Overview of filariasis, clinical manifestations, acute inflammation of lymphatic tissue, lymphatic obstructive lesions, diagnostic conditions, pathological conditions, identification of Bancroftian filariasis, emergence of Malayan filariasis, treatment measures, western medicine treatment, Chinese medicine treatment, symptomatic treatment, and overview of filariasis pathogens-onchocerciasis, ivermectin against onchocerciasis, canine filariasis and cotton rat filariasis have broad-spectrum anti-filariasis activities. It can affect the normal development of microfilaria in female uterus, inhibit its release from pregnant uterus, and quickly reduce the number of microfilaria in patients' skin. It is the first choice for the treatment of onchocerciasis, with high oral efficacy, but little effect on adults. Oral 1 time, 0. 15-0.2mg per kilogram of body weight, and retreatment every 6-65438+2 months for several years 1 time. Treatment with ethambutol can kill microfilaria and adults for Bancroftian filariasis and Malay Filariasis, and has considerable effect on giant filariasis of Bancroftian Filariasis, Malay Filariasis, Timor Filariasis and Loa Filariasis. In patients with filariasis, microfilaria can quickly disappear from the blood. Bancroft filariasis or Malay filariasis, given 1 600mg twice a day after meals, for 7 days as a course of treatment, with an interval of 1-2 months for 2-3 courses of treatment; To treat filariasis, 1 time is 2-3mg/kg body weight, and 1 time is 3 times a day for 2-3 weeks, and treatment must be carried out after 3-4 weeks; The initial dose of onchocerciasis is small, 0.5mg 1 time, 0.5 mg 1 time/day, 2 times the next day, and increased to 1 time 1 mg on the third day, 3 times a day. If there is no serious reaction, it can be increased to 1 multiplied by 2. Lymphatic filariasis originated from filariasis. In recent years, furosemide developed in China has a strong effect on adults, and has a strong killing effect on adults and microfilaria of cotton filariasis, Malayan filariasis and Bancroftian filariasis. Its insecticidal activity and curative effect are better than buprofezin (Haiqunsheng). For Bancroftian filariasis, 20mg/kg body weight 1 day, taken 3 times after meals for 7 days. Malayan filariasis, 1 day, per kilogram of body weight 1 5-20mg, administered three times after meals for 6 days1course of treatment. Blood filariasis (elephantiasis), commonly known as "Bigfoot Mania", is rarely heard of now, but it was very common in China in the first half of last century. The most typical sequela is severe swelling of lower limbs. There was a folk song "Eight people sat around the table, but the dog couldn't get in", which meant that the leg was swollen badly and there was no gap. This is a true portrayal of the harm of filariasis. Blood filariasis is a parasitic disease transmitted by mosquitoes. This pathogen exists in animals and cannot be transmitted from person to person. Blood filariasis will seriously damage the lymphatic system of human body, lead to repeated inflammation, and lead to the loss of work ability of patients. The clinical manifestations in areas threatened by lymphatic filariasis in the world are acute inflammation of lymphatic tissue (1), acute lymphangitis and lymphadenitis: most of them are located in the lower limbs, with periodic attacks, accompanied by high fever and chills. (2) Filariasis: aversion to cold and fever, with periodic attacks. Life history of filariasis (3) spermatic cord inflammation: epididymitis, orchitis, testicular and epididymal swelling, tenderness, spermatic cord nodules, tenderness. (4) Pulmonary eosinophilic infiltration syndrome: symptoms such as chills, fever, cough and asthma can be seen. Obstructive lymphangiopathy is characterized by lymphadenopathy, lymphangiopathy, hydrocele of testis, chyluria, elephantiasis (more common in lower limbs, scrotum and upper limbs), lymphatic ascites and chylous ascites. Diagnostic condition: 1. Life history of epidemic areas. 2. Recurrent lymphadenitis, retrograde lymphangitis, chyluria, spermatic cord inflammation, elephantiasis, lymphatic ascites and chylous ascites may occur. 3. Laboratory examination of hemogram of filariasis (1): the total number of white blood cells and eosinophils increased in the early stage. (2) Immunological examination: Complement fixation test, agar diffusion test and enzyme-linked immunosorbent assay are positive, which is helpful for diagnosis. (3) Etiological examination ① From afternoon 10 to 2 am the next day, take 3 drops of earlobe blood and put it on a glass slide to directly search for microfilaria. ② microfilaria was found in chyluria and hydrocele of tunica vaginalis. ③ Lower extremity lymph node biopsy for adults. 