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Essentials for Treatment of TCM Pediatrics

Updated: Monday, Mar 25,2013, 3:31:22 PM
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Commonly-used internal therapies
The internal therapies commonly used in pediatrics include dispelling wind to relieve exterior, stopping cough and asthma, clearing away heat and toxic materials, cooling blood to stop bleeding, eliminating colic caused by as caris, promoting digestion and removing food stagnancy, relieving convulsion for resuscitation, inducing diuresis to remove edema, strengthening spleen and replenishing qi, reinforcing primordial qi to supplement kidney, activating blood circulation to resolve blood stasis and restoring yang from collapse. The application of these therapeutic methods in the treatment of infantile diseases will be discussed in the sections concerned. The following therapeutic methods are widely used in treatment of infantile diseases.

Activation of the spleen
Activation of the spleen is a therapeutic method of regulating the spleen and stomach and promoting transformation and transportation to restore the normal physiological functions of the spleen. This therapeutic method is of ten used to treat syndrome due to dysfunction of the spleen. It has the characteristics of tonifying without stagnating and impairing healthy qi. Activation of the spleen and reinforcement of the spleen (reinforcing the  spleen qi, nourishing spleen blood, nourishing spleen yin  and warming spleen yang) are relative, the former can be categorized into activating the spleen to resolve dampness, activating the spleen to promote appetite, regulating qi to promote transformation, and warming and activating the spleen yang. Clinically these therapeutic methods are used in coordination with other methods, such asnourishing the spleen and promoting digestion to remove stagnation. Activation of the spleen can be used extensively to treat disorders of the spleen and stomach, such as infantile anorexia, diarrhea, abdominal pain, vomiting and malnutrition. The compatibility of drugs in the application of this method is modified according to the pathological conditions of the patients.

 Activating the spleen to resolve damphess
This method is used to treat the syndrome due to encumbering of the spleen by dampness marked by chest distress, anorexia, epigastric fullness, abdominal distension,greasy taste in the mouth without thirst, scanty urine and diarrhea as well as thick and greasy tongue fur. Cangzhu (Rhizoma Atractylodis) is the main drug used to activate the spleen by eliminating dampness and dispersing yang to remove turbidity because it tends to migrate. Other commonly used medicinal herbs are Huoxiang (Herba Agastachis ), Peilan (Herba Eupatorii), Baidoukou ( Semen Amomi Cardamoni ), Banxia (Rhizoma pineltiae), Houpohua ( Flos Magnoliae Officinalis ), Dadouhuangjuan (Doujuan), Biandou (Semen Dotichoris) and  Cheqianzi ( Semen Plantaginis ), etc. The commonly used prescription is Buhuanjin Zhengqi Powder.

Activating the spleen to promote appetite
This method is used to treat retention of food marked by abdominal distension, belching with putrid odor, nausea, anorexia, abdominal pain, diarrhea, foul stool with indigested material, restless sleep and dirty greasy tongue fur as well as improper feeding before the onset of the disease. The commonly-used medicinal herbs are Cangzhu ( Rhizoma Atractylodis ),  Jiaoshanzha  ( carbonized Fructus Crataegi ), Jineijin ( Endothelium Corneum Gigeriae GaUi ) , Shenqu ( Massa Fermentata Medicina-tis), Guya ( Fructus Oryzae Germinatus ) and Maiya ( Fructus hordei Germinatus ), etc.. The commonly used prescriptions are Baohe Pill (Lenitive Pill) and Xiaoru Pill (Pill for Promoting Digestion of Milk).

Regulating qi to supplement transformarion and transportation
This method is used to treat the syndrome due to disorder of qi activity marked by retention of food, abdominal distension like tympanites, belching, abdominal pain which alleviate after defecation and breaking wind, thin whitish tongue. The commonly used medicinal herbs are Chenpi (Pericarpium Citri Reticutatae ),  Muxiang (Radix Aucklandiae ), Zhike ( Fructus Aurantii ), Binglang ( Semen Arecae ), Dafupi ( Pericarpium Arecae), Dingxiang (Flos Caryophylli) and Laifuzi (Semen Raphani), etc..  The prescription used is Muxiang Binglang Pill (Pill of Aucklandia and Areca Seed).

Warming and activating spleen yang
This method is used to treat inactivation of spleen Yangmarked by sallow complexion, dispiritedness, averinto cold, fatigue, cold abdominal pain, poor appetite, postcibal distention, drooling, loose stool, clear profuse urine, pale tongue, and thin whitish tongue fur. The commonly used medicinal herbs are Paojiang ( baked gin-get), Cangzhu ( Rhizoma Atractyoodis ), Roudoukou (Semen Myristicae ) , Caodoukou ( Semen Alpiniae KatSumadai), Sharen ( Fructus Amomi), Yizhiren ( Fructus Alpiniae Oxyphyllae), etc.. The prescription used is Fuzi Lizhong Pill (Pill of Aconit Root for Regulating Middle Energizer).

