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Acute suppurative osteomyelitis diagnosis and treatment technology

 

 

 

China's traditional Chinese medicine reported

 

 

 

        Acute purulent meningitis is by staphylococcus aureus or hemolytic streptococcus caused bone tissue (bone marrow, bone and periosteum) of acute abscessing inflammation. The disease in children under the age of 10, good hair at limbs of long bone ofepiphyses fusing end, especially in the upper and lower tibial femoral most, humerus, and they also happen in radius. Due to the wide use of antibiotics, makes the disease of the cure rate greatly improved, but also there are parts of the diagnosis and treatment for patients with less or bacteria to the antibiotic resistance and become chronic osteomyelitis, form fistula, prolonged fuyu, even cause severe disability.

 

        etiology

 

        Toxic heat note bone: a DingDu sores furuncle or measles, typhoid disease, YuDu not completely, toxic heat in deep inside, v "to the marrow into carbuncle; Or diet ministry, seven emotions yu disorderly, endogenous fire poison, warm and profound lingers turn heat, bone festering corruption, and cost disease.

 

        Damage infection: open damage, and from the wound poison into the deep in bone, block the meridians, stagnant blood and blood stasis, long and turn heat, heat and decay meat, with bone into carbuncle. Local closed damage, such as fall amid the DaShan, blood stagnate and congestion meridian, accumulate stasis into carbuncle, hurt by a poison.

 

        Upright weak: the whole body upright is weak, the pericardium invaded, evil poison wenjie in inside, can't the deep channeling instead spread to the marrow, bones and muscles is insufficient local resistance, the evil poison stay together, multiply harm. This is the onset of internal factors.

 

        In short, toxic heat is osteomyelitis of pathogenic factors, is the basis of virtual is osteomyelitis, damage is the common cause meningitis.

 

        Clinical manifestations

 

        Initial: onset nasty, infection poisoning symptoms, the whole body high fever, anorexia, cold shivers, body temperature up to 39 ℃ ~ 40, restless, pulse flood number, quality red tongue, moss yellow boring. The person that weigh can appear septic shock and stun. Limb pang, 1 ~ 2 days namely can't activities, tenderness, swelling limitations in the bone.

 

        Into pus) : about the onset of 3 ~ 4 days, the severe pain with persistent, dare not activities, and then body have ring abscess formation, skin temperature increase red. About last about a week, can ease the pain of sudden (this is the periosteum abscess rupture levy). But local tenderness intensifies, puncture can take purulent fluid.

 

        Fistula formation: subperiosteal abscess by crushing broken to soft tissue, deep abscess formation; About 3 ~ 4 weeks, to skin by deep abscess formation burst fistula. Body heat and limb pain gradually ease, appear god force, pale, weary tongue light moss less pulse condition count, etc.

 

        treatment

 

        Acute suppurative osteomyelitis early have serious infection poisoning symptoms, such as not in time to the correct treatment, can threaten life, or turned into chronic osteomyelitis, form fistula, prolonged fuyu. Treatment is critical to the success of the early control of infection and fenestration and decompression, prevent bone destruction and death widely bone formation. Also stressed that the regional and global pay equal attention to, to give consideration to the outside and inside cure, traditional Chinese medicine and western medicine of the combination of the comprehensive treatment principle.

 

        1. "away, and ask, repair" 3 laws treatment

 

        (1) not toxic heat formed early abscess ChiCheng pilot, in guangzhou etc.have primarily.

 

        Treatment: qingrejiedu, the blood stasis, complete with the wet. Agent: five disinfection drink, medicinal honeysuckle 20 grams, the mother chrysanthemum 15 grams, the dandelion 15 grams, purple flower DeDing 15 grams, purple TianKui son back 15 g; Or huanglian jiedu decoction and XianFang for drink, medicinal coptis chinensis franch 9 g, radix scutellariae 6 g, cortex phellodendri 6 g, gardenia 9 g, 3 g a. dahurica, fritillary, 6 grams, wind 6 grams, 6 grams of herbaceous peony, to end six grams, liquorice section 6 g, soap Angle thorn (fry) 6 g, grilled pangolin 6 grams, TianHuaFen 6 g, 6 grams frankincense, myrrh 6 g, honeysuckle 9 g, 9 g dried tangerine or orange peel. Are injury blood stasis and nut 6 g, safflower 6 g, God ZhanYu add water to feed the ox horn, born tuberous root, violet snow Dan, bezoar.

 

        (2) into the crushing not sepsis, "give priority to law.

 

        Treatment: "through pus. Agent: Toni disinfection scattered, medicinal ginseng 3 g, 3 g river xiong, root of herbaceous peony 3 g, born astragalus 3 g, angelica root 3 g, 3 g large-headed atractylodes, poria cocos 3 g, 3 g honeysuckle, a. dahurica 1.5 g, liquorice 1.5 g and 1.5 g soap Angle thorn, platycodon grandiflorum 1.5 grams. Blunt made powder, or by illness discretionary dose water frying clothing.

 

        (3) pus collapse and constitution has hand, should give priority to fill up method.