4. Acute lymphadenitis and lymphangitis should be differentiated from bacterial lymphadenitis. Differentiation and Analysis of Pathological Disease Bancroftian Filariasis If it weren't for Japan's war against China, the Japanese might not pay much attention to the prevalence of Filariasis in Taiwan Province Province, and Maxwell's different views from those of cities and villages would be a historical unsolved case. In order to ensure the channel advantage of the Taiwan Province Strait, Japan began to expand the Magong Naval Base in Penghu from 1935 to enhance the maintenance capability of ships. Based on the requirements of the military department to ensure the health of workers, Magong invited Tadashio Tanaka, a naval medical officer of Hong Kong Hospital, to inspect 229 workers from Penghu at Magong Base. 99 people were found to have clinical symptoms of filariasis, accounting for 43.3% of the total number of people examined; Among them, 37 people found bloodshot worms in peripheral blood, accounting for 16.2% of the total number of people examined. Importantly, Shigeo Tanaka proved for the first time that all these patients were victims of bancroftian filariasis, and this survey was also the first time in the history of Taiwan Province Province to confirm the existence of this filariasis through scientific examination. Tanaka believes that Bancrombiculiasis is highly popular not only in Magong, but also in other islands of Penghu Islands according to the information provided by patients. Just as Hsinchu military doctor Yukio Nakamura discovered the second host of paragonimiasis, the research report of a second-class military doctor like Shigeo Tanaka had to be ratified by a senior intellectual at that time, that is, the Faculty of Medicine of Imperial University of Taipei, before it passed the correct scientific review procedure. 1939 was in the preparatory stage of the Pacific War. Yokogawa, a famous professor of parasitology at the Faculty of Medicine of Imperial University of Taipei, led five experts from the school, including Kobayashi Hideyoshi, Youben Liangxiang, Lu Wande and Yokogawa Zongxiong (the son of Yokogawa), to form a filariasis investigation team in Penghu to confirm Tanaka's report, and the doctor crossed the scale of large-scale investigation. The investigation team examined 2,843 people from 4 villages and 2 public schools in Magong, Baisha and Xiyu Island, and found that 244 people were infected with Haemophilus banneri, with an infection rate of 8.6%. Confirming Penghu as a high endemic area of Bancroftian filariasis cannot solve the gap between Maxwell's observation and Chengcun's conclusion. Huang also conducted further blood tests on filariasis in Wandanzhuang and Xiaoqiuqiu in Pingtung area of the island. No positive carriers were found among 5267 people who were examined. According to Huang's discovery, Yokogawa thinks that a village on the southwest coast of Taiwan Province Province is most likely located in Magong area, not the main island of Taiwan Province Province. However, after the war, Fan Bingjun cited a series of investigations from 1958 to the 1960s, but found that many patients in this province came from the southwest coastal counties of Taiwan Province Province. In this study, we investigated 150 townships in 1 5 counties in Taiwan Province Province, and each township randomly selected1000 people. The total number of people examined was 178, 42 1, and 2670 people were positive, with an average filariasis infection rate of 1.5%. This study confirmed that 23 townships in five counties in southwest Taiwan Province Province were infected areas with Bancroftian filariasis, including Mailiao Township in Yunlin County. Deer grass and Zhu Yi township in Chiayi county; Hua Shan, Xinhua, Yanshui, Xigang, Yongkang, Guiren, Guanmiao, Rende and Madou townships in Tainan County; Okayama, Ziguan, Dashe, Tommy, Yong 'an, Hunei, Luzhu, Yanchao, Linyuan and Qiaotou Township in Kaohsiung County; And the urban and rural areas of Pingtung County. The occurrence of filariasis in Malays is worldwide, mainly prevalent in tropical and subtropical regions. Malayan filariasis is confined to Asia and mainly prevalent in Southeast Asia. Many provinces in China are infected with bancroftian filariasis and Malay filariasis, but the infection rate is higher in the southeast coastal areas: Shanghai, Zhejiang, Fujian, Guangdong, Guangxi and other places, among which the proportion of mixed infection of the two kinds of filariasis is the highest, with an average of about 20%. According to the research of Fan Bingzhen and Xu Yujie, Bancroftian filariasis should be the main disease in Taiwan Province Province, and there should be no cases of Malay filariasis in Taiwan Province Island. However, from 1949 to the early 1950s, due to the withdrawal of troops from the mainland to Taiwan Province, some existing cases of Malay filariasis were brought. According to their follow-up survey, there are about 27,000 filariasis patients in Chinese mainland, half of whom are infected with Malay filariasis; However, in 1955, 96% of the islanders evacuated from Chenda Island, Zhejiang Province were infected with Malay filariasis. It should be noted that the