[General information]
Yunnan Baiyao poisoning 1 1 case. Atrioventricular block 1 case, toxic shock in 2 cases.
[Cause of occurrence]
The occurrence and severity of toxic reactions of Yunnan Baiyao are related to individual tolerance, but the main cause of poisoning is oral overdose. The toxic dose of Yunnan Baiyao is about 2 ~ 4g (once taken), which is 4 ~ 8 times of the maximum therapeutic dose. If you overdose this medicine 2-3 times in 24 hours, you will increase the risk of poisoning.
[time of occurrence]
There were 1 case of onset immediately after overdose, and there were several cases of late onset after overdose. Most people get sick within 20 ~ 30 minutes after taking the medicine, and poisoning symptoms can also appear within 1 hour after taking the medicine. Some people get sick within 10 minutes after taking Baibaodan orally.
[Clinical manifestations]
Yunnan Baiyao poisoning is similar to aconitine poisoning. ① The main symptoms are dizziness, headache, dizziness, unstable standing, numbness of mouth, tongue and limbs, palpitation, heartburn, nausea, vomiting and restlessness. ② Individual patients have decreased or increased blood pressure, bradycardia, arrhythmia, conduction block and diarrhea. (3) Even pale face, cyanosis of mouth and lips, cold sweat dripping, cold limbs, phlegm in throat, shallow breathing, weak heart sound, no six pulses, and no blood pressure measurement.
[Preventive and Control Measures]
① Yunnan Baiyao poisoning is directly related to its dosage, so the key to prevent poisoning is to correctly grasp the dosage and application indications and guide patients to take appropriate medication methods. Don't mistakenly think that the larger the dose, the better the effect, and don't increase the dose for quick effect. Yunnan Baiyao is generally taken orally, with the dosage of 0.25 ~ 0.5g for adults, 3 ~ 4 times a day, and given to children according to their age. If the dosage needs to be increased due to illness, it should also be started with a small dose and gradually increased, but the maximum dose 1 time should not exceed 2g, and 1 day should not exceed 4g. (2) If the drug is poisoned, the drug should be stopped immediately. Gastric lavage with 1/5000 potassium permanganate solution (P.P solution), catharsis with 50% magnesium sulfate, glucose, vitamin C, vitamin B 1 and vitamin B6, and symptomatic treatment. If bradycardia occurs and blood pressure drops, atropine or 654-2 can be used. You can also use mung bean150g, licorice root 50g (wrapped with gauze), brown sugar100g, or ginger15g, licorice root15g, and honeysuckle flower 30g, and take them frequently. ③ After the above treatment, the poisoning symptoms can gradually disappear within 1 ~ 2 days.
(2) allergic reaction
[General information]
16 allergic reaction cases of Yunnan Baiyao. Among them, 4 cases were allergic shock, 2 cases were caused by oral administration and 2 cases by external application. 7 cases were allergic drug eruption, 2 cases were caused by oral administration of Yunnan Baiyao and 5 cases were caused by external application of Yunnan Baiyao. There were 3 cases of anaphylactic shock with drug eruption, 2 cases caused by oral administration and 1 case caused by external application. 6 cases of skin congestion caused by external application of Yunnan Baiyao ointment. In addition, some cases of compound Baiyao tincture had nausea, vomiting, oral anesthesia, dizziness and other reactions after oral administration, and the symptoms could be eliminated after drug withdrawal, and no adverse reactions were found for external use.
[Cause of occurrence]
Oral or external use of Yunnan Baiyao and external use of Yunnan Baiyao ointment can cause allergic reactions, which have no obvious relationship with drug dosage. Common doses cause allergic reactions, the sensitization dose is 0.2 ~ 0.5g, and the minimum sensitization dose is 0.05g (Yunnan Baiyao for external use). 16 patients with allergic reaction of Yunnan Baiyao were all caused by routine usage and dosage. Some patients have a history of unexplained allergic reactions to penicillin or urticaria. The occurrence and degree of allergic reaction are mainly related to the allergic constitution of patients, and the quality of drugs may also be one of the factors. We should pay enough attention to it in clinic.
[time of occurrence]
Some patients get sick the next day after repeated medication, and some patients appear immediately after the first medication for several minutes to 2 hours. The fastest one is anaphylactic shock after external use of Yunnan Baiyao about 0.05g 1 min. ..
