"Diarrhea" is very common in life. Acute enteritis is the most common disease in diarrhea. Once people eat improperly, what often happens is acute enteritis. (1) Etiology of acute enteritis: (1) Overeating, eating too much high-fat and high-protein food, drinking too much alcohol and cold drinks, or catching cold. (2) Eating rotten and polluted food, such as overnight food that has not been heated and disinfected, rotten fish and shrimp, stale crabs and seafood, meat food that has been stored in the refrigerator for a long time, and fermented and deteriorated milk and dairy products. (3) Individual patients have allergic reactions to food. Acute enteritis occurs frequently in summer, which is related to hot weather and perishable food. If the "disease enters from the mouth" is well controlled, acute enteritis will be greatly reduced. (2) Clinical manifestations of acute enteritis: (1) Abdominal pain and diarrhea are the main features. Most of them have pain around the navel, showing paroxysmal colic, which causes defecation feeling, and abdominal pain is slightly relieved after defecation. Diarrhea is mostly watery and contains indigestible food residues. Generally, you can defecate 7-8 times a day, up to a dozen times. After treatment,1~ 2 days, 2 ~ 3 days at most, and the condition is relatively good. (2) Hypervocal bowel sounds. You can clearly hear the "cooing" sound in the abdomen near the patient. (3) Some severe patients were accompanied by low-grade fever, nausea and vomiting, and dehydration symptoms. (4) Acute enteritis should be distinguished from diarrhea caused by other diseases. Generally speaking, the milder case of diarrhea is generally acute enteritis. Other diseases need to go to the hospital for further examination before they can be diagnosed. (3) Rescue measures: (1) First, stay in bed, keep warm, and fast for 12 hours, and then gradually take a small amount of liquid food, such as rice soup, lotus root starch, porridge, noodle soup, etc., and slowly return to normal diet. (2) Properly relieve pain and diarrhea. Oral belladonna tablets. If diarrhea is serious, you can eat some burnt steamed bread slices or rice porridge to stop diarrhea. (3) Encourage drinking more water, as shown in "Rescue measures for acute gastritis". (4) Patients with mild illness may not need "anti-inflammatory drugs". Generally, drugs such as lactase, berberine and norfloxacin can be selected. (5) Patients with severe diarrhea and dehydration should be sent to the hospital for intravenous infusion treatment in time. What is acute enteritis? Acute enteritis is a common and frequently-occurring disease in summer and autumn. Most of them are caused by microbial infections such as bacteria and viruses, and their main manifestations are abdominal pain, diarrhea, nausea, vomiting, fever, etc. In severe cases, dehydration, electrolyte disorder and shock can be caused. The diagnosis of acute enteritis is not difficult, and patients often have sudden onset in summer and autumn; Most of them have a history of eating improperly or eating by mistake; It is characterized by explosive epidemic; Most patients show nausea and vomiting first, followed by diarrhea, ranging from 3 to 5 days a day, or even dozens of times. The stool is watery, dark yellow or greenish, and stinky, which may be accompanied by abdominal cramps, fever, body aches and other symptoms. Routine stool examination and stool culture, red and white blood cell count can be normal or abnormal. Patients with nausea, vomiting, abdominal pain and diarrhea at the same time, so it is also called acute gastroenteritis. What factors are related to the onset of acute enteritis? (1) Salmonella and halophilic bacteria (Vibrio parahaemolyticus) are the most common infections of bacteria and toxins, staphylococcus aureus is the most common toxin, and viruses can also be seen. There are often cases of collective illness or multiple families. Such as eating contaminated poultry, livestock meat and fish; Or eat seafood such as crabs and snails grown by halophilic bacteria, and eat leftovers and leftovers contaminated by Staphylococcus aureus. (2) Eating cold food or some drugs such as salicylates, sulfonamides and some antibiotics due to physical and chemical factors; Or taking strong acid, strong alkali and pesticides by mistake can cause this disease. What are the pathological changes of acute enteritis? The gastrointestinal mucosa is hyperemia, edema and exudation, and the