Invigorating qi to supplement transformation and transportation
This method is used to treat failure of the spleen in transportation and transformation due to asthenia marked by lusterless complexion, emaciation, lusterless hair, dispiritedness, lassitude, susceptibility to sweating, anorexia, loose stool, liability to diarrhea after meal, pale tongue and thin whitish fur. The commonly used medicinal herbs are Dangshen (Radix Codonopsis Pilosulae ), Baizhu (Rhizoma Atractylodis Macrocephalae ), Shanyao ( Rhizoma Dioscoreae ), Cangzhu (Rhizoma Atractylodis), Fuling ( Poria ), Chenpi ( Pericarpium Citri Reticulatae), Jiaoshanzha ( carbonized Fructus Crataegi) and Gancao (Radix Glycyrrhizae), etc.. The prescriptions used are yigong Powder (Powder with Marvelous Effect) and Zisheng Jianpi Pill.Nourishing the stomach to supplement transformation and transportation
This method is used to treat insufficiency of stomach yin marked by retention offood, dry mouth, preference for drinking water, disturbed sleep, retention of dry feces, scanty brownish urine, feverish palms and soles, dry lips, reddish tongue with deficient moist, scanty or patched tongue fur. The commonly used medicinal herbs are Maimengdong (Radix Ophiopogonis ), Shashen (Radix  Glehniae ),  Biandou  ( Semen  Dolichoris ), Baishaoyao ( Radix Paeonia Alba ), Wumei ( Fructus Mume ), Shihu ( Herba Dendrobii ), Fuling ( Poria ),  Xiangyuanpi ( Cortex Citri ), Guya ( Fructus Oryzae Germinatus ) and Jineijin (Endothelium Corneum Gigeriae Galli ), etc.. The prescription used is Yangwei  Zengye Decoction (Decoction for Nourishing the Stomach to Promote the Production of Body Fluid).

Regulation of the lung
Regualtion of the lung is a therapeutic method used to regulate pulmonary qi by means of dispersion, cleansing and descent, eliminate pathogenic factors in the lung by clearing away heat and resolving phlegm as well as nourish pulmonary qi and yin to restore the physiological functions of the lung to govern qi and respiration. The method of regulating the lung is often used in coordination with the methods of resolving phlegm and stopping cough to ease asthma, applicable to the treatment of infantile common cold, cough, asthmatic cough due to pneumonia and asthma.

Dispersing the lung to relieve the exterior
This method is used to treat failure of the pulmonary qi to disperse. It can be further divided into relieving the exterior and dispersing the lung with acrid and warm drugs, relieving the exterior and dispersing the lung with acrid and cool drugs, and relieving the exterior and dispersing the lung with acrid and cold drugs according to the etiological differences.
(1)Relieving the exterior and dispersing the lung with acrid and warm drugs  This method is used treat wind and cold attack of the lung marked by fever, aversion to cold, anhidrosis, stuffy nose, running nose, cough, thin whitish sputum, itching throat, no thirst, slight reddish tongue, thin whitish fur, and floating-tense pulse, etc.. The commonly-used medicinal herbs are Mahuang (Herba Ephedrae ), Guizhi ( Ramulus Cinnamomi), Xixin (Herba Asari ), Zisuye ( Folium Perilae), Jingjie (Herba Schizonepetae), Fangfeng (Radix Ledebouriellae ), Congbai ( Bulbus Allii Fistulosi ), Dandouchi ( Semen Sojaem Praeparatum ), Xingren (Semen Armeniacae Amarum ) and Baiqian ( Rhizoma cynanchi   Stauntonii)  etc    The prescriptions used are San'ao Decoction, Congchi Decoction and Xingsu Powder.