[Clinical manifestations]
① Dizziness, headache, fatigue, chest tightness, palpitation, abdominal pain, nausea and vomiting, and itching all over the body. (2) Or drug eruption, or skin congestion. ③ In anaphylactic shock, shortness of breath, cold sweat, pallor, cyanosis of lips, shallow breathing, weak pulse, cold limbs, decreased blood pressure, and even sudden fainting, unconsciousness, dull heart sounds and slow response to light.
[Preventive and Control Measures]
① The allergic reaction of Yunnan Baiyao is mainly caused by individual differences. Patients with physical allergy who have a history of drug allergy or allergic diseases should use this product with caution; If one or both parents have a history of allergies, they should also be cautious when using this medicine. After taking the medicine, the patient's condition changes and reaction to the medicine should be closely observed, and first aid should be given in time if allergic reaction occurs. ② Stop using the drug immediately and remove it. At the same time, intravenous dexamethasone 10 mg plus 50% glucose injection 20 ml, intramuscular promethazine 25 mg. After remission, take vitamin C, prednisone and chlorpheniramine orally until recovery. In addition to the above-mentioned treatment measures, patients with anaphylactic shock should be given oxygen immediately, injected with adrenaline 1 mg subcutaneously, and combined with other bioactive drugs to correct shock and treat acidosis and other complications. ③ After the above treatment, the condition was relieved after 10 minutes, obviously improved after half an hour to 1 hour, and recovered after 1 ~ 3 days. The local skin allergy caused by Yunnan Baiyao Shangshi ointment will automatically subside after stopping the drug.
(iii) Acute renal failure
[General information]
Acute renal failure caused by Yunnan Baiyao 1 case.
[Cause of occurrence]
It is caused by oral routine dosage of Yunnan Baiyao.
[time of occurrence]
Take Yunnan Baiyao immediately after taking it.
[Clinical manifestations]
① Pale face, puffy eyelids, general fatigue, cyanosis of lips, cold limbs, vomiting, abdominal pain, diarrhea, dark brown mucus-like stool discharge, anuria, etc. ② Routine urine examination showed protein, red blood cells, white blood cells and granular casts; blood chemistry examination showed that urea nitrogen and creatinine increased, while carbon dioxide binding capacity decreased.
[Preventive and Control Measures]
(1) Actively rescue and treat acute renal failure. Maintain water, electrolyte and acid-base balance, control azotemia and prevent various complications. ② You can try Zaojiao Tongguan Powder: 9 grams of Anemarrhena asphodeloides, 9 grams of Cortex Phellodendri, 9 grams of Cinnamomum cassia, 25 grams of talc, 25 grams of Semen Vaccariae, 6 grams of Zaojiao, 30 grams of shallots and 7 pieces of Fructus Lipuidambaris, so as to clear the lower energizer. And intramuscular injection of Ilex pubescens injection 2 ~ 4 ml, 2 ~ 3 times a day.
incomplete abortion
[General information]
Incomplete abortion caused by Yunnan Baiyao 1 case.
[Cause of occurrence]
Pregnant women take Yunnan Baiyao orally. Take this medicine 1 bottle (4g per bottle, total dose 12g) for 3 consecutive days. Product of Yunnan Baiyao Factory, batch number: 83020 1- 8 1), swallowed with red fuse (3 capsules per bottle 1 capsule).
[time of occurrence]
After taking this medicine for 3 days, abdominal pain occurred at 9 am on the fourth day, and vaginal bleeding occurred in the afternoon.
[Clinical manifestations]
① After taking Yunnan Baiyao, pregnant women have dizziness, paroxysmal pain in the lower abdomen, backache, vaginal bleeding and blood clots. ② The body temperature is slightly higher, the pulse is faster, and the lower abdomen is slightly tender. Gynecological examination showed that a small amount of dark red blood flowed out of the vagina and the cervix was wide open.
[Preventive and Control Measures]
① Yunnan Baiyao is a taboo for pregnant women and cannot be used. ② Immediately perform uterine curettage to remove embryonic tissue and blood clots in uterine cavity; Penicillin is also used to prevent secondary infection. It can be cured in a few days.
(5) Slight dry mouth
During the period of taking Yunnan Baiyao, some patients may have slight dry mouth, and no treatment or withdrawal is needed.
(6) Acute pharyngitis
[General information]
Acute pharyngolaryngitis caused by Yunnan Baiyao 1 case.
[Cause of occurrence]
Improper medication method. Put 0.5g of Yunnan Baiyao (batch number: 840 10 1-27) dry powder into the mouth and take it with cold boiled water. The dust of this medicine stimulates the throat mucosa and causes acute inflammation.
[time of occurrence]
Immediately after taking it.