surface is covered with flaky yellow exudate or mucus, and the lesion can be localized or diffuse. There are erosions and bleeding spots on the wrinkled wall of mucosa. If the superficial epithelial cells are necrotic and shed, and the intrinsic membrane blood vessels are damaged, it will cause bleeding and plasma extravasation, often with neutrophils, lymphocytes, plasma cells and a small amount of eosinophils infiltrating, and in severe cases, submucosa also has congestion and edema. Small intestine is the main lesion site in salmonella gastroenteritis, but it also involves colon, causing dysentery-like symptoms. Salmonella is invasive, causing mucosal inflammatory reaction, accompanied by neutrophil infiltration in submucosa, sometimes as deep as lamina propria. Inflammatory cells produce and release prostaglandin, which increases the activity of adenylate cyclase. Salmonella secretes enterotoxin, which directly stimulates adenylate cyclase system, which greatly increases the secretion ability of intestinal fluid, exceeding the reabsorption ability of intestinal tract, causing diarrhea. What are the clinical manifestations of acute enteritis? (1) Gastrointestinal symptoms: Nausea, vomiting, abdominal pain and diarrhea are the main symptoms of this disease. Vomiting has a sudden onset, often with nausea first, followed by vomiting, and most of the vomit is stomach contents. In severe cases, bile or bloody substances can be vomited. Abdominal pain is more common in the middle and upper abdomen, and severe cases can be paroxysmal colic. Diarrhea is characterized by watery stools, ranging from several times to dozens of times a day, accompanied by foul smell, mostly dark yellow or greenish stools, rarely with purulent blood, and no sense of urgency and heavy feeling. (2) Systemic symptoms: Generally, systemic symptoms are mild. Severe patients have symptoms such as fever, dehydration, acidosis, shock, and occasionally acute upper gastrointestinal bleeding. (3) Signs: Early or mild cases may have no signs. During physical examination, there may be mild tenderness in the upper abdomen or umbilicus, and bowel sounds are often obviously hyperactive. Generally, patients have a short course of disease and can heal themselves within a few days. What are the laboratory tests of acute enteritis? (1) Blood test: The white blood cells in blood routine can be slightly increased, and the erythrocyte sedimentation rate is slightly accelerated. (2) Routine stool or culture: most of them are normal, and a small amount of white blood cells and red blood cells can also be seen. In case of bacterial infection, pathogenic bacteria can be found. What is the diagnostic basis of acute enteritis? The diagnosis of this disease is mainly based on acute onset, recent history of eating disorder or taking drugs that have bad stimulation to the stomach, as well as clinical manifestations such as nausea, vomiting, abdominal pain and diarrhea. Routine stool includes mucus and red and white blood cells. Bacterial culture can find pathogenic bacteria. White blood cell count increased slightly. What diseases are acute enteritis differentiated from? When there is upper gastrointestinal bleeding, it should be differentiated from bleeding caused by peptic ulcer and esophageal varices rupture. A few cases have severe abdominal pain, which should be differentiated from peptic ulcer perforation, acute cholecystitis, acute peritonitis, acute appendicitis and atypical acute myocardial infarction. What is the treatment principle of acute enteritis? (1) Remove the inducement, stay in bed and eat light and digestible food. (2) If pathogenic bacteria are found, they should be administered according to the drug sensitivity test, or berberine 0.1~ 0.2g or PPA 0.5 ~1.0g, 3 ~ 4 times a day, orally. (3) Symptomatic treatment, abdominal pain can be treated with atropine. Dehydrated patients should be rehydrated and pay attention to correct electrolyte disorder and acidosis. Shock should be treated as shock. What are the commonly used therapeutic drugs for acute enteritis? (1) Spasticity and pain relief: Abdominal pain can be treated with spasmolytic agents, such as oral atropine 0.3 ~ 0.6 mg or propafenone/kloc-0.5 mg ~ 30 mg, intramuscular injection of anisodamine 5 ~/kloc-0.0 mg, or analgesic 1 branch. (2) Antibacterial and anti-inflammatory: In case of bacterial infection, antibiotic drugs should be selected, such as berberine 0.3g, three times a day, compound