Exploration on the treatment of pediatric heat-bound constipation with concurrent diarrhea by"treating obstruction with purgation"method
Heat-bound constipation with concurrent diarrhea,a condition characterized by the accumulation of heat in the intestines,causing dry feces to accumulate and leading to the intermittent excretion of foul water,is often attributed to external pathogenic factors,inappropriate diet or medication,and chronic constipation.Infants and young children,with their delicate constitution of both yin and yang,are prone to deficiencies in qi,blood,and body fluids.When heat dries up yin and accumulates in the gastrointestinal tract,disrupting normal conduction,dry feces accu-mulate in the intestines,stimulating the intestinal mucosa,resulting in increased secretions and the exudation of body fluids.Clinically,this manifests as abdominal distension and pain around the umbilicus that is aggravated by touch,accompanied by intermittent expulsion of foul-smelling water from the anus.Although the causes may vary,the pathogenesis is the same:obstruction occurs where there is obstruction,and diarrhea occurs where there is diarrhea.The"concurrent diarrhea"is a superficial manifestation,whereas the"heat-bound constipation"is the essence.It is crucial to differentiate heat-bound constipation with concurrent diarrhea from diarrhea,constipation,and their comor-bid conditions.The"golden standard"for diagnosis is palpation to detect fecal masses.The treatment approach should adhere to the principle of"treating obstruction with purgation,"employing the San Chengqi Decoctions(三承气汤)formulated by ZHANG Zhongjing,with modifications based on the specific condition of the child.Medica-tion should be administered in small but precise doses,avoiding excessive purgation,and treatment should be dis-continued once the disease is alleviated,with attention paid to post-treatment care.Prevention strategies should focus on maintaining intestinal patency,maintaining a balanced diet,avoiding prolonged sitting and sedentary lifestyles,and guarding against other illnesses.
heat-bound constipation with concurrent diarrheapediatrictreating obstruction with purgationsyndrome differentiation and treatment
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