 

        Treatment: having blood. Agent: eight Jane soup, medicinal dangshen 10 grams, white atractylodes 10 grams, poria cocos 10 grams, roasted liquorice 5 grams, river xiong 6 g, angelica root 10 grams, cooked dihuang 10 grams, root of herbaceous peony 10 grams; Good or for soup, medicinal dangshen 10 grams, white atractylodes 12 grams, poria cocos 12 grams, angelica root 10 grams, river xiong 6 g, cooked dihuang 12 grams, root of herbaceous peony 12 grams, astragalus membranaceus 10 grams, roasted liquorice 5 grams, cinnamon (bake a blunt) 0.6 grams.

 

        (4) the acute phase not into the pus, can choose the scattering, golden double bogeys come loose, water adjustable external treatment, a bandage daily.

 

        2. The application of antibiotics

 

        The correct use of antibiotics is the important link of the control the illness, once established diagnosis should be used to, enough, combination principle, the general selection broad-spectrum antibiotics such as penicillin, gentamycin, erythromycin, chloromycetin, such as white with drugs. Choose two or more drugs coupled, intravenous drug, or according to the bacteria cultures and bacteria for blood the sensitive degree of antibiotics, and clinical curative effect after use to adjust antibiotics. Antibiotics to continue to use the body temperature to normal after four weeks or so.

 

        3. Surgical therapy

 

        Incision and drainage are common and effective treatment, the operation purpose is to achieve decompression drainage, ruled out pus, reduce toxin absorption, can reduce the chance of sepsis occurred, it can reduce the bony destruction. Surgery appropriate early, unfavorable, wait and see. If use big agent antibiotics 2 ~ 3 days or so, body temperature don't fall, poisoning symptoms don't reduce, but is instead increase the trend, should strive for early surgery. Surgery is will the lesion site after exposure, cut the periosteum, then in bone lesions on perforation, or cut with bone open the window, make the marrow cavity pus adequate drainage. Rinse the wound with physiological saline, can be put into antibiotics, skin subcutaneous all of the suture, placed in the rubber or salt yarn article drainage, 24 hours it out. Can also be placed in the marrow cavity plastic pipe, drip into the antibiotics, infusion therapy. In the infusion therapy, often should check the plastic pipe was clear, especially the plastic pipe easy jam drainage, causing drainage not free, aggravating the wound swelling.

 

        Appropriate technology

 

        1. LuoAnMin experience for external use irrigation

 

        (1) agent composition: 900 g rhizoma coptidis, cortex phellodendri 1200 grams, rheum 1800 grams, liquorice 450 grams.

 

        (2) functions and the Lord cure: the line stasis, dredging, heat the wet. Treatment of osteomyelitis.

 

        (3) usage: irrigation after cooking made sterile purification solution, with 0.03 grams per milliliter crude, match into 3% concentration infusion in 500 ml empty bottle inside, used to clean up the postoperative residual lesions of bone cavity block perfusion drainage, daily 3000 ml, 24 hours to maintain infusion, generally lasted 1 ~ 2 weeks, stay drainage gives clear rear can pull off the liquid.

 

        2. YangWenShui treatment osteomyelitis experience

 

        After the collapse of osteomyelitis carrion for external use the new three cuts, every time 0.1 ~ 0.3 grams, and the wound where carrion, with mention pus, expelling rotten, born new effects of mercury allergies are disabled; After the collapse of osteomyelitis, carrion, don't go granulation is not long not easy for external use only remove the convergent sloughs scattered or have muscle convergent scattered; And osteomyelitis fistula or fistula form long-term festering not more for external use only 3 kinds of a gun; After crushing local and red hot osteomyelitis pain is for external use only remove pain sloughs scattered.

 

        3. The series of osteomyelitis

 

        For 863 research projects, including resistance of bone osteomyelitis, inflammation of the spirit, and anointed by swelling.

 

        (1) effect and the Lord cure: the qingrejiedu, scattered stasis detumescence. Used to attach bone osteomyelitis is examined and toxic heat and blood stasis person.

 

        (2) usage: oral, a 8 ~ 10 slices, a day of 3 times, or as directed by a physician, children reduction.

 

        Features: (1) to (3 sloughs, rapid onset. Can promote bone cells can generate, selective role for discharging water in, fistula in the human body formed part of the focus of the focal areas, blood circulation to get reconstruction, osteoblasts generation, there are also inactivated lesions staphylococcus aureus, pseudomonas aeruginosa, etc. (2) the role of contains a large amount of promoting up a cell phagocytosis function element and regulate endocrine reaction, and enhance the lesions ALP enzyme activity, can effectively promote the granulation growth, new bone, callus formation. (3) to make up for upright and resistance to the attacks is given priority to, regulates endocrine, enhance the body's blood circulation, make new bone formation, eliminate inflammation, thus effectively improve the body's metabolic secretory function of the organization, to all sorts of osteomyelitis partners, through comprehensive regulate specimens, to avoid the surgical treatment of recurrent drawbacks. Pregnant women to carefully use. (excerpt from "the orthopaedic disease diagnosis and treatment technology") the D4