Treating Chickenpox with TCM
abstracted & translated by
Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM
Keywords: Chinese medicine, Chinese herbal medicine, pediatrics, chickenpox
Chickenpox is an infectious disease caused by the varicella_zoster virus which results in a blister_like rash,
itching, fatigue, and fever. The rash appears first on the trunk and face but can spread over the entire body causing between 250-500 itchy blisters. Most cases of chickenpox occur in persons less than 15 years old. Prior to the use of varicella vaccine, the disease had annual cycles, peaking in the spring of each year. Chickenpox is highly infectious and spreads from person to person by direct contact or through the air from an infected person’s coughing or sneezing. A persons with chickenpox is contagious 1_2 days before the rash appears and until all blisters have formed scabs. It takes from 10_21 days after contact with an infected person for someone to develop chickenpox.
In children, chickenpox most commonly causes an illness that lasts about 5_10 days. Children usually miss 5-6 days of school or childcare due to their chickenpox. About half of all children with chickenpox visit a health care provider due to symptoms of their illness such as high fever, severe itching, an uncomfortable rash, dehydration, or headache. In addition, about one child in 10 has a complication from chickenpox serious enough to visit a health care provider, including infected skin lesions, other infections, dehydration from vomiting or diarrhea, exacerbation of asthma, or more serious complications such as pneumonia.
Certain groups of persons are more likely to have more serious illness with complications. These include adults, infants, adolescents, and people with weak immune systems from either illnesses or from medications such a long_term steroids. Serious complications from chickenpox include bacterial infections which can involve many sites of the body including the skin, tissues under the skin, bone, lungs, joints, and the blood. Other serious complications are due directly to the virus infection and include viral pneumonia, bleeding problems and encephalitis.
Today, most children in North America are vaccinated against chickenpox. However, no vaccine is 100% effective in preventing disease. For chickenpox vaccine, 8-9 out of every 10 people who are vaccinated are completely protected from chickenpox, and the vaccine almost always prevents against severe disease. If a vaccinated person does get chickenpox, it is usually a very mild case with fewer skin lesions (usually less than 50) lasting only a few days, no fever or a low fever, and few other symptoms. Nevertheless, certain persons should not receive the chickenpox vaccine. These persons are 1) those who ever had a serious allergic reaction to chickenpox vaccine, neomycin, or gelatin; 2) those who now have moderate or serious illness; 3) those who are pregnant; or 4) those who are unable to fight serious infections because of any kind of cancer or cancer treatment with x_rays or drugs, a disease that depresses cellular immune function, treatment with drugs such as long_term steroids, or have gotten blood products such as immune globulin or a transfusion during the past five months. Common side effects of immunization include pain, redness, or swelling where the shot was given (occurring about 20% of the time), a very mild rash or several small bumps (in about 1% to 4% of vaccine recipients). In very rare instances, it may be possible for someone who gets a rash from chickenpox vaccine to give vaccine strain chickenpox to another person. Persons developing a rash after vaccination should take extra precautions to avoid contact with anyone whose immune system is not working properly.
In issue #2, 2002 of Xin Zhong Yi (New Chinese Medicine), Zheng Dui-fa of Ding An, Hainan published an article titled, “The Treatment of 80 Cases of Severe Chickenpox with Qing Re Jie Du Tang Jia Jian (Clear Heat & Resolve Toxins Decoction with Additions & Subtractions),” on page 52 of that journal. A precis of that article is given below to afford Western patients yet more options for the treatment of this condition.
Altogether, there were 150 patients in this study, all of whom were seen at the Chinese author’s hospital as out-patients. These 150 patients were randomly divided into two groups, a treatment group and a comparison group. In the treatment group there were 80 patients, 46 males and 34 females aged 3-17 years with an average age of eight years. These patients had been ill for from 1-7 days, with an average disease duration of 2.4 days. In the comparison group, there were 75 patients, 42 males and 33 females aged 3.5-16 years, with an average age of 7.6 years. These patients had been ill for from 1-6 days, with an average disease duration of 2.2 days. All the patients both groups had a fever of between 38.5-40E C and all had papular skin lesion which gradually became water-filled blisters. These were the size of beans. At the top of these blisters, there was concave indentation similar to the navel. These lesions were thickly clustered and widely diffused on the body on the torso. four limbs, mouth and nose, eyelids, and external genitalia.