(2) Relieving the exterior and dispersing the  lung with acrid and cool drugs  This method is used to treat wind and heat attack of the lung marked by serious fever, light aversion to cold or aversion to wind, sweating, stuffy nose with thick nasal discharge, cough, grayish white or slightly yellowish sticky thick sputum, red throat, dry mouth and slight thirst, reddish tongue, thin yellowish fur and floating-fast pulse, etc.. The commonly used medicinal herbs are Jinyinhua (Flos Lonicerae ), Lianqiao ( Fructus Forsythiae ),  Sangye  ( Folium Mori), Juhua ( Flos Chrysanthemi ), Chantui ( Periostracum Cicadae ), Bohe ( Herba Menthae ), Niubangzi ( Fructus Arctii), Qianhu (Radix Peucedani ), Xingren ( Semen Armeniacae Amarum ) and Jiegeng ( Retinervus Citri Reticulatae Fructus ) , etc.. The prescriptions used are Yinqiao Powder (Powder of Lonicera and Forsythia) and Sangju Decoction (Decoction of Mulberry leaf and Chrysanthemum).
(3) Relieving the heat and dispersing the lung with acrid and cold drugs  This method is used to treat serious syndrome of the lung blocked by wind and heat marked by fever, frequent cough, dyspnea with flapping of ala nasi, sputum rale in the throat, sticky and yellowish sputum, dysphoria, thirst, reddish tongue, yellowish and slightly greasy fur, floating-fast-slippery pulse. The medicinal herbs commonly used are Mahuang (Herba Ephedrae ) , Xingren ( Semen Armeniacae Amarum ) , Shengshigao ( Gypsum Fibrosum), Sbenggancao (Radix Glycyrrhizae), Sangye ( Folium Mori), Daqingye (Folium Isatidis ), Gualoupi ( Pericarpium Trichosanthis ), Pipaye ( Folium Eriobotryae ), and Sangbaipi ( Cortex  Mori Radicis), etc.. The prescription used is Maxing Shigan Decoction.

Clearing away heat in the lung and resolving phlegm
This method is used to treat accumulation of phlegm and heat in the lung marked by fever, frequent cough, dyspnea with flapping of ala nasi, sputum rale in the  throat, sticky and yellowish sputum, dysphoria, thirst,dry stool, yellowish urine, reddish tongue, yellowish  greasy fur, taut-slippery or slippery-fast pulse. The commonly used medicinal herbs are Shengshigao (Gypsum  Fibrosum ) , Sangbaipi ( Cortex Mori Radicis ), Digupi ( Cortex Hyperici Japonici ), Huangqin ( Radix Scutel-
 lariae ), Yuxingcao ( Herba Houttuyniae ), Jinyinhua  ( Flos Lonicerae ) and huzhang ( Rhizoma Polygoni Cuspidati) for clearing away heat in the lung; Zhebeimu (Bulbus Fritillarae Thunbergii ), Fabanxia ( prepared Rhizoma Pinelliae ), Gualoupi ( Pericarpium Trichosanthis), Daigesan ( powder of Indigo Naturalis and Gecko) and Tianzhuhuang ( Concretio Silicea Bambusae)  for resolving heat phlegm; Zhimahuang (prepared Herba  Ephedrae) and Xingren ( Semen Armeniacae Amarum) for relieving stagnant pulmonary qi. The prescriptions Used are Wuhu Decoction, Xiebai Powder (Powder for Purging the Lung), Qingjin Huatan Decoction (Decoction for Clearing away Heat in the Lung and Resolving Phlegm) and Dingchuan Decoction (Decoction for Stopping Asthma). If stagnation of the lung and asthma due to sputum are serious, Tinglizi ( Semen Lepidii seu Descurainiae) and Laifuzi (Semen Raphani) for purging the lung are added, as used in the prescriptions like Tingli Dazao Xiefei Decoction (Decoction of Lepidium Seed and Jujube for Removing Phlegm from the Lung) and Tingli Powder (lepidium Seed Powder).

Warming the lung to descend adverse flow of qi
This method is used to treat retention of cold phlegm in the lung marked by cough, asthma, thin whitish or frothy sputum, sputum rale in the throat, inability to lie on bed due to serious asthma, no thirst, pale tongue, whitish slippery fur and taut-slippery pulse, etc.. The commonly used medicinal herbs are Mahuang (Herba Ephedrae ) , Guizhi ( Ramulus Cinnamomi ), Ganjiang (Rhizoma Zingiberis) and Xixin (Herba Asari ) for warming the lung to dispel cold; Banxia (Rhizoma Pinelliae ),  Houpo ( Cortex Magnoliae Officinalis ),  Suzi ( Fructus Perillae ) , Xingren (Semen Armeniacae Amarum), Baiqian (Rhizoma Cynanchi Stauntonii), Baijiezi ( Semen Sinapis Albae ) , xuanfuhua ( Flos Inulae ) and Wuweizi (Fructus Schisandrae )  for resolving phlegm to stop asthma. The prescriptions used are Xiaoqinglong Decoction, Suzi Jiangqi Decoction (Decoction of Perilla Seed for Descending Qi) and Shegan Mahuang Decoction.

