How to treat creeping corneal ulcer with traditional Chinese and Western Medicine

Abstract: creeping corneal ulcer is seen in the elderly who are weak or have chronic dacryocystitis. The pathogenic bacteria were highly virulent Diplococcus pneumoniae, Staphylococcus aureus and hemolytic streptococcus. Minor corneal trauma, such as grain stabbing, nail bruise and branch abrasion, is often the inducement. Generally, it has an acute onset, rapid development and many changes. If it is not treated in time or handled improperly, it can cause corneal perforation, seriously affect vision and even blindness. Clinical manifestations of

creeping corneal ulcer:

and

have an acute onset. They often suddenly feel eye pain, photophobia, tears and sudden drop of vision 24-48 hours after corneal trauma. Examination showed bulbar conjunctival edema and mixed hyperemia. There are grayish yellow dense infiltrating foci on the cornea, edema around the cornea, blurred focus boundary, and soon form ulcer. The bottom of the ulcer is dirty and covered with necrotic tissue, and the edge of the ulcer extends stealthily to the periphery and deep. If the inflammation cannot be controlled quickly, corneal perforation and even endophthalmitis are easy to occur. The toxin infiltrates into the anterior chamber, which is easy to be complicated with iridocyclitis, anterior chamber empyema, pupil narrowing, and adhesion between iris and lens.

diagnosis of creeping corneal ulcer:

1. Trauma history is often the inducement. 2. Typical clinical manifestations and signs. 3. When scraping materials from the edge of ulcer for smear or culture, pathogenic bacteria can often be found.

treatment of creeping corneal ulcer:

1. Western medicine treatment:

(1) 10000 units / ml penicillin and 0.5% streptomycin, once every half an hour, alternately (only if the skin test is negative). When the disease is stable, change it to once every 1-2 hours. Eye drops such as kanamycin, gentamicin and ofloxacin can also be used.

(2) antibiotics can be injected under the conjunctiva in severe cases.

(3) for those with poor therapeutic effect on the above drugs, Thistle can be selected according to thistle sensitivity test.

(4) when there is iridocyclitis, 1% atropine cream should be used to dilate the pupils as soon as possible.

(5) local hot compress.

(6) patients with chronic dacryocystitis should wash the lacrimal sac with normal saline and antibiotics every day. Lacrimal sac surgery should be performed after keratitis is controlled.

and

(7) can be used as therapeutic corneal transplantation for patients with long-term cure or perforation, and conjunctival flap covering for patients with five conditions.

2. Traditional Chinese medicine treatment: creeping corneal ulcer, which is called coagulation pannus in traditional Chinese medicine.

and

(1) wind heat congestion: black eyes, such as stars, unclear edges, dirty surface, such as thin grease, tugboat red, shy tears, bead pain, headache, decreased vision, red tongue, thin yellow fur, floating pulse number.

and

therapy: dispel wind, clear away heat and remove clouds.

and

prescriptions: 10 grams of bupleurum, Rhizoma Coptidis, Vitex, gentian, Mutong, Schizonepeta tenuifolia and Fangfeng, 12 grams of Scutellaria baicalensis, radix paeoniae rubra and Fructus Gardeniae, and 8 grams of licorice. You can add cicada clothes, Tribulus terrestris, wood thief and so on.

and

(2) are full of heat: large areas of fat clotting, deep caves, yellow fluid rushing up, white eyes mixed with red and swollen, red and swollen eyelids, shy and hard to open, frequent hot tears, multicolor yellow, or fever, thirst, red constipation, red tongue, thick yellow coating and powerful pulse number. Treatment of

and

: clearing heat, purging fire and detoxifying.

and

prescriptions: Guishen, gentian, plantain, Fructus aurantii, cooked rhubarb, Fangfeng, Rhizoma Coptidis, Notopterygii and bupleurum, 10g each, 12g each of Scutellaria baicalensis, mulberry bark, raw land, red peony, Ligusticum chuanxiong and Equisetum, and 6G roasted licorice.

(3) positive deficiency and evil retention: the fat on the pannus is thin, but it does not converge for a long time, the white eye is red and not heavy, the conscious symptoms are light, the tongue is light, and the pulse is weak.

and

therapy: supporting the right and expelling evil.

and

prescriptions: 12 grams of Astragalus membranaceus, honeysuckle, Ligusticum chuanxiong, Angelica sinensis, Paeonia alba and Atractylodes macrocephala, 10 grams of Platycodon grandiflorum, Angelica dahurica and ginseng, 8 grams of licorice and 15 grams of Poria cocos.

