treated by latent puncture and pus aspiration. Insert the needle from the normal skin around the abscess. Drain the pus as much as possible, and then inject 5% isoniazid solution or 10% streptomycin solution into the pus cavity for flushing. And leave a proper amount in the abscess cavity twice a week.
3. If the cold abscess ruptures to form an ulcer or sinus, if the secondary infection is not obvious, it can be included in the operation. Carefully exclude all diseased tissues. The wound was not sutured, and the dressing was changed with streptomycin solution.
4. Cold abscess secondary to purulent infection. Incision and drainage should be done first, and scraping should be done if necessary after infection is controlled.
Traditional therapy in China
Traditional Chinese medicine believes that the onset of scrofula is mostly caused by the accumulation of wind, heat and toxin in triple energizer and liver and gallbladder, and the deficiency of qi and blood in liver and kidney can be divided into acute and chronic types. Acute is mostly caused by exogenous wind-heat and endogenous phlegm-toxin; Chronic diseases are mostly caused by qi stagnation and deficiency. The disease often manifests as anger, depression and depression.
Chilodan
The book "Dan San Gao Wan Fang" in the Pharmacopoeia of the Middle Qing Dynasty records the treatment history of Qiluodan, which is 149 years ago.
Ingredients are made from many traditional Chinese herbal medicines, including Prunella vulgaris, Ranunculus ternatus, Angelica sinensis, Forsythia suspensa, Crocus sativus, etc.
Functions and indications of scrofula, lymphadenitis and lymphadenopathy.
According to the statistics of China journal of traditional chinese medicine in June 1979 and 65438+February, 855 cases of lymphadenopathy were clinically treated, 849 cases were cured and 6 cases were calcified.
Usage and dosage: Take 7 capsules three times a day with warm boiled water. Do not eat corn.
Source: journal of traditional chinese medicine, China 1979/ 12.
Excerpt from China Pharmacopoeia.
Tuberculosis pill
【 Name 】 Yinfei Pill.
Indications: Lymph node tuberculosis (LN).
"Powder" is made of more than 20 kinds of superior Chinese medicines, such as bee dew room, rosin, snake slough, alum, etc.
【 Usage and Dosage 】 Take yellow wine half an hour after meals, one pill at a time.
[Drug shape] This product is a red cylinder.
[Source] National Patent Drug List.
[Taboo] Remember to get angry. It is not advisable to get angry after taking the medicine.
【 Efficacy 】 This medicine can cure lymph node tuberculosis by taking 1 ~ 4 pairs.
[Storage] Sealed and refrigerated.
Palm moxibustion therapy
Indications: lymphadenitis, scrofula and lymphomas.
Transmission area: Sulu.
Main ingredients: starch, realgar, etc.
Usage: Take two capsules each time for 24 hours.
Avoid: do not eat spicy food for six months, seafood for three months and rooster for one month after taking the medicine.
Caution: Do not swallow.
Shengxuan decoction
It was recorded in the third volume of The Secret Collection of the Blue Room.
It is one of Li's effective prescriptions for treating lymphoid tuberculosis in the past hundred years.
【 Name 】 Neixiaoshengxuan Decoction
Indications: the "scrofula" in lymph nodes is different in hardness, and the sputum nucleus of the scrofula is swollen or painful.
[Powder] There are more than 60 flavors such as Yin Zhong, Scrophularia, Monkey Jujube, Fructus Trichosanthis, Cicada and Xuan Ming.
[Usage] Take orally by heating.
[Description] This product is a brown packaged decoction.
[Source] China Pharmacopoeia and Journal of Traditional Chinese Medicine.
[Taboo] Pregnant women should not use it.
[Storage] Sealed and refrigerated.
Wugong powder
2 centipedes and 2 fresh eggs.
