Helminthiasis

　　Helminthiasis is a disease caused by helminths寄生 in the human body, including ascariasis, hookworm disease, pinworm disease, tapeworm disease, echinococcosis, and liver fluke disease.

　　China is located in temperate and subtropical regions, and its geography, climate, and soil conditions are all suitable for the growth and reproduction of intestinal parasites, so helminthiasis is a common and frequently occurring disease in China, especially with a high incidence rate in rural areas and children.

　　Severe cases can present with different complications depending on the site of the parasites, such as appendicitis, pelvic inflammatory disease, peritonitis, and intestinal obstruction. Most patients gradually appear discomfort or pain in the upper abdomen, decreased appetite, diarrhea, fatigue, and weight loss within 1 to 2 months after infection. Cystic echinococcosis with liver cysts has symptoms such as hidden pain in the liver area, a feeling of fullness in the upper abdomen, dyspepsia, weight loss, anemia, liver enlargement, and a mass in the upper abdomen. Pulmonary cystic echinococcosis has symptoms such as hidden pain, piercing pain, chest tightness, cough, shortness of breath, hemoptysis, and sometimes coughs out chitinous fragments of the inner cyst or daughter cysts, or the head hooks of the protoscoleces are found during sputum microscopy.

　　Most cases caused by the adult worms show no symptoms. The most common symptom is abdominal pain, located around the umbilicus, with intermittent recurrence, accompanied by muscle tension and tenderness. There are often symptoms such as decreased appetite and nausea, dyspepsia, restlessness, urticaria, diarrhea or constipation at times, and sudden onset of episodic pain around the umbilicus without tenderness when pressed. It can also be accompanied by diarrhea or constipation. Children with the disease may sometimes cause neurological symptoms such as convulsions, night terrors, bruxism, and pica.

　　The symptoms of the digestive system are manifested as: most patients gradually appear discomfort or pain in the upper abdomen, decreased appetite, diarrhea, fatigue, and weight loss within 1 to 2 months after infection.

　　In addition, the disease can also cause anemia symptoms: after 3-5 months of severe infection, progressive anemia appears gradually, manifested as dizziness, tinnitus, palpitations, shortness of breath, etc. Long-term severe anemia can lead to heart disease, manifested as cardiac enlargement and increased heart rate. Severe anemia is often accompanied by hypoalbuminemia, resulting in edema of the lower limbs or the whole body.

　　To prevent nematodiasis, the following should be done:

　　1. Strengthen health education and raise the public's awareness of disease prevention.

　　2. Do not eat raw or undercooked freshwater fish and shrimps to prevent accidental ingestion of cysticercoids, and prevent 'disease from the mouth'.

　　3. Strengthen fecal management to prevent eggs from entering the water. Control the source of infection, actively treat patients and carriers.

　　4. Properly control the first intermediate host: if the density of snails in the fish pond is too high, drug treatment can be used to control the spread of Clonorchiasis sinensis and control the source of infection; mass screening and treatment of patients can effectively control the spread of the disease.

　　5. Cut off the transmission route: strengthen fecal management. Strengthen personal protection: avoid close contact with contaminated soil barefoot, and it is best to wear rubber shoes when working in the fields. Pay attention to dietary hygiene habits, such as washing fruits and vegetables before eating them raw.

　　Determination of nematodiasis requires fecal examination and pathogen detection according to the situation. In endemic areas with a history of walking barefoot on the ground and clinical symptoms such as anemia, hookworm disease should be considered. The detection of eggs in the feces is the basis for diagnosis. When the number of eggs in the feces is not much, the detection rate of direct smears is low, and the more reliable method is the saturated salt water floating method and the hookworm culture method. The detection rate of taeniasis eggs in the anal swab is high. It is very difficult to distinguish the eggs of pork tapeworm and beef tapeworm in terms of morphology, and it is necessary to obtain the pregnant segment or the head segment for the final identification.

　　Nematodiasis is a general term that includes multiple parasitic infections, and the specific food therapy is as follows:

　　1, Vinegar (fermented vinegar is best)

　　Function: Calm worms and relieve pain, expel worms.