Strengthening the lung with tonification
This therapeutic method, further divided into the methods of nourishing pulmonary qi and replenishing yin to moisten the lung, is used to treat the deficiency syndrome of the lung.
(1) Nourishing pulmonary qi   This therapeutic method is used to treat deficiency syndrome of pulmonary qi marked by pale complexion, short breath, no desire to speak, weak voice, dispirited lassitude, or weak cough worsened after movement, or spontaneous sweating, aversion to wind, susceptibility to cold, pale tongue with thin fur as well as thin-weak pulse. The commonly-used herbs are Zhihuangqi (prepared Radix Astragali seu Hedysari), Dangshen ( Radix Codonopsis Pilosulae ), Baizhu ( Rhizoma Atractylodis Macrocephalae ), Shanyao (Rhizoma Dioscoreae ), Lingzhi (Gaboderma Lucidum), Renshen (Radix Ginseng), Zhigancao (prepared Radix Glycyrrhizae ) and Wuweizi ( Fructus Schisandrae), etc.. The prescriptions used are Yupingfeng Powder (Jade-screen Powder) and Renshen Wuweizi Decoction (Decoction of Radix Ginseng and Fructus Schisandrae).
(2) Replenishing yin to moisten the lung  This therapeutic method is used to treat deficiency syndrome of pulmonary yin marked by cough without sputum, dry mouth and throat, emaciation, hectic fever, night sweating, flushed complexion, reddish and dry tongue with patched fur as well as thin-fast pulse. The commonly-used drugs are Shashen (Radix Glehniae ), Maimendong (Radix Ophiopogonis ), Shanyao ( Rhizoma Dioscoreae ), Yuzhu ( Rhizoma Polygonati Odorati ) , Huangjing ( Rhizoma Polygonati ), Shengdihuang ( Radix Rehmanniae), Ejiao (Colla CoriiAsini) and Fengmi (Mel), etc.. The prescriptions used are Shengmai Powder (Pulsation- promoting powder), Shashen Maidong Decoction and Qingzao Jiufei Decoction (Decoction for Relieving Dryness of the Lung).

Nourishing the kidney
This therapeutic method is used to treat kidney deficiency syndrome which is a commonly encountered syndrome in clinic, because the kidney tends to become as thenic and prolonged duration of disease is liable to affect the kidney among the infants. That is why kidney-nourishing therapy is used so frequently in the treatment of infantile diseases, such as infantile nephrotic syndrome, chronic nephritis, enuresis, underdevelopment of the brain, hypophrenia, malnutrition, cretinism, dwarfism as well as chronic and prolonged diseases (such as prolonged diarrhea and prolonged asthma) and some acute and severe diseases. Kidney deficiency syndrome can be classified into deficiency syndromes of the kidney yang and kidney yin as well as both kidney yin and kidney yang. Accordingly the kidney-nourishing therapy can be further divided into the therapies for warming kidney yang, replenishing kidney yin and nourishing both kidney yin and kidney yang.

Warming the kidney yang
This therapeutic method is used to treat deficiency syndrome of kidney yang marked by pale or blackish complexion, dispiritedness, dizziness, tinnitus, weakness of the waist and knees, aversion to cold, cold limbs, or  prolonged diarrhea, or frequent micturition at night, enuresis, or severe edema of the lower limbs with non-rebounding depression under pressure, pale and corpulent tongue, or tongue with tooth prints, whitish thin fur and deep thready pulse. The commonly-used herbs are Fuzi (Radix Aconiti Praeparata ) , Rougui ( Cortex Cinnamomi), Buguzhi ( Fruztus Psoraleae), Yinyanghuo ( Her ba Epimedii) , Tusizi ( Semen Cuscutae ) , Roucongrong ( Herba Cistanchis) and Lurong ( Cornu Cervi pantotrichum) for strengthening yang ; Shudihuang (Radix Reh manniae Praeparata ) , Shouwu ( Radix Polygoni Multiflo-ri), Shanzhuyu (Fructus Corni), Nuzhenzi (Fructus Ligustri lucidi) and hhnliancao (Herba Ecliptae ) are added for replenishing yin for the purpose of obtaining yang from yin. The prescriptions used are Jingui Shenqi Pill and Yougui  Decoction (Decoction for Reinforcing the Kidney Yang).