sulfamethoxazole1~ 2 tablets each time, three to four times a day. Norfloxacin 0.1~ 0.2, three times a day. Gentamicin160,000 units, taken orally, 3-4 times a day. If you vomit violently or lose water obviously, give intravenous drip of glucose saline. In case of acidosis, the 5% sodium bicarbonate solution should be properly static. Upper gastrointestinal bleeding should be treated with fluid replacement or blood transfusion, gastric lavage with ice water, and oral antacid. How does TCM recognize acute enteritis? There is no name of acute enteritis in traditional Chinese medicine. According to the main clinical manifestations of this disease, it belongs to the categories of vomiting, abdominal pain, diarrhea, cholera, strangulation and loss of syndrome in traditional Chinese medicine. The causes of the disease are pathogenic feeling, food injury, emotional disorder and weakness of viscera, but the main key lies in spleen and stomach dysfunction and gastrointestinal dysfunction. (1) Feel the evil turn of summer and autumn, and the summer heat is wet and transpiration. If it is inappropriate to adjust it, feel the dirty and turbid air of summer heat; Or the spleen and stomach are damaged due to cold sleeping, cold and dampness soaking, cold evil and foul gas, depression and stagnation of middle energizer, and the disorder of ascending and descending leads to the disease. (2) Overeating and stagnation caused by diet injury; Or eat fat and sweet, damp and hot; Or eating cold and unclean things by mistake, damaging the spleen and stomach, causing dereliction of duty in transportation, failing to absorb the essence of water grains, stopping instead for dampness stagnation, not rising clear gas, not falling turbid gas, and vomiting and diarrhea, resulting in this disease. (3) Emotional disorder, spleen deficiency, or original food stagnation, or originally damp resistance, but did not cause the disease, and then due to emotional disorder, depression and anger, mental stress, resulting in liver failure to drain, crossing the spleen and stomach, spleen and stomach constraints, abnormal transport and transformation, resulting in disease. As the article "Jing Yue Quan Shu Diarrhea" said: "Anyone who has diarrhea in case of anger will eat when he is angry first, which will hurt the spleen and stomach. Therefore, if something is committed, it will happen with the touch. This disease of liver and spleen is also covered with liver and wood, and his temper is injured." (4) Spleen and stomach weakness, long-term eating disorder, internal injury due to fatigue, or lingering illness can all lead to spleen and stomach weakness. Because the spleen dominates transport and digestion, the stomach dominates reception, but the spleen and stomach weakness cannot tolerate Shui Gu and subtle transport and digestion, so that water turns into dampness, and the valley turns into stagnation, and the dampness stops, and the turbidity is indistinguishable, and the disease is not completed. How does TCM recognize the pathogenesis of acute enteritis? Spleen is the foundation of the day after tomorrow, the source of qi and blood biochemistry. Being located in the middle jiao, it belongs to the dirty soil, likes dryness and hates dampness, and it mainly promotes the ascending and clearing of qi, transports and transforms Shui Gu, and transfers body fluid. The stomach and spleen are in the exterior-interior relationship, and the main recipient is Shui Gu, and the qi is descending, which likes moistening and hates dryness. The two dirty organs * * * are one dry and one wet, one receiving and one transporting, and * * * plays the function of strengthening, transporting and receiving. During the summer and autumn, the summer heat and dampness are steaming, and the patient is greedy for cold or eating corrosive things by mistake, resulting in spleen and stomach injury, loss of balance between clear and turbid, and confusion in the gastrointestinal tract, resulting in vomiting and diarrhea. How to treat acute enteritis of damp-heat type in stomach and intestines? Syndrome manifestations: sudden onset, frequent nausea, vomiting and acid swallowing, abdominal pain, urgent diarrhea, unpleasant stool, yellow and brown feces, yellow and greasy tongue coating, and slippery pulse. Syndrome analysis: Gastrointestinal damp-heat, more common in summer, summer heat with dampness, damage to the spleen and stomach, internal disturbance of the stomach and