　　Indications: Children with various intestinal parasites accompanied by abdominal pain.

　　Prescription: Vinegar, ginger, Sichuan pepper (in appropriate amount) and others.

　　Preparation: Wash 100 grams of ginger, slice it, place it in 250 milliliters of rice vinegar, seal the jar for 7 days.

　　Administration: Take 30 milliliters of vinegar warm, once every 6 hours, take for 2 days. Place 3 grams of tea leaves in a cup, pour boiling water over it, steep for 5 minutes, filter out the tea juice, add 2 milliliters of vinegar, take regularly, which can expel intestinal parasites. Take 60 milliliters of vinegar, add a little Sichuan pepper, boil and remove the Sichuan pepper, take it all at once, which can treat various intestinal parasitic infections.

　　2, Plum wine

　　Function: Promote saliva and quench thirst, harmonize the stomach and calm worms, with the effects of expelling nematodes and relieving pain.

　　Indications: Treatment for children with roundworm disease, hookworm disease, and other nematode infections, as well as nausea, vomiting, and abdominal pain caused by the disease.

　　Prescription: 30 grams of plum (can also be replaced with plum candy from a food store, but the amount should be increased), 100 milliliters of yellow wine.

　　Preparation: Wash the plum, place it in a bowl, add yellow wine, cover it. Place it in a pot, steam over water for 30 minutes.

　　Take 5-10 milliliters each time, take on an empty stomach in the morning (heat before taking), take for 7 consecutive days.

　　The drug treatment of helminthiasis mainly includes the following 4 categories:

　　One, benzimidazole compounds This class of drugs is a broad-spectrum anthelmintic that can kill ascaris, hookworms, and other parasites. The mechanism of action is that the drug selectively and irreversibly inhibits the absorption of glucose in the worm body, causing the endogenous glycogen in the worm body to be exhausted, and inhibits fumarate reductase, preventing the production of adenosine triphosphate, causing the worm to be unable to survive and reproduce, and eventually die. Commonly used drugs include:

　　1, mebendazole The daily dose for children is 50-150mg, 100mg for adults each time, taken in the morning and evening, taken for 3 days consecutively; if not fully expelled, the second course of treatment can be used after three weeks. This drug has a good ascaris expulsion effect, with rare side effects, and abdominal pain, diarrhea may occur when a large number of infections are treated with this drug, but it is mild.

　　2, albendazole Trade name intestinal worm clear, a new broad-spectrum anthelmintic. The dose is 400mg, taken once. The efficacy reaches more than 90%. However, in large-scale treatment, there are occasionally reactions of vomiting ascaris.

　　3, levamisole The dosage is 150mg, taken once, this drug is less effective in expelling ascaris than mebendazole, but is better than piperazine, with mild side effects, occasional nausea, vomiting, decreased appetite, etc., and a few patients may experience mild liver function damage after taking the medicine. Early pregnancy, liver, and kidney diseases should be used with caution.

　　4, Thiabendazole, 25mg per kilogram of body weight for adults, taken once in the morning and evening, taken for 3 days consecutively, the daily dose should not exceed 3g, this drug has been replaced by mebendazole.

　　Two, thiabendazole (trade name antiparasitic, vermifuge) This is a broad-spectrum antiparasitic drug that can cause severe muscle contraction in the muscles of the worm, causing spastic paralysis. The dosage is 5-10mg/kg, taken once at night. Side effects include headache, dizziness, vomiting, etc., and should be delayed in pregnant women, acute hepatitis, nephritis, severe heart disease, and fever patients.

　　Three, mebendazole (citric acid piperazine) Adults take 3-4g each time, children take 150mg per kilogram of body weight per day (not exceeding 3g as the maximum dose), taken at bedtime, taken for 2 days consecutively, and vermifuge is added for constipated patients. The side effects are mild, and there may be occasional dizziness, vomiting, headache, etc. This medicine is used less and less.

　　Four, others There are reports of oxygen and acupuncture worm expulsion, which sometimes have unexpected effects.