Replenishing Kidney Yin
This method is used to treat deficiency syndrome of kidney yin marked by emaciation, dizziness, tinnitus,  hectic fever, night sweating, feverish sensation over the palms, soles and chest, blackish and lusterless complexion, or red cheeks, weakness of the waist and knees, yellowish urine and dry feces, reddish tongue with scanty fur and thready-fast pulse. The herbs commonly used are Shudihuang (Radix Rehmanniaeae Praeparata), Zhishouwu (prepared Radix Polygoni Muttiflori ), Shanzhuyu (Fruztus Corni), Gouqizi ( Fructus Lycii ), Nuzhenzi (Fructus Ligustri Lucidi), hanliancao (Herba Ecliptae) and Guibanjiao (Colta Ptastri Testudinis ), etc.. The prescriptions used are Liuwei Dihuang Pill (Pill of Six Drugs Including Rehmannia), zuogui Decoction and Zhibai Dihuang Pill (Pill of Anemarrhena, Phellodendron and Rehmannia)

Nourishing both yin and yang
This method is used to treat simultaneous deficiency of beth the kidney yin and kidney yang marked by simultaneous appearance of the symptoms and signs related to the asthenia of both the kidney yin and kidney yang. The commonly-used herbs are Renshen (Radix Ginseng ),huangqi (Radix Astragali seu Hedysari), Rougui ( Cortex Cinnamomi ),  Yinyanghuo  ( Herba Epimedii ), hutaorou (Semen Juglandis), Gejie (Gecko), Ziheche (Placenta Hominis ), Dongchongxiacao ( Cordyceps ),  Lurong ( Cornu Cervi Pantotrichum), Shudihuang ( Radix Rehmanniae Praeparata ) , Shouwu (Radix Polygoni Multiflori ), Danggui ( Radix Angelicae Sinensis ), Ejiao ( Colla Corii Asini), Guiban ( Plastrum Testudinis), Gouqizi ( Frutus Lycii ), Shanzhuyu ( Fructus Corni) and Nuizhenzi (Fructus Ligustri Lucidi), etc..  The prescriptions used are Heche Dazao Bolus and Shenqi Dihuang Decoction.

Activating blood circulation to eliminate stasis
Activating blood circulation to eliminate stasis is one of the most commonly-used therapeutic methods in clinic. It is mainly used to treat obstruction syndrome due to blood stasis. Its application is extended to the treatment of other diseases in recent years. In pediatrics, it is taken as the main or supplementary therapy to treat sclerema neonatorum, neonatal hepatitis syndrome, viral hepatitis, pneumonia, bronchial asthma, viral myocarditis, various glomerulopathy, disorders of certain connective tissues,  hemorrhagic diseases and some acute and severe diseases. The curative effect is satisfactory.

Activating blood circulation by cooling
This therapeutic method is used to treat invasion of heat into nutrient and blood phases marked by worsened fever at night, delirium, crimson tongue and fast pulse or epistaxis, dental bleeding, hematemesis, hematochezia, hematuria with bright red or purplish colour, various ecchymosis and maculae with fresh colour as well as reddish tongue and thin-fast-powerful pulse. The commonly- used herbs are Shuiniujiao ( Cornu Bubali), Xuanshen (Radix Scrophulariae ), Shengdihuang ( Radix Rehmanniae ),  Mudanpi  ( Cortex Moutan  Radicis ), Chishaoyao ( Radix Paeoniae Rubra ), Zicao ( Radix Arnebiae seu Lithospermi ), Daqingye ( Folium Isatidis), Huzhang (Rhizoma Polygoni Cuspidati ) , Danshen (Radix Salviae Miltiorrhizae ) , Sanqi (Radix Notoginseng) and Qiancao (Radix Rubiae), etc. The prescriptions used are Qingying Decoction (Decoction for Cleaning Heat in the Ying System), Xijiao Dihuang Decoction and Shihui Powder.

Warming meridians to activate blood circulation
This method is used to treat stagnation of blood due to cold accumulation marked by dull complexion, painful and cold extremities, purplish colour of the skin or redness and swelling like chilblain; or marked by cold abdominal pain, cold body and limbs, alleviation of pain with warmth, darkish colour of tongue and deep-slow-unsmooth pulse. The commonly used herbs are Rougui (Cortex Cinnamomi), Guizhi ( Ramulus Cinnamomi ), Fuzi (Radix Aconiti Praeparata ), Xixin ( Herba Asari ), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Ligustici Chuanxiong ) , Chishaoyao ( Radix Paeoniae Rubra), Honghua (Flos Carthami), zelan (Herba Lycopi ), Jiangxiang ( Lignum Dalbergiae Odoriferae) and Wulingzhi (Faeces Trogopterorum), etc. The prescriptions used are Danggui Sini Decoction (Chinese Angelica Decoction for Restoring Yang) and Yangzang Decoction (Decoction for Nourishing the Viscera).