[Clinical manifestations]
(1) Choking cough, throat knife-like pain, hoarseness. ② Examination showed congestion and edema of throat and vocal cords.
[Preventive and Control Measures]
① When taking Yunnan Baiyao powder, take it with warm water or adjust it, and avoid taking it with cold water. ② According to acute pharyngolaryngitis, aerosol inhalation, anti-infection, symptomatic treatment, expelling wind, clearing away heat and toxic materials, etc. (3) recovered after a few days.
(7) Upper gastrointestinal bleeding
[General information]
Yunnan Baiyao in the treatment of upper gastrointestinal bleeding caused by irregular menstruation 1 case.
[Cause of occurrence]
Excessive abuse of Yunnan Baiyao. The patient's irregular menstruation has lasted for 4 years, which belongs to the syndrome of deficiency of qi and blood and unstable du meridian. Lack of supplementing it, but actually eliminating it. No matter what the symptoms are, Yunnan Baiyao (1 bottle (4g) for promoting blood circulation and removing blood stasis) should be given gently, three times a day, with red condoms first for three days.
[time of occurrence]
Upper gastrointestinal bleeding occurred on the third night after overdose of Yunnan Baiyao and Hongbao pills.
[Clinical manifestations]
① Chest tightness and discomfort, a little dull pain in the upper abdomen, vomiting blood, and black stool. ② The body temperature rises, the blood pressure drops slightly, and the fecal occult blood test is positive.
[Preventive and Control Measures]
① Irregular menstruation is a common disease in women. Yunnan Baiyao can treat irregular menstruation by promoting blood circulation to remove blood stasis, diminishing inflammation and relieving pain, but there are many reasons for irregular menstruation. Clinical treatment should carefully check the cause, distinguish between excess and deficiency, and prescribe the right medicine. From Huang Qi to now, medical images attach great importance to syndrome differentiation and treatment, which is also a major feature of Chinese medicine. For the application of Yunnan Baiyao, we should also use drugs in a dialectical way, be good at using drugs, and not ignore or abuse excessive amounts. This product has the components of promoting blood circulation, and it is not suitable for those with insufficient qi and blood or no signs of blood stasis. (2) According to the emergency treatment of upper gastrointestinal bleeding, actively stop bleeding, transfuse blood and replenish blood volume, and closely observe the changes of the disease. ③ Healed after treatment.
(viii) Thrombocytopenic purpura
[General information]
Two cases of thrombocytopenia and allergic purpura caused by Yunnan Baiyao. They are all caused by oral administration, 0.5g each time, three times a day, all of which are routine usage and dosage. Before taking Yunnan Baiyao, the platelet count was normal, which was 200× 109/L and 160× 109/L respectively. There was no hemorrhagic disease in the past.
[Cause of occurrence]
It may be that the patient's body is particularly sensitive to Yunnan Baiyao, leading to secondary thrombocytopenia.
[time of occurrence]
Two patients developed thrombocytopenic purpura after 2 weeks and 65438 0 months respectively.
[Clinical manifestations]
The main manifestations were bleeding of skin and mucous membrane, and the platelet count decreased obviously. Black stool, nosebleed, gingival bleeding, scattered ecchymosis and flaky ecchymosis with uneven distribution can be seen on the whole skin. Platelet counts were 40× 109/L and 60× 109/L, respectively.
[Preventive and Control Measures]
① Long-term application of Yunnan Baiyao should pay attention to the adverse reactions of thrombocytopenic purpura and check the platelet count regularly. If new bleeding occurs during the use of Yunnan Baiyao, the platelet count should be checked frequently. ② When thrombocytopenic purpura is found, the drug should be stopped immediately, and antiplatelet drugs such as Leixuesheng, CoA, inosine, vitamin C and Zhixuemin should be used. ③ After treatment 10 ~ 14 days, it can be cured. Black stool disappeared, nose bleeding and gum bleeding stopped, and skin petechiae and ecchymosis disappeared; The platelet count increased to 180× 109/L and 160× 109/L respectively.
(9) Upper abdominal discomfort
[General information]
After taking Yunnan Baiyao, some patients felt discomfort in the upper abdomen.
[Cause of occurrence]
Mainly due to individual differences, some patients have low tolerance to this drug. Followed by fasting medication and large doses.
[time of occurrence]
I feel uncomfortable after eating it.
[Clinical manifestations]
Upper abdominal discomfort, or mild nausea, or heartburn, or mild burning sensation.
