The rules of acupoint selection of acupuncture and moxibustion for scrofula in ancient times / 中国针灸

Based on data mining technology, the rules of acupoint selection of acupuncture-moxibustion for scrofula in ancient times were analyzed. The relevant articles of acupuncture and moxibustion for scrofula were searched in the Chinese Medical Code, and the original article, acupoint name, acupoint characteristic, and acupoint meridian tropism, etc. were screened and extracted. The Microsoft Excel 2019 was used to establish a acupoint prescription database, and the frequency of acupoints as well as their meridian tropism and characteristics were analyzed. The SPSS21.0 was applied to perform cluster analysis of acupuncture prescriptions; the SPSS Modeler 18.0 was used to perform the association rules analysis of the neck and the chest-armpit acupoints, respectively. As a result, 314 acupuncture prescriptions were extracted, including 236 single-acupoint prescriptions and 78 multiple-acupoints prescriptions (53 for neck and 25 for chest-armpit). A total of 54 acupoints were involved, with a total frequency of 530. The top 3 commonly-used acupoints were Tianjing (TE 10), Zulinqi (GB 41) and Taichong (LR 3); the most commonly-used meridians were hand shaoyang meridian, foot shaoyang meridian, hand yangming meridian and foot yangming meridian; the most commonly-used special acupoints were he-sea points and shu-stream points. The cluster analysis obtained 6 clusters, and the association rule analysis obtained that the core prescriptions of the neck were Quchi (LI 11), Jianyu (LI 15), Tianjing (TE 10) and Jianjing (GB 21), while the core prescriptions of the chest-armpit were Daling (PC 7), Yanglingquan (GB 34), Danzhong (CV 17), Jianjing (GB 21), Waiguan (TE 5), Zhigou (TE 6), Yuanye (GB 22) and Zhangmen (LR 13). The core prescriptions obtained from association rule analysis by difference areas were basically consistent with those by cluster analysis of total prescriptions.

Analysis on specific effect of acupoints at the upper arms in treatment of scrofula and goiter / 中国针灸

Through analyzing the indication distribution of the different acupoints located at the upper limbs recorded in

Ideas sobre la escrófula en Chile, antes de 1882 / Ideas about the scrofula in Chile, before 1882

n Desde la antigüedad la escrófula o lamparón era descrita como tumefacción crónica de ganglios linfáticos cervicales, que afectaba principalmente a niños, adolescentes y jóvenes. Se pensaba que algunas veces también podía comprometer otras partes del cuerpo y cursar con caquexia letal. En el presente artículo se intentó indagar las ideas reinantes en Chile sobre las características y tratamiento de la escrófula, antes del descubrimiento del bacilo tuberculoso. Se revisaron estadísticas principalmente hospitalarias, textos extranjeros disponibles y opiniones de médicos que trabajaron en Chile. Se consignaba el diagnóstico de escrófula en aproximadamente 2,2% de los pacientes, y tisis en 3,8 porciento. Sin embargo, ambas condiciones pueden haber sido inadecuadamente identificadas, especialmente debido a sub-diagnóstico de tisis pulmonar en casos clasificados como neumonía o pleuresía. En el tiempo descrito se opinaba que la escrófula era causada principalmente por transmisión hereditaria, alimentación inadecuada o sífilis en individuos predispuestos por un temperamento linfático. No se encontraron textos chilenos en que se normaran criterios para el diagnóstico de escrófula. Para el tratamiento se mencionaban plantas medicinales y algunos compuestos químicos administrados en infusiones o emplastos. Quedan dudas para interpretar lo que se pensaba sobre el significado y límites de las condiciones denominadas escrófula, escrofuloso y tisis. Este problema se aprecia también en la literatura clínic. (AU)

Since ancient times, scrofula was described as a chronic swelling of cervical lymph nodes, affecting mostly children and young people, and that sometimes it could also compromise other parts of the body, evolving into a lethal consumptive disease. The purpose of this study was to determine the main perceptions about scrofula in Chile, its characteristics and treatment, before the discovery of the tubercle bacillus. Hospital statistics on diseases, available foreign literature, and opinions of physicians who had worked in Chile were reviewed. Scrofula was diagnosed in roughly 2.2 percent of patients, and phthisis in 3.8 percent. Nevertheless, both conditions may have been inadequately identified, especially due to underdiagnosis of pulmonary phthisis, classified as pneumonia or pleurisy in some cases. Scrofula was considered to be caused chiefly by hereditary transmission, an inadequate diet, or syphilis, in people predisposed by a lymphatic temperament. No Chilean texts establishing criteria for diagnosing scrofula were found. Some writings suggested using medicinal plant infusions or poultices to treat scrofula. Uncertainty persists to understand the meaning and limits assigned to the conditions named scrofula, scrofulous and phthisis. This dilemma is also found in the international clinical literature, being attributed mainly to insufficient scientific and methodological development in that epoch.(Au)

Escrófula, forma frecuente de tuberculosis extrapulmonar. Presentación de un caso / Scrofula, a frequent form of extrapulmonary tuberculosis. Case presentation

