韩雪分期论治重症手足口病经验

手足口病的发病基础为正虚邪入。出疹期:邪在三阳,病位在表,病性属实证、热证,外有表邪,内有郁热,治以解肌透邪、兼清郁热,方用大柴胡汤加减;神经系统受累期:病机属正气虚弱,风邪内侵,治以扶正祛风,调和营卫,方予《古今验录》续命汤;心肺功能衰竭前期:邪入三阴、病在六经,属于手足口病重症危重型,如不及时救治将迅速转入心肺功能衰竭期,故当治以祛风散邪、回阳救逆,方用《古今验录》续命汤合小续命汤;心肺功能衰竭期:邪热内闭、元气衰竭,此时需急挽垂绝之阳,救暴脱之阴,同时透发外散内闭之阳热,使得营阴不被耗灼,则病情向愈,方宜选小续命汤合四逆汤、真武汤、理中汤。恢复期:气血虚弱,正虚邪恋,治以益气活血、祛风扶正,方用千金续命汤加减。

Han Xue's Experience in Treating Severe Hand-foot-mouth Disease Based on Syndrome and Stage Differentiation

The basis of this disease is Zheng Qi deficiency and Evil invading.During the eruption period,the Evil is in Sanyang and the disease is located on the surface.Besides,the character of the disease is excessiveness and Heat,that is,the evil is at external and the Heat is at internal.The treatment is sweating to clear the Heat,with modified Da Chaihu Decoction being used.During nervous system involvement period,the treatment should be strengthening Zheng Qi,dispeling Wind and reconciling Ying Qi and Wei Qi,with Xu Ming Decoction being used,which was recorded in Gu Jin Yan Lu.In the early stage of cardiopulmonary failure,the Evil enters the three Yin and the disease is in the six meridians.It belongs to the severe critical illness of the disease.If it is not treated in time,it would be quickly transferred to the fourth stage.At this time,it is necessary to dispel Wind and Evil,with Xiao Xu Ming Decoction combined with Xiao Xu Ming Decoction being used,which was recorded in Gu Jin Yan Lu.In the cardiopulmonary failure period,Evil Heat is blocked within body and Yuan Qi is exhausting.At this time,rescuing the Yin and same time dispeling the closed Yang Heat to the outside should be the treatment choice,with Xiao Xu Ming Decoction combined with Sini Decoction,Zhenwu Decoction,or Lizhong Decoction.Recovery period:Qi and blood are weak,and Zheng Qi deficiency induced Evil tangling,tonifying Qi and blood circulation as well as dispelling Wind and strengthening Zheng Qi should be used,with modified Qian Jin Xu Ming Decoction being used.