fu-organs, nausea and vomiting when turbid qi goes up; There is heat in the intestine, and the damp heat accumulates in steaming the gastrointestinal tract, so it is urgent to diarrhea; Dampness blocks middle energizer, and abdominal pain occurs when qi is unfavorable; Yellow and greasy fur and slippery pulse are all damp-heat syndromes. Treatment: clear away damp heat and regulate the stomach. Prescription: Gegen Qinlian Decoction: Radix Puerariae, Scutellariae Radix, Coptidis Rhizoma, Flos Lonicerae, Lotus Leaf, White Lablab, Glycyrrhrizae Radix and Plantaginis Semen. Radix puerariae and Flos lonicerae in the medicine can relieve muscle and clear away heat, promote clearing away heat and stop diarrhea; Scutellaria baicalensis Georgi and Coptidis Rhizoma are bitter and cold, clearing heat and drying dampness; Poria cocos and plantain seeds strengthen the spleen and promote diuresis; Lentils and lotus leaves clear away heat and damp; Glycyrrhiza uralensis Fisch relieves pain and harmonizes various drugs. If abdominal pain is severe, add Radix Paeoniae Alba and Radix Aucklandiae to regulate qi and slow down the middle warmer; Vomiting drama, you can take Yushudan first to stop vomiting; Those with food stagnation should add medicated leaven, malt, hawthorn and other digestion products. How to treat acute enteritis with cold-dampness block? Symptoms and manifestations: vomiting with clear water, nausea, diarrhea like water, abdominal pain and bowel sounds, aversion to cold and fever, body aches, thin white or greasy fur, and thready pulse. Syndrome analysis: at the turn of summer and autumn, when people are greedy for cold and sleeping outdoors, cold and dampness invade the body, cold and evil are offensive, and the spleen and stomach are injured, they will see vomiting, diarrhea and watery stools; If cold and dampness are abundant in the interior and qi in the spleen and stomach is not smooth, abdominal pain and bowel sounds will occur. If pathogenic factors bind the muscle surface and the camp and the health are not in harmony, fever and aversion to cold will lead to headache and body pain. White and greasy fur, moist or floating pulse, is an image of cold and dampness. Treatment: dispel evil and turbid, dispel cold and remove dampness. Prescription: Huoxiang Zhengqi Powder: Huoxiang, Pericarpium Arecae, Radix Angelicae Dahuricae, Perillae, Poria, Pinellia ternate, Atractylodis Rhizoma, Pericarpium Citri Tangerinae and Cortex Magnolia Officinalis. In the prescription, Pogostemon cablin, Perilla frutescens and Magnolia Officinalis dispel pathogenic factors and turn turbid, while Pinellia ternata, Pericarpium Citri Tangerinae, Poria, Pericarpium Arecae and Stomach reduce adverse reactions; Angelica dahurica and perilla frutescens are pungent and warm to relieve exterior syndrome. Addition and subtraction: Schizonepeta tenuifolia and Saposhnikovia divaricata can be added for those with aversion to cold and fever; Headache, plus Notopterygium Rhizoma and Radix Angelicae Pubescentis; If there is stagnation with abdominal distension, remove Atractylodis Macrocephala, add fried Massa Medicata Fermentata and chicken gizzard-membrane to help digestion and guide stagnation. What is the diagnosis and treatment of acute enteritis with food stagnation in gastrointestinal tract? Syndrome manifestations: nausea and anorexia, eating worse, vomiting faster, abdominal pain, diarrhea with foul smell, urgency and discomfort, pain reduction after diarrhea, thick and greasy fur and slippery pulse. Syndrome analysis: improper diet, especially eating corrodes, or gluttony leads to cold, overeating, which leads to food stagnation, obstruction of the gastrointestinal tract, qi disorder, turbid qi ascending, and sour and smelly; If you bet on food, you will be stinking like a defeated egg; If the diarrhea corrodes and goes out, the abdominal pain will be relieved; Thick and greasy tongue coating and slippery pulse are the signs of food stagnation. Treatment: regulating stomach, reducing adverse reaction, promoting digestion and resolving stagnation. Prescription: Baohe Pill: burnt hawthorn, fried Massa Medicata Fermentata, Poria, Pinellia ternata, dried tangerine peel, forsythia suspensa and radish seeds. In the prescription, hawthorn, medicated leaven, radish seed and poria cocos can help digestion and stomach; Pericarpium Citri Reticulatae and Rhizoma Pinelliae regulate qi and reduce adverse reactions; Forsythia suspensa digestion