Introducción: Las formas de presentación de la tuberculosis (Tb) incluyen: la tuberculosis pulmonar, la miliar y la extrapulmonar. Fuera del pulmón, los sitios donde con mayor frecuencia se localiza la tuberculosis son, por orden de frecuencia: ganglios linfáticos, pleura, aparato genitourinario, huesos y articulaciones, meninges, peritoneo y pericardio. Objetivo: Presentar un caso interesante en la clínica de Tuberculosis extrapulmonar y Tuberculosis pulmonar. Presentación del caso: Paciente masculino de 65 años de edad, alcohólico crónico y fumador, empezó a presentar un aumento de volumen en la región lateral derecha del cuello que fue creciendo progresivamente; además de tos húmeda con expectoración blanquecina, disfagia a los alimentos sólidos, astenia, anorexia y pérdida de peso. Al examen físico se evidencian múltiples adenopatías cervicales supurativas, la mayor de 6cm y estertores crepitantes en tercio superior de hemitórax derecho. La prueba de Mantoux fue positiva y la radiografía de tórax sugestiva de TB pulmonar. El paciente fue egresado por alta a petición con tratamiento antituberculoso y antibiótico ambulatorio, los cuales fueron abandonados por parte del paciente. Es ingresado en segunda ocasión en el Servicio de Geriatría por ulceración de la lesión mayor del cuello donde fallece al tercer día por una sepsis generalizada. Conclusiones: La tuberculosis de los ganglios linfáticos es la presentación más común de la tuberculosis extrapulmonar. Esta enfermedad ataca principalmente a personas inmunodeprimidas y en el caso presentado el paciente tenia factores que podrían haber deprimido su sistema inmune como la edad, el alcoholismo crónico y el tabaquismo(AU)

Introduction: The forms of presentation of the tuberculosis (Tb) include: the pulmonary, miliaria and extrapulmonary tuberculosis. Outside of the lung, the where places with major frequency localizes tuberculosis are, by order of frequency: lymphatic ganglions, pleura, genitourinary system, bones and joints, meninges, peritoneum and pericardium. Objective: To present an interesting case in the clinic of extrapulmonary Tb and lung Tb. Case presentation: Masculine 65-years patient of age, chronic alcoholic and smoker. That began to present an increase of volume in the lateral right region of the neck that went growing progressively; besides humid cough with whitish expectoration, dysphagia to the solid foods, asthenia, anorexia and loss of weight. The physical examination made evident multiple cervical suppurative adenopathias, the major of 6cm and crepitating rasps at the superior third of the right hemi-thorax. The Mantoux proof was positive and the thorax X-ray suggested a pulmonary TB. The patient was discharged with a treatment against tuberculosis and ambulatory antibiotic, which were abandoned by the patient. He was entered in second occasion in the service of geriatrics for ulceration of the major injury of the neck and dies at the third day for a generalized sepsis. Conclusions: The tuberculosis of the lymphatic ganglions is the more common presentation of the extrapulmonary tuberculosis. Illness attacks principally to the persons with low defenses and in the presented case the patient had factors that could have depressed his immune system as the age, the chronic alcoholism and the smoking(AU)

La escrófula en el siglo XIX / Scrofula in the 19th century

In the 19th century scrofula or scrofulous adenitis was a frequent condition estimated by the finding of swollen cervical lymph nodes or scars, occurring in both sexes at all epochs of life, mainly in children. It was thought that it principally affected people with an inherited phlegmatic constitution that involved a scrofulous disposition or "diathesis". The disease would be triggered by environmental agents, bad habits or excesses in style of life. Besides injuring cervical lymph nodes, in some cases scrofula could compromise other groups of lymph nodes, bones, joints, lungs or other viscera. In some of its clinical presentations the disease could be healed while others were often lethal disorders. The finding of multiorgan compromise, caseation and "tuberculization" of the lesions originated discussion whether scrofula and tuberculosis were one or two different diseases and if they affected subjects with a common diathesis or people with a distinct scrofulous or tuberculous diathesis. Along the 19th century, before the discovery of Koch's bacillus, the notion of contagion as a cause of scrofula and tuberculosis was not predominant in Europe.

En el siglo XIX la escrófula era frecuente, estimada por la percepción de nódulos o cicatrices en el cuello. Paulatinamente se le empezó a denominar adenitis escrofulosa. Podía presentarse en personas de ambos sexos en todas las épocas de la vida; pero era más frecuente en la infancia. Se pensaba que afectaba principalmente a sujetos con una constitución flemática heredada que implicaba una susceptibilidad o diátesis escrofulosa. La enfermedad sería desencadenada por agentes ambientales, hábitos, o excesos en el estilo de vida. Aparte de los ganglios linfáticos cervicales, podía afectar otros grupos ganglionares, huesos, articulaciones, pulmones y otras visceras, atribuyéndosele diversas formas de presentación que variaban entre las potencialmente curables a las frecuentemente mortales. La afectación multiorgánica, la caseificación y la "tuberculización" de las lesiones originaron la discusión sobre si la escrófula y la tuberculosis eran una sola enfermedad o dos diferentes, y si se desencadenaban sobre una diátesis común o cada una sobre una diátesis específica escrofulosa o tuberculosa. En la mayor parte del siglo XIX, antes del descubrimiento del bacilo de Koch, la noción de contagio como causa de la escrófula y de la tuberculosis pulmonar no parecía predominar en países europeos.

