Shigella dysentery

　　Shigella dysentery is caused by frequent anxiety, frequent movement of liver fire, in the middle of autumn, heart heat greedy for coolness, eating a lot of melons and fruits, resulting in dysentery, clinical manifestations include abdominal pain, diarrhea, tenesmus, purulent blood stools, accompanied by systemic toxic symptoms.

　　The clinical manifestations of Shigella dysentery include abdominal pain, diarrhea, tenesmus, purulent blood stools, accompanied by systemic toxic symptoms, in addition to its clinical manifestations, it can also cause other diseases. Complications of Shigella dysentery can cause symptoms such as weight loss and malnutrition.

　　The clinical manifestations of shigellosis include abdominal pain, diarrhea, tenesmus, purulent blood stools, accompanied by systemic toxic symptoms. Infants have a weak response to infection, the onset is slow, and the stool is often loose and indigestible at the beginning, and the course of the disease is prone to prolongation. Children over 3 years of age have an acute onset, with fever, diarrhea, and abdominal pain as the main symptoms, and may have convulsions and vomiting. Patients infected with Shigella dysenteriae or Shigella flexneri have more severe conditions, are prone to toxic type shigellosis, and are more common in children aged 3 to 7. Artificially fed infants are physically weaker and are prone to complications.

　　Gypsum is a medicine for treating exterior syndrome with real heat. Now this condition does not involve exterior syndrome, so why is it also used in the formula? The answer is that gypsum is the sacred medicine for treating patients with real heat in the Yangming stomach. It does not matter whether it is due to exterior syndrome or not. The Qi of the Yangming stomach should flow downward continuously. If there is heat, the Qi tends to rise instead of descending. Because the Qi of the stomach is carried upward by heat, it often causes nausea, vomiting, and loss of appetite. If one only knows how to clear the heat but does not know how to descend the Qi, the treatment is often not effective. Only gypsum, being cool and heavy (even when decocted into a decoction, it still has a heavy quality), can clear real heat with its coolness and suppress the reversed Qi with its weight. Therefore, for those with Qi rising due to real heat in the stomach that causes a loss of appetite, taking it can have an immediate effect. If one must say that gypsum is specifically for treating real heat due to exterior syndrome and should not be used for internal injury with real heat.

　　In acute cases, the total white blood cell count and neutrophils increase, with possible left shift of the nucleus. Chronic patients may have anemia. Typical patients may have a large number of pus cells and red blood cells, as well as phagocytes, in the stool examination. Atypical cases may only show a few white blood cells. Positive results can be obtained by selecting stools with pus and blood. X-ray and sigmoidoscopy can be used for the examination and differential diagnosis of chronic bacillary dysentery.

　　The following will introduce in detail the therapeutic diet methods and dietary taboos for lockjaw dysentery:

　　Therapeutic Diet Method:

　　1. Composition: Equal parts of single clove garlic and coptis. Usage: Grind together into fine powder, make into pills with rice gruel. Take 3 to 6 grams, three times a day.

　　2. Composition: 30 grams of tannic acid from pomegranate peel, 50 grams of brown sugar. Usage: First, boil the pomegranate peel to extract the juice, mix with brown sugar and take it warm. Take 1 to 2 times a day, and continue for several days.

　　3. Composition: 50 grams of purple garlic, an appropriate amount of syrup. Usage: Peel the garlic, crush it into a paste, soak in 100 milliliters of warm water for 2 hours, filter with gauze, and add half the amount of syrup. Adults take 80 to 100 milliliters a day, divided into 4 doses, and children take 15 to 40 milliliters a day, divided into 3 doses.

　　4. Composition: 10 grams of tea leaves, 60 grams of hawthorn, 3 slices of ginger. Usage: Boil and add sugar to drink. Take one dose a day, and finish it in 2 to 3 doses. Indications: Dysentery and bacterial food poisoning.

