From the aspects of the epidemic situation, clinical symptoms and Chinese medicine treatment at home and abroad in recent years, the clinical research on the treatment of hand, foot and mouth disease with Chinese medicine in recent years was reviewed.
Keywords epidemiology and epidemiology of hand, foot and mouth disease; Summary of traditional Chinese medicine treatment
Hand, foot and mouth disease (hand? Feet? Foot-and-mouth disease (HFMD) is a common infectious disease caused by various enteroviruses (among which 7 1 virus is the most serious), mainly occurring in infants. Although hand, foot and mouth disease was newly named in 1970s, similar diseases such as measles and rubella are very common in history, and its pathogenesis and treatment principle are * * *. When it broke out, it was collectively called "epidemic rash" by Chinese medicine [1]. Traditional Chinese medicine has rich experience and effective prevention and treatment rules in treating epidemic rash.
1 Overview at home and abroad
Since 1974, Shcmidt et al. reported for the first time that enterovirus 7 1 (EV7 1) was isolated from encephalitis patients in California, USA. EV7 1 has caused more than ten outbreaks and epidemics in the world. EV7 1 epidemic occurred in Australia 1972- 1973, 1986 and 1999. Most severe patients are accompanied by central nervous system symptoms, including aseptic meningitis, Guillain-Barre syndrome, ataxia, fever and convulsion, and some patients are also accompanied by severe respiratory symptoms. 1In 975, there were more than 750 cases of EV7 1 infection in Bulgaria, mainly infants, with no symptoms of hand, foot and mouth disease and only symptoms of the central nervous system. Among them, there were 545 cases of aseptic meningitis, 52 cases of poliomyelitis and 68 cases of brainstem encephalitis (44 cases died). The main death cases were respiratory failure caused by medulla oblongata involvement. There were two outbreaks of VE7 1973 and 1978 in Japan. The main clinical symptom is hand-foot-mouth disease, which is mild, but central nervous system symptoms are also observed (24% in 1973 and 8% in 1978). 1997-2000 EV7 1 is active again in Japan. During the epidemic period, the skin and mucous membrane showed that EV7 1 had considerable variation, the genotype of the strain was different from the past, and it had a strong neurotoxicity tendency. The nervous system manifestations related to EV7 1 infection have different characteristics due to the different affected parts such as cerebellum, brain stem and diencephalon. 1997, an epidemic of hand, foot and mouth disease occurred in Malaysia, which was mainly caused by EV7 1. * * * 2628 cases were diagnosed and 29 cases died. The average age of the deceased was 1.5 years old, and 17 cases showed pulmonary edema on chest film. 1998 there were 129 106 cases of hand-foot-mouth disease in Taiwan Province province, among which 405 cases had serious complications, including encephalitis, aseptic meningitis, pulmonary edema and pulmonary hemorrhage. Among them, 78 cases died, 83% died of pulmonary edema or hemorrhage, 965,438+0% of the children died under 5 years old, and EV 765,438+0 accounted for 4.87% of the isolated virus patients. In 2000, hand-foot-mouth disease broke out again in Taiwan Province Province, with 80,677 cases and 4 deaths per person. From June 5, 2000 to 10, thousands of children in Singapore were infected with hand, foot and mouth disease, and four children died. At 1987 and 1995, the Wuhan Institute of Virology isolated EV7 1 virus from hand, foot and mouth patients. 1In 1998, Shenzhen Health and Epidemic Prevention Station also isolated two strains of EV7 1 virus from patients with hand, foot and mouth disease. Hand-foot-mouth disease (HFMD) caused by EV7 1 broke out in Xiamen on 1999, and a few cases were accompanied by central nervous system complications. In 2000, hand, foot and mouth disease (HFMD) caused by enterovirus 7 1 occurred in a kindergarten in Shanghai, and 13 strains of EV7 1 virus were isolated. 1An EV7 1 epidemic occurred in Hongkong, China in 1987. The first death occurred in 200 1 year, and 1 two-year-old boy died of pulmonary edema and pulmonary hemorrhage. From the monitoring of Shenzhen EV7 1 infection on 1998, it was found that besides hand, foot and mouth disease, there were many clinical symptoms, such as nervous system infection, myocarditis and pneumonia. 200 1, 2 1 strain EV7 1 virus was isolated from children with hand, foot and mouth disease and lower limb paralysis in Guangzhou, among which 3 strains were children with acute lower limb paralysis [2]. Since 2008, the epidemic situation of hand, foot and mouth disease (HFMD) in Singapore and Taiwan Province province of China has obviously increased compared with the same period of last year, and it is spreading to many areas in China. At present, more than 9 provinces and cities have reported cases of hand, foot and mouth disease, namely: Beijing, Chongqing, Shaanxi, Anhui, Zhejiang, Hubei, Hunan, Jiangxi and Guangdong. On May 5th, Chongqing reported that there were 5 cases of hand-foot-mouth disease/kloc-0, among which 5 cases were hospitalized for observation. Chongqing Municipal Health Bureau issued the first hand, foot and mouth disease warning, requiring hospitals to report the epidemic situation daily and closely prevent and control it. Guangdong Provincial Health Department announced on May 3rd that 925 cases of hand, foot and mouth disease were reported in Guangdong Province, and 3 cases died. From May 6th, Zhejiang Province, there were *** 1 198 cases and death 1 person. Cases were also found in Beijing, Shaanxi, Hunan, Hubei and Jiangxi, but no deaths were reported. As the origin and hardest hit area of this hand, foot and mouth disease, the situation in Anhui Province is the most serious. At present, the number of published cases has reached 5 1 and 5 1, and 22 cases have died [3].
2 Clinical symptoms
The incubation period of the disease is 2 ~ 7 days, and the sources of infection include patients and recessive infected people. Acute onset, fever, maculopapules and herpes on palms or soles, rash on buttocks or knees. There is inflammatory blush around the rash, and there is less liquid in the blister; The oral mucosa is scattered with herpes, and the pain is obvious. Some children may be accompanied by cough, runny nose, loss of appetite, nausea, vomiting and headache. EV7 1 is neurotoxic, and the main manifestations involving the nervous system are acute aseptic meningitis, brainstem encephalitis, encephalitis, poliomyelitis, Guillain-Barre syndrome and fatal encephalitis with cerebral hernia. The nervous system complications caused by EV7 1 infection can lead to death or permanent muscle paralysis. The most common clinical symptom of EV7 1 central infection is fever, followed by rash, sleep disorder, vomiting, muscle spasm, ataxia and fatigue. Central nervous system involvement occurs 2 ~ 4 days after the rash, and the most important manifestations of early central infection are myoclonia and sleep disorder.