stagnation of stagnation of heat. Addition and subtraction: if food stagnation turns into heat and the stool is uncomfortable, you can take Zhizhi Daozhi Pill; If the stomach is hot and vomits, Jiang Zhuru and ochre can be added. How to treat acute enteritis with spleen and stomach weakness syndrome: deficiency of natural endowment, deficiency of spleen, careless diet, namely easy vomiting and diarrhea, thin stool, vomiting with clear water, intermittent rest, accompanied by dull complexion, weakness of limbs, pale tongue and thready pulse. Syndrome analysis: the spleen and stomach are weak, the transport and transformation are dereliction of duty, and it is easy to vomit and diarrhea, and the diarrhea lasts for a long time; The source of qi and blood is insufficient, so the face is dull and the limbs are weak; Pale tongue and moist pulse are both signs of weakness of the spleen and stomach. Treatment: spleen and qi, and stomach dampness. Prescription: Shenlingbaizhu Powder: Ginseng, Atractylodis Rhizoma, Rhizoma Dioscoreae, Poria, Lentils, Fructus Amomi, Coicis Semen, and Radix Glycyrrhizae Preparata. Ginseng, Atractylodes macrocephala, Poria, and roasted grass are used to invigorate qi and spleen. Lentils, coix seed and yam are lightly infiltrated to promote diuresis; Amomum villosum regulates qi, making qi flow up and down, then vomiting and diarrhea can be stopped. Addition and subtraction: For those with food stagnation, Endothelium Corneum Gigeriae Galli, Fructus Crataegi and Massa Medicata Fermentata should be added; For patients with abdominal pain who even like warming and pressing, dried ginger and white peony root can be used; Those who have long diarrhea and proctoptosis can take Buzhong Yiqi Pill. What are the traditional Chinese medicines and simple prescriptions for acute enteritis? (1) Xianglian Huazhi Pill 1 pill, twice a day. It is used for damp-heat stagnation, abdominal pain and diarrhea, or red and white diarrhea, which is urgent in the interior and then heavy. Or Jiawei Xianglian Pill, which can clear away heat and eliminate dampness, relieve stagnation and stop diarrhea. Xiangsha Yangwei Pill is used for cold-dampness blocking diarrhea, 6g each time, twice a day. Those who suffer from gastrointestinal stagnation use Yueju Baohe Pill, 6g each time, twice a day. Patients with spleen and stomach weakness use Xiangsha Liujunzi Pill, 6g each time, twice a day. Warming and benefiting qi, invigorating spleen and nourishing stomach. (2) Poria cocos 15g, Huang Lian 6g, Alisma orientalis 5g, Coicis Semen 15g, Plantaginis Semen 15g, Pueraria lobata 15g, Talcum 15g and Glycyrrhiza uralensis 3g, which are used for damp-heat diarrhea. (3) Jiao Sanxian 10g, Areca catechu 10g, Amomum villosum 10g, Raphanus sativus 10g, Salvia miltiorrhiza 10g, Mint 6g, Pericarpium Arecae 10g, etc. How to master the principles and methods of TCM syndrome differentiation treatment for acute enteritis? Acute enteritis is pathogenic, fierce, sudden and sudden. The cause is often spleen injury and dampness accumulation. Spleen governs transport and transformation, preferring dryness and aversion to dampness. The stomach governs acceptance, and it likes moistening and hates dryness. Spleen ascending stomach descending, exterior and interior helping, dryness and dampness combining, * * * complete the function of digestion and absorption. Once the balance of dryness and dampness is out of balance, it is easy to appear that "dampness will lead to diarrhea". The pathogenesis of this disease lies in the negligence of spleen and stomach transport, and if the spleen fails to rise, it will slip down and diarrhea. Acute enteritis is dominated by excess evil, so eliminating evil is the key, and eliminating evil is healthy. No matter exogenous factors, food stagnation and internal injuries, damp pathogen can be stopped internally, and the main pathogen can be eliminated to eliminate damp pathogen. The method of eliminating dampness is nothing more than aromatic dampness, light osmosis and diuresis, bitter cold and dampness, dispelling wind and overcoming dampness, pungent ventilation and dampness, invigorating spleen and dampness, warming yang and dampness. Drugs should be selected according to the syndrome differentiation of cold, heat, exterior, interior, yin, yang, deficiency and excess, and then the products of invigorating spleen and benefiting stomach should be used. Although acute enteritis is caused by excess pathogen, it also