　　5. Composition: 15 to 20 grams of green tea leaves. Usage: Brew and drink as tea. For severe cases, add 30 grains of glutinous rice and a little salt, stir-fry in a pot until yellow, then boil with water to make it taste bitter and salty. Take the juice together, once a day, twice for mild cases, and 2 to 4 times for severe cases.

　　6. Composition: 15 grams of tea leaves, 50 grams of portulaca oleracea, 30 grams of brown sugar. Usage: Boil and drink as tea, take for 3 to 8 consecutive days.

　　7. Composition: 5 grams of green vegetables, 10 grams of ginger, 30 grams of prune meat. Usage: Cut the prune meat into pieces, finely chop the ginger, put them in a thermos with tea, pour boiling water over, cover and steep for half an hour, then add an appropriate amount of brown sugar and take it hot. Take 3 times a day. Supplement: It also has a therapeutic effect on amebic dysentery.

　　8. Composition: 10 grams of green tea, 10 grams of lonicera japonica, 6 grams of rose and tangerine peel, 3 grams of jasminum and licorice. Usage: Infuse with boiling water, cover and steep for 10 to 20 minutes before drinking. Drink 3 to 5 times a day. The dosage for children should be reduced accordingly.

　　9. Composition: 9 grams of tea leaves, 60 milliliters of white grape juice, 10 milliliters of ginger juice, 30 grams of honey. Usage: Boil the tea leaves for 1 hour to extract 100 milliliters of juice, mix it with the other juices and take it once.

　　10. Composition: 100 grams of green tea, 25 milliliters of白酒 (white liquor). Usage: Boil green tea with 700 milliliters of water for 20 minutes, remove the residue, concentrate to 75 milliliters, add白酒 after cooling, take 1-2 milliliters every 4-6 hours, and stop when cured.

　　11. Composition: 2 sour pomegranates, 30 grams of honey. Usage: Mash the pomegranate and squeeze out the juice, mix it with honey, and drink it with warm water. Take 2 times a day, for several days in a row.

　　12. Composition: Fresh radish, a certain amount of rice vinegar, and sugar. Usage: Peel the radish, wash it with cool water, cut it into thin slices, add a certain amount of rice vinegar and sugar, mix well and eat, twice a day.

　　Diet should be easy to digest, rich in nutrition, sufficient in water content, and non-irritating. Eat small, frequent meals.

　　Dietary taboos:

　　1. Acute stage with marked abdominal pain and vomiting should adopt light, liquid foods, such as thick rice gruel, 5-10% fried flour paste, lotus root starch, light fruit juice, vegetable juice, and light tea water. Avoid milk, soy milk, and sweetened beverages.

　　2. Improvement period, vomiting stops, the frequency of defecation decreases, and it is possible to eat nutritious liquid foods or low-fat, residue-free semi-liquid foods, such as milk, soy milk, egg custard, egg soup, oil-free liver puree soup or meat puree soup, etc. Eat 4-5 times a day, drink yogurt, which is beneficial to the disease.

　　3. Recovery period, defecation is basically normal. It is advisable to eat easily digestible semi-liquid or soft rice, and cooking should still focus on thin, fine, soft, and tender food that is easy to digest. Eat more purple-skinned garlic, and can eat raw apple puree, but other fruits should be limited. Avoid eating raw and cold, hard, greasy, fried foods, and spicy刺激性 foods prematurely. Avoid foods high in rough fiber and those that are prone to cause intestinal bloating, such as celery, chives, soybean sprouts, coarse grains, sweet potatoes, potatoes, radishes, etc.

　　Western medical treatment methods for clonic dysentery:

　　1. Treatment of acute dysentery of the common type

　　(1) Routine therapy: Children should rest in bed, be isolated, and adopt disinfection measures. Diet should mainly consist of liquid or semi-liquid foods. Children with severe vomiting, diarrhea, and abdominal distension may be on short-term fasting.

　　(2) Antibiotic therapy: Fluorophenac, gentamicin, coptis alkaloid, and复方新诺明 (compound nitrofurantoin) can be used in combination for oral administration. The course of treatment is 7-10 days.