Activating blood circulation to eliminate abdominal mass
This method is used to treat abdominal mass marked by stabbing, fixed abdominal pain aggravated by pressure, hypochondriac mass fixed in location, lusterless complexion, darkish lips, purplish tongue or with ecchymosis. The commonly-used drugs are Shuizhi ( Hirudo ), Zhechong (Fupolyphagaseu Steleophaga), Ezhu (Rhizama Zedoariae ), Sanleng ( Rhizoma Sparganii ),  Biejia ( Carapax Trionycis ), Dahuang ( Radix et Rhizoma Rhei), Taoren ( Semen Persicae ), Mudanpi ( Cortex Moutan Radicis ) , Wulingzhi ( Faeces Trogopterorum ), Chuanshanjia ( Squama Manitis ), Sanqi ( Radix Notoginseng) , Mull ( Concha Ostreae ) and Mangxiao ( Natrii Sulfas). The Prescription used is Biejiajian Pill (Decocted Turtle Shell Pill).

Nourishing blood to activate blood cirCulaUon
This method is used to treat stagnation due to blood deficiency marked by lusterless complexion, dizziness, palpitation, numbness of limbs, contraction of tendons, or paralysis, pale and darkish tongue or with ecchymosis, swelling-up of sublingual veins and thin-unsmooth or irregular pulse. The commonly-used drugs are Danggui ( Radix Angelicae  Sinensis ),  Jixueteng  ( Caulis Spatholobi ) , Danshen (Radix Salviae Miltiorrhizae ), Shudihuang  ( Radix  Rehmanniae  Praeparata ), Baishaoyao (Radix Paeonia Atba), Chuanxiong ( Rhizo- ma Ligustici Chuanxiong ) , Huangqi (Radix Astragali seu Hedysari ), Taoren ( Semen Persicae ), Honghua ( Flos Carthami), Gouqizi ( Fructus Lycii), Zhiheshouwu (prepared Radix Polygoni Multiflori ) and Shanzha (Fructus Crataegi), etc. The prescriptions used are Siwu Decoction (Decoction of Four Ingredients), Taohong Siwu Decoction and Danggui Buxue Decoction (Chinese Angelica Decoction for Replenishing Blood).

Removing stasis with purgation
This method refers to the method used to eliminate stagnation, dry feces, heat virulence and retention of fluid by means of promoting defecation, removing stagnation, purging excess and expelling various accumulation fluids. It is used to treat various diseases in pediatrics with immediate effects. In clinical application, attention should be paid to the individual constitution and specific pathologic conditions. It should be stopped immediately when the disease is cured so as to protect the healthy qi.

This therapeutic method is, according to the pathological conditions, used in coordination with other methods, such as promoting digestion to remove food retention, resolving phlegm to purge the lung, clearing away heat to remove toxic substance, activating blood circulation to resolve stasis and purgation for eliminating fluid retention,etc.. It can be used to treat the problems caused by internal retention or accumulation of pathogenic factors, such as constipation, dyspepsia, intestinal obstruction and parasitosis; the problems caused by excessive accumulation of phlegmatic heat, such as asthma, pneumonia and acute laryngitis; the problems caused by hyperabundance of febrile virulence, such as pneumonia, tonsillitis, encephalitis, meningitis, appenditis and acute pancreatitis; the problems caused by retention of blood stasis, such as hepatic abscess, cirrhosis of the liver and carcinoma in the abdominal cavity; as well as the problems caused by retention of fluid, such as nephrotic syndrome, acute left heart failure and exudative pleurisy.

 Removing food retention in intestines with purgation
This method is used to treat internal sthenic retention and accumulation syndrome marked by abdominal distending pain, constipation, or diarrhea with abdominal pain, tenesmus, yellowish urine, reddish tongue with greasy fur and deep and excess pulse. The drugs usually used are Muxiang ( Radix Aucktandiae), Binglang ( Semen Arecae) , Zhishi ( Fructus Aurantii Immaturus ),Chenpi (Pericarpium Citri Reticulatae), Ezhu (Rhizoma Zedoar/ae), Houpo ( Cortex Magnoliae Officinalis),
Lianqiao (Fructus Forsythiae), Huhuanglian (Rhizoma Picrorhizae), Dahuang ( Radix et Rhizoma Rhei ),Mangxiao (Natrii Sulfas ), Qianniuzi (Semen Pharbitid/s), Jiaoshanzha (carbonized Fructus Crataegi ) and Shenqu (Massa Fermentata Medicinalis ), etc.. The prescriptions used are Muxiang Binglang Pill (Pill of Aucklandria and Areca Seed), Zhishi Daozhi Pill (Pill of Immature Bitter Orange for Removing Stagnancy) and Tiaowei Chengqi Decoction (Purgative Decoction for Coordinating the Function of the Stomach). If there isparasitos is, Wanying Pill, Quchong Powder (Powder for
Eliminating Worm) and quhui Chengqi Decoction may be used.