[Preventive and Control Measures]
Temporarily stop taking medicine for a few days or reduce the dose. Try to avoid taking medicine on an empty stomach.
(10) Abdominal pain
[General information]
After Yunnan Baiyao was applied, some patients had abdominal pain.
[Cause of occurrence]
A few patients have abdominal pain after oral retention enema or retention enema after mixing tin powder and Shengji powder.
[time of occurrence]
Abdominal pain was found after oral or enema treatment.
[Clinical manifestations]
Mild abdominal pain, lower abdominal pain retention enema, or lower abdominal discomfort, or anal discomfort.
[Preventive and Control Measures]
① The symptoms caused by oral administration generally disappear within 1 ~ 2 days after drug withdrawal, and no treatment is needed. ② The defecation caused by retention enema can disappear without special treatment; For patients with severe symptoms, 5ml 10% novocaine can be added to the enema, or 15 ~ 20 times can be suspended for 3 ~ 5 days after the enema.
(Xi) Inflammatory reaction on the wound surface
[General information]
Wound inflammation caused by external application of Yunnan Baiyao was 2 1 case. Among them, fresh wound bleeding 13 cases, cervical erosion 8 cases.
[Cause of occurrence]
The main reason is that the application method of Yunnan Baiyao external application wound is not correctly mastered. Yunnan Baiyao was directly applied to the wound without thorough debridement, washing and disinfection before applying medicine to the lesion, which led to inflammatory reaction at the lesion. (Some people think that direct contact between drugs and tissues will produce local stimulation and cause che-mota xis, which will make phagocytes such as white blood cells and monocytes gather at the wound site and form inflammatory cell infiltration, thus causing a series of inflammatory reactions such as redness, swelling, heat and pain; On the other hand, when the skin is cut, due to improper use of drugs, drugs can be implanted between the wound tissues on both sides, which is similar to the role of foreign bodies, hindering the growth of granulation tissue and preventing the formation of collagen fibers connecting the edges of the wounds on both sides, thus hindering the healing and repair process of the wound tissues. 395 cases of open trauma treated by external application of Yunnan Baiyao. First, the wound was washed repeatedly with normal saline to remove foreign bodies and skin flaps, and then disinfected routinely. Then a little of this medicine was added to the wound, and finally it was wrapped with gauze and fixed with adhesive tape. It can not only stop bleeding quickly, but also promote healing and relieve pain. No infection occurred and the cure rate reached 100%. At the same time, no systemic or local adverse reactions were found, and satisfactory results were achieved. Therefore, the occurrence of wound inflammation is mainly due to the failure to master the correct external application method of this drug. )
[time of occurrence]
Patients with fresh wound bleeding will get sick after 2 hours of external use of this medicine, and there will be inflammatory reaction after local application of cervical erosion.
[Clinical manifestations]
① The pain at the wound site is obvious and pulsatile, and the symptoms are more unbearable than the author's pain. ② Examination showed that although the bleeding at the wound had stopped, the blood and medicine formed a mixed scab, and there were many secretions under the scab. The secretion of patients who came to see a doctor late even showed obvious purulent changes, with obvious swelling, high skin temperature and purple-black inflammation around the wound. ③ After local medication, patients with cervical erosion often have a burning sensation in their vaginas, and leucorrhea increases.
[Preventive and Control Measures]
① Correct application of external application of Yunnan Baiyao lesions. Before external use of drugs, the damaged skin tissue or infected person must be carefully debrided. First of all, the affected area should be washed repeatedly with normal saline and neogilamine to remove foreign bodies, skin flaps and blood clots, and routine disinfection should be carried out. Then Yunnan Baiyao can be applied to the focus (some people think that Yunnan Baiyao is only suitable for the initial onset of toxic sores. If it has suppurated, it only needs to be taken orally, not externally applied to the affected area; It is also considered that external application of this product is only suitable for closed wounds with complete skin, not for open wounds with bleeding and broken skin. For open wounds, oral drugs should be taken to stop bleeding, or other drugs or methods should be used for treatment. However, at present, the external application of Yunnan Baiyao focus has been widely used in many diseases, such as open trauma, frostbite, hemorrhoids, bedsore, nipple rupture, wound ulcer, omphalitis in children, anal surgery, recurrent aphtha, sebaceous cyst infection, etc., with remarkable curative effect and no obvious adverse reactions. Therefore, it is very important to correctly master the application method of external application of Yunnan Baiyao lesions. ② After external application, some patients may have slight burning pain or itching, which is well tolerated and does not need treatment, and will gradually disappear with the remission of the disease.