[Usage] Put the centipede on the tile, dry it and grind it into powder, and divide it into 2 parts; Take fresh eggs, break one end, and a little egg white will flow out. Pour centipede powder 1 serving into each egg and paste the small mouth with paper or bread. In the morning, cook 1 eggs with 30 grams of Prunella vulgaris, eat eggs and drink soup; In the evening, wrap the 1 egg with several layers of wet paper and cook it in a grey fire. 10 day is 1 course of treatment.
Note: centipede is poisonous, so children and the infirm should reduce it; During the medication, it is forbidden to take spicy and irritating substances and sexual intercourse; Do not use it for patients with fever and hemoptysis, and use it after the condition is stable.
Ambrosia ointment
5,000 grams of catnip.
[Usage] Wash the medicinal materials, add water15000g, soak them in clear water for 3 days, simmer for 3 hours to remove residues, then simmer until they bubble like fish eyes, then paste them and bottle them for later use. According to the wound condition, after removing the necrotic tissue and pterygium from the wound under local anesthesia, cover it with sterile gauze coated with cat's eye ointment (if there is a sinus, scrape off bean dregs and pus with a scraper) and change the dressing every other day/kloc-0 times, depending on the amount of pus, until the wound surface heals. In severe cases, anti-tuberculosis drugs can be added.
[Efficacy] 245 cases (306 sores) with cervical lymph node nuclear rupture were treated with this recipe, and all of them were cured.
Note: Ophiopogon japonicus is Ranunculus ternatus of Euphorbiaceae. The whole herb has expectorant, antitussive, antiasthmatic, detoxicating and antipruritic effects.
Centipede egg
Scolopendra 1, Scorpion 3, Egg 1.
[Usage] Apply the medicine and bake it, * * * grind it into fine powder, take the egg, open 1 hole, add the powder, stir it evenly, wrap it with dough, put it in plant ash and cook it, once a day, 1 tablet, and 1 0 day is a course of treatment.
Huangjing Xiaku Ointment
[Medicinal Materials] Fresh Polygonatum sibiricum 100g, fresh Prunella vulgaris 200g.
[Usage] Chop the medicinal materials, add 500 ml of water, decoct, and finally concentrate into paste. When in use, according to the size of the affected part, the ointment is coated on the sterilized gauze and stuck on the affected part. If there is ulcer, cut the gauze into 1 hole to facilitate pus discharge. Change the dressing every day 1 time.
Tuberculosis ointment
[Medicine] Pyrola 80g, carbolic acid 100ml, tung oil 200ml.
[Usage] Put tung oil in a porcelain bowl or a small iron pot, boil it with low heat, add carbolic acid, cook it with lime to a semi-paste, and bottle it for later use. When in use, it is applied to the affected part, 2-3 times a day.
【 Efficacy 】 This prescription is used to treat suppurative cervical lymph node tuberculosis, and it can be cured after continuous application of 1-2 weeks.
Prescription for eliminating lymph node tuberculosis
[Medicinal Materials] 20g Scrophularia, Fritillaria, seaweed, Prunella vulgaris, Radix Rehmanniae 15g, and 9g Pangolin.
[Usage] Take 1 dose with water every day. 1 month is a course of treatment. According to the physical condition, honey can also be made into pills, taking 6 grams each morning and evening.
Yang Dan pills
Main ingredients: sheep bile dry paste, Stemona, Bletilla striata, Fritillaria thunbergii, licorice.
Function and pharmacology: moistening lung and resolving phlegm, detoxifying and killing insects. Pharmacology has proved that cholic acid and deoxycholic acid in sheep bile have certain antibacterial effects on many bacteria; Stemona and Glycyrrhiza uralensis Fisch also have inhibitory effects on human mycobacterium tuberculosis and various bacteria in vitro.
Dosage and usage: 3g each time, twice a day, with warm boiled water. Avoid spicy, cold and greasy food.
1. Take 200 grams of fresh Smilax glabra and fry it twice a day. 1 week, with 1 course. After 1 course of treatment, stop 1 week, and then carry out the second course of treatment, usually with 1 ~ 3 courses of treatment.