 Resolving phlegm and dredging fu or-gans
This method is used to treat hyperabundance of phlegmatic heat marked by red and hot face, asthmatic cough, dyspnea, sputum rale in the throat, chest distress and distention, dysphoria and thirst, constipation, scanty and yellow urine, reddish tongue with yellowish greasy
fur as well as taut-slippery pulse. The drugs usually used are Tinglizi ( Semen Lepidii seu Deseurainiae ) , Xingren( Semen Armeniacae Amarum ), Sangbaipi ( Cortex Mori Radicis ), Laifuzi ( Semen Raphani ), Huangqin (Radix Scuteltariae ) , Tianzhuhuang ( Concretio Silicea
Bambusae ), Xianzhuli ( fresh Succus Bambusae ), Mengshi ( Lapis Chloriti ) , Dahuang (Radix et Rhizoma Rhei ), Qianniuzi ( Semen Pharbitidis ) and Binglang (Semen Arecae ). The prescriptions used are Mengshi Guntan Pill (Pill of Chlorite-schist for Expelling Phlegm),Suting Pill and Niuhuang Duoming Powder.

Dredging fu organs to eliminate heat
This method is used to treat hyperabundance of heat virulence marked by continuous high fever, syncope or mania, stiff neck, spasm of limbs, sputum rale in the throat, skin eruption, dyspnea, constipation, scanty and yellowish urine, thorny tongue with rough grayish and yellowish fur as well as taut-rapid pulse. The commonly-used drugs are Huanglian (Rhizama Coptidis ), Huangqin
(Radix Scutellariae ), Shengshigao ( Gypsum Fibrosum), Zhizi ( Fructus Gardeniae ), Mudanpi ( Cortex
Moutan Radicis ), Shengdihuang (Radix Rehmanniae ), Lianqiao ( Fructus Forsythiae ), Dahuang ( Radix et Rhizoma Rhei) , Mangxiao ( Natrii Sulfas ) and Gancao (Radix Glycyrrhizae), etc.. The prescriptions used are Liangge Powder (Powder for Removing Heat from the Diaphram) and Shiquan Kuhan Jiubu Decoction, etc.

Purgation for elimination of fluid re-tention
This method is used to treat fluid retention syndrome marked by dyspneic cough, palpitation and chest oppression, inability to lie flat due to dysphoria, cyanotic lips; or hypochondriac retention of fluid, referred pain of the chest and hypochondrium due to cough and expectoration, epigastric fullness, retching, short breath, headache and dizziness; or abdominal fullness, constipation, scanty
urine and whitish greasy tongue fur as well as deep-thin-rapid pulse. The drugs usually used are Tinglizi (SemenLepidii seu Descurainiae ), Sangbaipi (Cortex Mori Rad/c/s ), Gualou ( Fructus Trichosanthis ), Jiaomu(Semen Zanthoxyli ), Fangji ( Radix Stephaniae Tetrandrae), Zexie (Rhizoma Alismatis), Dahuang (Radix et Rhizoma Rhei) , Qianniuzi ( Semen Pharbitidis ),Gansui (Radix Euphorbiae Kansui ), Daji ( Herba seu Radix Cirsii Japonici ), Yuanhua ( Floj Genkwa ), Muxiang (Radix Aucklandiae ) and Binglang ( Semen Arecae), etc.. The prescriptions used are Jijiaolihuang Pill, Shizao Decoction (Ten-Jujube Pill) and Zhouche Pill.

The commonly-used external therapies
External therapies are of the same importance as theinternal therapies and are extensively used in the clinical treatment. Since the infants are tender in muscles and skin and pure in visceral qi, it is easier for drugs to work effectively. If properly used, drugs usually can exert immediate effects. The use of external therapies, same as that of the internal therapies, should be made on the basis of syndrome differentiation.  The selection of drugs,methods and regions for application must be made accordi
ing to individual patient, time and pathological conditions in order to accomplish the goal of curing the disease. The external therapies commonly-used in pediatrics are navel therapy, application,  enema,  wearing and ultrasonic aerosol inhalation, etc..