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for keratitisE “

(4) in case of iridocyclitis, mydriasis should be dilated with 1% atropine cream as soon as possible.

(5) local hot compress.

(6) patients with chronic dacryocystitis should wash the lacrimal sac with normal saline and antibiotics every day. Lacrimal sac surgery can be performed after keratitis is controlled.

(7) those who cannot heal for a long time or have perforation can be treated with therapeutic corneal transplantation, and those with five conditions can also be covered with conjunctival flap.

2. Traditional Chinese medicine treatment: creeping corneal ulcer, which is called coagulation pannus in traditional Chinese medicine. It is treated according to symptoms, and the curative effect is quite good.

(1) wind heat congestion: black eyes, such as stars, unclear edges, dirty surface, such as thin grease, tugboat red, shy tears, bead pain, headache, decreased vision, red tongue, thin yellow fur, floating pulse number.

treatment: dispel the wind, clear away heat and remove clouds.

prescription: 10 grams of bupleurum, Rhizoma Coptidis, Vitex, gentian, Mutong, Schizonepeta tenuifolia and Fangfeng, 12 grams of Scutellaria baicalensis, red peony, gardenia kernel and 8 grams of licorice. Cicada clothes, Tribulus terrestris and Equisetum can be added as appropriate.

(2) intense heat in the interior: large fat clots, deep caves, yellow fluid rushing up, white eyes mixed with red and swollen, red and swollen eyelids, shy and hard to open, frequent hot tears, multi-color yellow, or fever, thirst, red constipation, red tongue, thick yellow coating and powerful pulse number.

treatment method: clearing heat, purging fire and detoxifying.

prescription: Guishen, gentian, plantain, Fructus aurantii, cooked rhubarb, Fangfeng, Rhizoma Chuanlian, Notopterygii and Bupleurum 10 g each, Scutellaria baicalensis, mulberry, raw land, red peony, Ligusticum chuanxiong and Equisetum, and roasted licorice 6 g each.

(3) retention of positive deficiency and evil: the fat on the pannus is thin, but it does not converge for a long time, the white eye is red and not heavy, the conscious symptoms are light, the tongue is light, and the pulse is weak.

treatment method: supporting the right and expelling the evil.

prescription: 12 grams of Astragalus membranaceus, honeysuckle, Ligusticum chuanxiong, Angelica sinensis, white peony and Atractylodes macrocephala, 10 grams of Platycodon grandiflorum, Angelica dahurica and ginseng, 8 grams of licorice and 15 grams of Poria cocos.

, diagnosis of creeping corneal ulcer: 1. Trauma history is often the inducement. 2. Typical clinical manifestations and signs. 3. Pathogenic bacteria can often be found by scraping materials from the edge of the ulcer for smear or culture. Treatment methods of creeping corneal ulcer: 1. Western medicine treatment: (1) 10000 units / ml penicillin and 0.5% streptomycin, once every half an hour, alternately (only if the skin test is negative can it be used). When the condition is stable, change it to once every 1-2 hours. Eye drops such as kanamycin, gentamicin and ofloxacin can also be used., (2) in severe cases, antibiotics can be injected under the conjunctiva., (3) for those with poor therapeutic effect of the above drugs, Thistle can be selected according to thistle sensitivity test., (4) in case of iridocyclitis, 1% atropine cream should be used to dilate the pupils as soon as possible., (5) local hot compress., (6) patients with chronic dacryocystitis should wash the lacrimal sac with normal saline and antibiotics every day. Lacrimal sac surgery should be performed after keratitis is controlled., (7) therapeutic keratoplasty can be performed for those who cannot recover for a long time or have perforation, and conjunctival flap covering can also be performed for those with five conditions., 2. Treatment with traditional Chinese medicine: creeping corneal ulcer, which is called coagulation pannus in traditional Chinese medicine. It is treated according to symptoms, and the curative effect is quite good., (1) wind heat accumulation: black eyes are covered like stars, the edge is unclear, the surface is dirty, such as thin grease, the tugboat is red, shy and tears, bead pain, headache, decreased vision, red tongue, thin yellow fur and floating pulse., Treatment: dispel wind, clear away heat and remove pannus