2. Treatment of lymphadenitis, scrofula and simple goiter: 20g of laver, 2 eggs, 250g of clam shell, 60g of mung bean vermicelli and 30g of horseshoe powder. Firstly, water is used to dilute horseshoe powder; Eggs are shelled and stirred evenly; Wash the clam shell, put it in a pot, add appropriate amount of water, cook it with slow fire, add vermicelli, horseshoe powder and eggs, turn off the heat after boiling, and then add laver to taste and accompany the meal.
3. Porphyra 10g, decocted in water twice a day, or soaked in laver once a day for one or two months.
4. Porphyra and radish soup: Porphyra 15g, white radish 20g and dried tangerine peel 2 pieces, cooked together, seasoned with a little salt to cure goiter and lymph node tuberculosis.
5. Use 3 kilograms of raw taro, dry it and grind it into powder, use 300 grams of jellyfish (desalted) and 300 grams of horseshoe. Boil the two flavors with water to remove residues, add taro powder to make mung bean-sized pills, and take them in warm water, 6 grams each time, three times a day; Or wash fresh taro, steam it in a pot, peel it, season it with soy sauce and eat it as a dish every day. It can be used for treating diseases such as lymphadenopathy and cervical lymphadenopathy.
Edit this acupuncture and root cutting treatment
Acupuncture-root-cutting therapy is the best treatment for lymphoid tuberculosis at present, without any side effects. Taking Huatuo Jiaji point on the back of human body has no toxic and side effects and can play a radical role. Traditional root cutting therapy needs to make a small incision in the back of human body with a knife, and then puncture the fascia with a needle. Although the effect is good, it will leave ugly scars. In modern times, acupuncture was used instead of excision through the improvement of later generations, with better effect and no scar left in the prognosis. Patients with lymphoid tuberculosis can be cured after 3-5 treatments.
Edit this paragraph to prevent and control the source of infection
The main source of infection of tuberculosis is tuberculosis patients, especially those with positive sputum tuberculosis, who receive reasonable chemotherapy at an early stage. In a short time, the amount of tuberculosis in sputum decreased or even disappeared, and almost 100% could be cured. Therefore, early detection of patients, especially those with positive sputum test, and timely and reasonable chemotherapy are the central links of modern tuberculosis prevention and treatment.
The method of early detection of patients is to timely carry out X-ray chest film and bacteriological examination for the following people:
(1) Patients with chronic cough and hemoptysis who failed to respond to antibiotic treatment.
(2) Contacts around patients with open pulmonary tuberculosis.
(3) Family members of children with strong tuberculin test.
(4) Workers in factories and mines, especially silicosis patients.
(5) Regular chest X-ray examination can find some asymptomatic patients in the early stage.
Cut off the route of infection
Tuberculosis is mainly transmitted through respiratory tract. Therefore, spitting is prohibited, and the sputum, daily necessities and surrounding things of patients with positive bacteria should be disinfected and properly handled. Indoor ultraviolet irradiation can be used for disinfection once a day or once every other day for 2 hours. Tableware used by patients needs to be boiled and disinfected 10- 15 minutes, bedding needs to be exposed to the sun for 4-6 hours, and sputum box toilets can be used for 5%- 10.
Inoculate BCG
BCG is a non-pathogenic live vaccine. People who are not infected with tuberculosis can get specific immunity to tuberculosis after being inoculated into human body, and the protection rate is about 80%. It can last for 5- 10 years, so it will take several years for those who turn negative in nodulation test to replant. The vaccination target is those who have never eaten tuberculosis infection and have negative tuberculin test. The younger the better. It is usually injected within three months after birth, mainly for newborns, infants, primary and secondary school students and citizens in ethnic minority areas who have entered the city. Those with negative tuberculin test were vaccinated and replanted. There are two inoculation methods: intradermal injection and skin scratching, and intradermal injection is the best. The effect of BCG vaccination is positive, especially the incidence of acute miliary tuberculosis and tuberculous meningitis in children is obviously reduced, but the immunity produced by BCG vaccination is also relative, so other preventive measures should be paid attention to.