varies from person to person. Male, female, old and young have different constitutions and are treated separately. Those who have spleen weakness and are prone to diarrhea or diarrhea that is very weak and hurts qi and yin should pay special attention to strengthening the body resistance, instead of restraining the injury caused by real evil, that is, simply recognizing eliminating evil as the method, but should master the overall concept of traditional Chinese medicine and the characteristics of dialectical treatment, and differentiate symptoms according to symptoms. The key to its treatment lies in supplementing the deficiency, warming the cold, eliminating food stagnation, clearing away the benefit from damp heat, lifting up when it sinks, and stabilizing and astringent when it slips. The commonly used methods for this disease are: eliminating stagnation and promoting digestion, inducing stagnation and attacking downward, clearing away heat and removing dampness, promoting qi circulation and relieving bloating, etc. For those who are weak and have diarrhea for a long time, the methods of warming the middle energizer and strengthening the spleen, astringing the intestine to stop diarrhea, nourishing yin and clearing heat, supporting yang and removing stagnation can be used. The common clinical symptoms of cold and heat and deficiency-excess syndrome often do not simply exist, so the treatment and treatment can not be completely separated, and they must be changed according to the condition and cleverness. Attention should be paid to the following points in medication: ① The products that clear away heat and bitter cold should be used for a long time, otherwise it will easily hurt the qi of the spleen and stomach. (2) the agent of light osmosis and diuresis should not be used in excess, and excessive osmosis will dry up the body fluid and suppress the yin. ③ The astringent agent should not be used too early, and the astringent agent will converge too early, resulting in stagnation and remaining evil. (4) Don't use too much medicine under attack. Too much attack will hurt your vitality, especially for the weak. After diarrhea stops, the stomach qi should be protected, and Shenzhu Lingcao can be given to strengthen the spleen and replenish qi. If both qi and yin are deficient, showing dry mouth and tongue, and those who are too lazy to talk, they can throw Shengmai powder to replenish qi and nourish yin. What is the prognosis of acute enteritis and how to carry out preventive health care? (1) Prognosis: The prognosis of this disease is generally good. Due to the acute enteritis infected by Salmonella, the pathogenic bacteria in the intestine with severe gastrointestinal reaction are quickly excreted, so the symptoms of toxemia are generally mild, and patients recover more than in a short period of time. Some patients have poor body resistance, or suffer from some chronic diseases or receive treatment such as adrenocortical hormone and immunosuppressant, resulting in decreased body resistance, so bacteria can invade the blood from the intestinal wall and cause bacteremia, resulting in a larger infection process. Patients with sudden diarrhea should be rehydrated in time and pay attention to correct the electrolyte acid-base balance, otherwise there will be adverse consequences, especially for the elderly and infants. (2) Prevention: Actively carry out health education, and do not eat the meat and viscera of dead livestock. Meat, poultry, eggs, etc. should be cooked before eating. Strengthen food hygiene management, and spoiled and salmonella-contaminated foods are not allowed to be sold. Do a good job in canteen hygiene, establish a hygiene management system, pay serious attention to food production hygiene, and prevent food from being contaminated. Do a good job in water source protection, drinking water management and disinfection. (3) Health care: strengthen exercise, enhance physical fitness, and make spleen flourishing less susceptible to evil. Feel comfortable and keep the balance of gastrointestinal function. Diet, in order to facilitate the absorption function of the spleen and stomach. Careful living, shelter from the wind and cold is cloudy and dense, and the spirit is governance. What is the cure standard of acute enteritis? (1) Symptoms and signs disappeared. (2) due to severe vomiting or dehydration and acidosis, it is corrected after symptomatic treatment. Routine stool and blood tests are normal.