Those in the treatment group received the following Chinese medicinals: uncooked Radix Rehmanniae (Sheng Di), 10g, Rhizoma Coptidis Chinensis (Huang Lian), 3g, Fructus Arctii Lappae (Niu Bang Zi), Flos Seu Herba Schizoenepetae Tenuifoliae (Jing Jie Sui), Cortex Radicis Moutan (Dan Pi), Radix Lithospermi Seu Arnebiae (Zi Cao), and Fructus Forsythiae Suspensae (Lian Qiao), 8g each, Herba Menthae Haplocalycis (Bo He) and Caulis Akebiae (Mu Tong), 5g each, and Herba Lophatheri Gracilis (Dan Zhu Ye), 6g. These dosages were for patients 6-10 years of age. They were either reduced or added to depending on the patients age. In addition, if there was high fever, vexation, and agitation, Fructus Gardeniae Jasminoidis (Zhi Zi) and Herba Artemisae Apiaceae (Qing Hao) were added. If the water blisters were unusually large and full and not surrounded by a marked red halo, Rhizoma Smilacis Galbrae (Tu Fu Ling) and Rhizoma Atractylodis (Cang Zhu) were added. If itchy skin was severe, Cortex Radicis Dictamni Dasycarpi (Bai Xian Pi) and Periostracum Cicadae (Chan Tui) were added. If a red halo around the lesions was marked and the water blisters were smaller, then Radix Rubrus Paeoniae Lactiflorae (Chi Shao), Fructus Gardeniae Jasminoidis (Zhi Zi), and Flos Lonicerae Japonicae (Jin Yin Hua) were added. If the water blisters were a dark, purple, color or blood-filled, Flos Carthami Tinctorii (Hong Hua) was added. If the fluid inside the blisters was turbid and pussy due to superimposed infection, Herba Houttuyniae Cordatae Cum Radice (Yu Xing Cao), Herba Taraxaci Mongolici Cum Radice (Pu Gong Ying), and Flos Chrysanthemi Indici (Ye Ju Hua) were added. One packet of these medicinals was decocted in water down to 120ml of liquid per day, sweetened, and administered in two divided doses per day, with five days equaling one course of treatment.
Members of the comparison group received 5mg/kg of body weight of aspirin in 250ml of 5% glucose solution via intravenous drip once every eight hours. Five days also equaled one course of treatment for these patients as well. If the temperature went above 39E C, patients were given antipyretics to bring the temperature down.
Cure was defined as abatement of fever, drying up of all the water blisters, and no appearance of any lesions. Marked effect meant that the fever abated, 70% or more of the blisters dried up, and there was no appearance of any new lesions. Some effect meant that the fever abated, 50-70% of the blisters dried up, and there were only a few new lesions. No effect meant that the fever did not abate, less than 50% of the blisters dried up, and new lesions were seen. Based on these criteria, 35 patients in the treatment group were considered cured, 32 got a marked effect, and 13 got some effect. Therefore, the total effectiveness rate was listed as 100%. In the comparison group, 20 cases were considered cured, 25 got a marked effect, 26 got some effect, and four got no effect. Therefore, the total effectiveness rate in this group was listed as 94.67%. Therefore, the was no marked statistical difference in overall effectiveness between these two groups. However, the average number of days for the fever to abate in the treatment group was 2.93 days and it was 3.82 in the comparison group.
According to Dr. Zheng, chickenpox is due to the chickenpox virus assailing and attacking the skin where dampness brews, thus producing the characteristic chickenpox lesions. Therefore, Dr. Zheng believes that the treatment principles should be to out-thrust the exterior and cool the constructive, resolve toxins and percolate dampness. The above basic formula comes from the famous Qing dynasty medical encyclopedia, the Yi Zong Jin Jian (The Golden Mirror of Ancestral Medicine). Within it, Sheng Di, Zi Cao, and Dan Pi clear heat and cool the blood. Dan Zhu Ye clears heat from the qi aspect or division. Huang Lian clears heat, resolves toxins, and dries dampness. Lian Qiao, Bo He, Jing Jie Sui, and Niu Bang Zi clear heat, resolve toxins, and out-thrust the exterior. Mu Tong disinhibits water and percolates dampness. Thus, when all these medicinals are used together, their effect is to out-thrust the exterior and cool the constructive, resolve toxins and percolate dampness. When used in the treatment of severe chickenpox, Dr. Zheng believes it can shorten the course of disease and prevent complications.
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