 Navel therapy
Shenque (CV8), the acupoint on the navel, is an important acupoint located on the conception vessel and connects with the viscera through the meridians. During the development of the fetus, the navel is the last closure of the abdominal wall. Its horny layer is very thin. There is no subcutaneous fat tissue. The skin is directly connected with fascia and peritoneum. Its barrier action is weak while its permeability is strong. Under the navel there are inferior epigastric artery, vein and rich capillaries, so
drugs are easy to penetrate it and be absorbed. That is why navel therapy can treat various diseases. The navel therapy is marked by application of medicinal paste, insertion of medicinal powder or wearing belly bag, among which application of medicinal paste is the most effective one, because the solvent in the medicinal paste (such as water, oil and honey, etc. ) and the sweat accumulating in
the navel after the application can promote the absorption of the drugs through the hydration of the horny layer. The navel therapy can be used to treat infantile diarrhea, anorexia, vomiting, dyspepsia, infantile malnutrition, abdominal pain, common cold, thrush, enuresis, hidrosis, urine retention, constipation, hernia and intestinal palsy. It is especially effective in treating gastrosplenic disorders.

Topical application of drugs
Topical application of drugs, a commonly-used external therapy, means to apply medicinal paste, cake or ordinary paste sprinkled with medicinal powder to the local regions. This therapy is significant in eliminating pathogenic factors and toxic materials, activating blood circulation by detoxffication, strengthening healthy qi and regulating ying-qi (nutrient qi) and wei-qi (defensive qi) so as to
regulate yin and yang, adjusting qi activity in ascending and descending, and harmonizing the viscera.
In making medicinal paste, the selection of solvent is very important for the drugs to exert effects, the commonly-used solvents are bee honey, wine, vinegar, maltose, sesame oil, animal fat, beeswax, white wax and vaseline, which should be selected according to the pathological conditions and the property of the drugs used. The medicinal paste should be made soft, moist and smooth for
its full play. Currently some kind of osmolar agent, such as azone, is used to promote the absorption of the drugs.

The use of application method is quite extensive. It is not only used in treating superficial ailments, such as furuncle, sore, carbuncle, ulcer and erysipelas, but also used in treating visceral disorders, such as diarrhea,pneumonia and asthma. Generally speaking, local topical application is used to treat external problems and the disorders with confined location, while acupoint application is used to treat internal disorders and the disorders with extensive involvement. In treating disorders in the upper
energizer, the medicinal preparation is applied to such acupoints as Shanzhong ( CV17 ),  Feishu ( BL13 ), Laogong (PC8) and Neiguan (PC6). While in treating disorders in the middle energizer, the medicinal preparation is applied to the acupoints like Shenque (CV8) and Zhongwan (CV12). For treating disorders of lower energizer, medicinal preparations is applied to Dantian (Ex), Guanyuan (CV4) and Yongquan (KII, etc..

Enema therapy
Enema therapy is a therapeutic method marked by  infusion of medicinal liquid into the intestines through anus. Around the rectum there are rich arteries, veins and lymph plexus which provide the rectum with sufficient blood and make it easier for the medicinal liquid to be directly absorbed into the blood without the involvement of  the stomach and the small intestine, effectively preventing the digestive juice from affecting or destroying the medicinal liquid and making it easier for the medicinal liquid to exert effects directly.
Enema therapy can be classified into retention-enema and rectoclysis. The sick infant assumes the lying position and the buttocks are cushioned to prevent the medicinal liquid from flowing out. The dosage for retenton-enema is usually small. A syringe of 50 ml is selected to absorb proper amount of the medicinal liquid and is connected with a sterilized infantile anal tube, the tip of which is lubricated with some lubricant. Then the tube is slowly inserted into the anus 6 to 10 cm in depth and the medicinal liquid is slowly pressed into the rectum. The dosage for rectoclysis is large, usually 100 to 200 ml. The bottle of the medicinal liquid is placed by the bed with the height of over 70 era. The rectoclysis usually lasts for 15 to 30 minutes. The insertion method is the same as that for the
retention-enema. The enema therapy is applicable to the treatment of infantile dysentery, constipation, diarrhea, fever, pneumonia and convulsion, etc..

Wearing therapy
Wearing therapy means to pack the medicinal powder into a small bag which is worn over the chest or abdomen of the infants. The medicinal powder also can be made into a pillow or a sleeveless garment or waistcoat to wear. Wearing therapy is an external therapy used to prevent and treat infantile diseases. The drugs used for such a purpose are usually fragrant, acrid and migratory, effective in
increasing the immunoglobulin and strengthening the body resistance to prevent and treat diseases through the absorption by the respiratory tract and the skin.
Wearing therapy is applicable to the treatment of common cold, cough, asthma, anorexia, diarrhea and abdominal pain, etc..

Tags: TCM Pediatrics Treatment

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