　　(3) Adsorption therapy: Simeticon can be administered, which has a strong adsorption effect on bacteria and toxins, can inhibit bacterial growth, and can also bind and interact with mucus proteins, strengthening the intestinal mucosal barrier function.

　　(4) Microecological therapy: Bifidobacterium-containing preparations can be used. By binding to the intestinal mucosal epithelial cells, it exerts a protective effect, inhibits bacterial invasion, and maintains the balance of intestinal microecology.

　　(5) Rehydration therapy: The method and amount of rehydration should be determined according to the degree of dehydration.

　　2. Treatment of chronic dysentery

　　(1) The commonly used drugs and dosages of antibiotic therapy are the same as those for acute bacillary dysentery, but the course of treatment should be longer. Intermittent therapy can be adopted, with medication for 7-10 days, followed by a rest period of 4 days, then treatment for another 4 days, followed by another rest period of 4 days, and then repeating this cycle for a total course of 3-4 weeks. Yellow coptis alkaloid or garlic mixed solution can also be used for enema treatment. However, it should be noted that long-term use of antibiotics can cause intestinal flora imbalance. It is advisable to switch to traditional Chinese medicine, vitamins, probiotics, and Simeticon, etc., after the stool culture turns negative and purulent stools disappear.

　　(2) Diet therapy: In addition to antibacterial treatment, chronic bacillary dysentery should also pay attention to improving the nutritional status of patients.

　　3. Treatment of toxic dysentery

　　(1) Improving microcirculation: Utilize atropine-like drugs to relieve vascular spasm and prevent shock. Use dopamine, phentolamine, and isoproterenol to dilate blood vessels. Use hypothermic drugs such as chlorpromazine to inhibit receptors on the vascular wall, causing dilation of the microvasculature, improving microcirculation, and having a sedative and hypometabolic effect. Use corticosteroids and hydrocortisone to reduce inflammation, cerebral edema, and alleviate toxic symptoms.

　　(2) Expansion and acid-base correction: Follow the principle of fluid resuscitation with a fast initial rate, followed by a slow rate, starting with salt and then sugar, and supplementing potassium when urine is seen.

　　(3) Respiratory failure: Oxygen therapy, maintain an open airway, use respiratory stimulants, and for severe cases, intubation or artificial respiration may be required.

　　(4) Reducing cerebral edema: For patients with cerebral form, it is necessary to use diuretics such as mannitol, and to administer dexamethasone intravenously or by rapid intravenous infusion.

　　(5) Infection control: Perform drug sensitivity tests in a timely manner and use antibiotics rationally. Before the results of the drug sensitivity test are available, the first choice is usually fluoroquinolones such as ciprofloxacin given intravenously, but due to the potential impact on the skeletal development of children, the course of treatment should not be too long. Generally, it is 5-7 days. Cephalosporins, such as cefoperazone and cefotaxime, are also commonly used to control infections.

　　(6) Antipyretic: Antipyretics such as Leflunomide, Paracetamol, and Naproxen can be used to reduce fever, as well as cold saline enema and physical cooling.

　　(7) Furazolidone, also known as Furoxone. This drug has antibacterial effects on Shigella, Salmonella, and others, and is not easy to produce drug resistance. There is no cross-resistance with other bacteria, and the concentration in the intestines is high after oral administration. The usual dose for adults is 0.1-0.2 grams, taken orally 3 times a day. Due to the significant side effects of furazolidone and the potential for drug-induced adverse reactions, it is now less commonly used.

　　(8) Berberine: After oral administration, this drug has poor absorption and has a strong effect on Shigella, so it is often used in the treatment of bacillary dysentery. The dose is 0.3 grams per time, taken 3-4 times a day.

　　(9) Sulfonamides: These drugs are difficult to absorb orally, so they can be used for anti-intestinal infections. Currently, the most commonly used is compound sulfamethoxazole, with a dose of 2 tablets per time, taken twice a day.