Alkaline Phosphatase Levels in Tuberculous Cervical Lymphadenitis - Could it be a Predictor for Diagnosis and Monitoring Response to Anti-tuberculous Treatment.

Introduction: Scrofula also known as tuberculous cervical lymphadenitis is one of the most common manifestations of tuberculosis (TB). India is a country that still remains plagued by this dreaded disease. The disease poses both diagnostic and therapeutic challenges because it mimics other pathologic processes and does not have consistent physical and laboratory findings. The monitoring of treatment in cases of cervical TB lymphadenitis is more complex due to the peculiar behavior of TB lymph nodes. Materials and Methods: The serum alkaline phosphatase (ALP) of all patients presenting with cervical TB lymphadenitis in the Revised National TB Control Programme (RNTCP) outpatient department (OPD) of MS Ramaiah Medical College was collected. An ALP level at the time of diagnosis was noted. Subsequently, serum ALP levels were measured when the patients come for Directly Observed Treatment Short to RNTCP OPD on 15th, 30th, and 60th day of starting anti-TB treatment (ATT). Results: It has been observed in the study that 72.2% of the patients with cervical tuberculous lymphadenitis had significantly elevated levels of serum ALP (>135 IU/L) at the time of presentation. Only 5.3% among the controls had high ALP, and the difference was statistically significant with a P < 0.001. With sensitivity = 72.2% and specificity of 94.5%, and assuming that the prevalence of TB is 3.2% the estimated positive predictive value is 30.3% and negative predictive value is 99.0%. Based on simple linear regression with ALP as dependent variable and time as independent variable, it is found that among the patients there is a decline in ALP values at an average of 33.4 in every 15 days. Conclusion: This study shows the significance of measurement of serum ALP as a supplementary tool in the diagnosis of cervical TB lymphadenitis. Serial monitoring of serum ALP can be used to monitor the response of ATT.

Analysis of Characteristics about Treating Phlegm Syndrome in Approaches of Phlegmatic Scrofula / 浙江中医药大学学报

[Objective] Have a research on therapeutic methods of phlegm syndrome of Li Ziyi in Qing dynasty, to sum up his therapeutic experience of such syndrome.[Methods]Analysis on the related states and cases on the base of researches on the contents of “Approaches of phlegmatic scrofula ”which was written by Mr. Li, elaborating his characteristics in treating such syndrome. [Results] Mr. Li considered that phlegm syndrome can be classified into milder phlegm and scrofula according to its level of the patient ’s condition and therapeutic effect. He also believed that several aspects should be taken into consideration through the therapeutic process:treat by internal combing with external treatment ,pay attention to seven emotions and smoothen the temper, emphasize nursing care and obey to the contraindication strictly. [Conclusion]There are features in Mr. Li ’s view on phlegm and his treating method of phlegm syndrome. His treating method has a good therapeutic effect and it is worth popularizing.

Prevalence of oral lesions in Brazilian patients with tuberculosis.

Background : Oral lesions of tuberculosis (TB) are rare and usually associated with the secondary form of the disease. Aim : The aim of the present study was to determine the prevalence of oral lesions in a cohort of TB-infected individuals. Materials and Methods : The study was carried out in two reference centers for the treatment of TB in Recife, Brazil. All patients treated for TB in the period from July 2008 to March 2009 were included in the study. The data was subjected to descriptive statistical analysis. Results : One hundred and twenty-one patients were included in the study. A marked male prevalence was observed, with a male:female ratio of 6.12:1. HIV coinfection was a common event (33%). Head and neck lesions of TB were rare. Cervical node enlargement was observed in seven individuals (5.8%) and oral ulceration in one patient (0.8%). Discussion : The low prevalence of oral lesions of TB is in accordance with other studies. Nodal involvement is the most common form of head and neck disease. Conclusion : While TB may be a common accompanying feature of HIV disease, orofacial complications of TB are rare in individuals resident in northern Brazil.

Color Doppler ultrasound in diagnosis and localization of scrofula in operation / 中国介入影像与治疗学

Objective To explore the two-dimensional images features and color flow characteristics of scrofula, as well as their application in the localization of scrofula. Methods A total of 110 cases of the scrofula confirmed by operation were retrospectively analyzed. Two-dimensional images and color flow characteristics, the relationship with vascular traveling and the invasion site were recorded. Results Lymph nodes of the lateral neck region along with large vessels were most commonly involved, then followed the submaxillary lymph nodes and the lymph nodes anterior neck longitudinally. There might be multiple lesions behaving differently on two-dimensional images and with different color flow characteristics. Conclusion Most of scrofula can be diagnosed clearly according to the two-dimensional images and color flow characteristics. The description of relationship between involved lymph nodes with vascular, the depth and position of scrofula make the operation safety.