local cases in Mazu and Kinmen, which are close to the mainland, are all patients with Bancroftian filariasis, except for cases of Malay filariasis brought by evacuees from the mainland, although the filariasis infection rate in the two places is as high as 45%. There are no cases of filariasis in Malaysia except Taiwan Province Province, Penghu, Kinmen and Mazu, which are under the control of the government. After living in Taiwan Province for decades, there are still no cases of Malaysian filariasis. It seems that none of these four places has the vector to effectively spread filariasis in Malaysia. However, according to the species of mosquito vectors, Anopheles sinensis is an important vector of malayan filariasis, which is widespread in the southeast coast of China, Taiwan Province Province, Penghu, Jinmen and Mazu. Why the existence of important mosquito vectors will not cause the spread of filariasis may need to be further discussed from the habitat habits of Anopheles sinensis, people's lifestyle, environmental development and other factors. According to the above-mentioned infection phenomena of bancroftian filariasis and Malay filariasis from the southeast coast of China to Taiwan Province Province, it is not difficult to see that although the environmental conditions and ecological circle of specific mosquito vectors are very wide; But the risk rate and types of filariasis still vary from place to place. These differences not only determine the success or failure of prevention and control in the future, but also show how local residents have affected the living conditions of specific mosquito vectors after operating or developing the natural environment, resulting in different filariasis infections in different places. Treatment measures: western medicine treatment (1) pathogen treatment: ethambutol 600mg per day, divided into 2-3 times, 1 week 1 course, with 3 courses of treatment intermittent; Furazolidone: 20mg/kg body weight per day, taken three times, 7 days as a course of treatment. (2) Symptomatic treatment: acute inflammation of lymphoid tissue can be treated with antipyretic and analgesic drugs or prednisone orally; Chylouria can be treated with 12.5% sodium iodide solution as renal pelvis perfusion or surgery. Surgical treatment of hydrocele of tunica vaginalis; Elephantiasis can be bound or treated with physical therapy. Treatment with traditional Chinese medicine (1) is characterized by intense heat toxicity: swelling and pain in limbs and * * *, redness and tenderness, fever and chills, red tongue with yellow coating and rapid pulse. Treatment: clearing away heat and toxic materials. Prescription: Flos Lonicerae 30g, Fructus Forsythiae 15g, Flos Chrysanthemi Indici 10g, Herba Taraxaci 30g, Herba Violae 30g and Radix Sophorae Flavescentis 30g. (2) Damp-heat betting: swelling and pain of lower limbs, aversion to cold and fever, red tongue, yellow greasy fur, slippery pulse and unfavorable urination. Treatment: clearing heat and promoting diuresis. Prescription: Rhizoma Dioscoreae Septemlobae 15g, Rhizoma Acori Graminei 10g, Cortex Phellodendri 10g, Semen Plantaginis 15g, Rhizoma Atractylodis Macrocephalae 10g, Poria 15g, and Folium Pyrrosiae/. (3) Insects blocking meridians: swelling of lower limbs, rough skin, thin yellow and greasy fur and slippery pulse. Treatment: killing insects, dispersing stagnation and dredging collaterals. Prescription: prepared nux vomica 1.5g, pangolin scales 15g, radix cyathulae 15g, angelica sinensis 10g, papaya 10g, radix stephaniae tetrandrae 10g, and rhizoma alismatis 15g. (4) Dried peaches (immature dried peaches) and dried pomegranate peels 10g, dried tea trees 3g, and a little salt. Put the first three ingredients into the pot, add appropriate amount of water to boil the soup, remove the residue and add salt to taste. Drink soup. Prescription: Filariasis, 5 yuan. Usage: decoct with wine, sugar and water, and take one dose each morning and evening. Prescription: for filariasis with elephantiasis of lower limbs, red amaranth is not limited. Usage: decoction is often taken. Symptomatic treatment 1. Acute lymphangitis and lymphadenitis. Prednisone, prednisone and aspirin can be taken orally for 2-3 days. Patients with bacterial infection should be given antibiotics. 2. chyluria. Stay in bed, raise pelvis, drink more boiled water, eat more mussels, limit fat and protein diet, and treat with traditional Chinese medicine. 3. The elephant's skin is swollen. (1) Keep the skin of the affected limb clean to avoid squeezing friction and trauma. ② Radiation heat binding therapy: put the affected limb into a brick leg furnace or electric oven at 60- 100℃, 1 time/day or once every other day for 30 minutes, 1 month is a course of treatment, and 2-3 courses of treatment are feasible every year. ③ Surgical treatment: skin transplantation can be performed for patients with severe lower limbs, and plastic surgery can be performed for patients with scrotal elephantiasis.