What Is Purpura Fulminans?

Purpura, Chinese medicine name. Also known as purpura, it is a clinical feature of pediatric bleeding that has blood spots under the skin and mucous membranes, petechiae, and fading. Often accompanied by epistaxis, dentition, and even vomiting, blood in the stool, and urine. The disease belongs to the category of blood evidence, and the "Grape disease", "muscle dysentery", and "spot poison" recorded in ancient Chinese medicine books have similarities with this disease. The disease includes Western medicine allergic purpura and thrombocytopenic purpura. The age of onset of allergic purpura is 3-14 years, especially in school-age children, more men than women, and more incidence in spring. The age of onset of thrombocytopenic purpura is mostly 2-5 years old. There is no difference between men and women. The mortality rate is about 1%. The main cause of death is intracranial hemorrhage.

Chinese name: Purpura
Disease site: Skin, mucous membrane
Related Western Medicine Diseases: Allergic purpura, thrombocytopenic purpura

Other name: Grape disease, Myosine, Spotted poison
Multiple groups: 3-14 years old
Disease classification: Pediatrics
Contagious: no

Purpur noun explanation

Purpura, also known as purpura, is one of the common bleeding disorders in children. It is characterized by bleeding from the skin and mucous membranes, petechiae, and fading. Often accompanied by epistaxis, dentition, and even vomiting, blood in the stool, and urine. The disease belongs to the category of blood evidence, and the "Grape disease", "muscle dysentery", and "spot poison" recorded in ancient Chinese medicine books have similarities with this disease.

The relationship between purpura and disease name in western medicine

The disease includes Western medicine allergic purpura and thrombocytopenic purpura. Purpura is a general term for changes in color after bleeding from the skin and mucous membranes. The clinical manifestations are bleeding spots, purpura, and ecchymosis, which are generally not elevated above the skin surface. It can be slightly raised only in allergic purpura. It starts to become purplish red, does not fade, and gradually becomes lighter in the future. .

Causes of purpura

Purpura is mainly based on disease and blood. In addition, because of the exogenous wind-heat evil, damp-heat and poisonous poisons impede the blood on the surface of the muscles. Inside, due to the lack of body, heart, spleen, qi and blood, kidney yin loss, inflammation due to deficient fire, blood is not due to menstruation, and deficiency syndrome is the main cause.

Purpura pathogenesis

Due to the childish yin and yang, the blood is not filled, the external defense is not solid, and the external feelings are seasonal and evil. All six qis are cremated and entrapped between the fur and muscle. The evil of wind and heat fights with qi and blood, heats the blood, injures blood, overflows the veins, penetrates under the skin, and develops purpura. Those who are evil can also hurt their yin and collaterals, and there will be blood in the stool and urine. If blood heat is delusional, stasis and intestines can cause severe abdominal pain. If the joint is wet and wet, local swelling and pain can be seen, and flexion and extension are unfavorable.

If children have insufficient natural endowment, or the disease is prolonged for a long time, and qi is consumed and yin is injured, qi deficiency and yin injury can be caused, and the condition changes from real to virtual, or mixed with virtual and real. Qi deficiency does not have the right to take pictures, qi does not take blood, blood does not spill out of the veins as usual; yin deficiency fire, blood moves with the fire, seeps out of the pulse, can cause recurrent purpura.

Clinical diagnosis of purpura

Essentials of purpura diagnosis

The disease is more acute, with bleeding as its main disease. In addition to the appearance of purpura on the skin and mucous membranes, it is often accompanied by epistaxis, palpitations, vomiting blood, blood in the stool, and blood in the urine. In severe bleeding, pale symptoms such as paleness can be seen, and even collapse occurs.

Differential diagnosis of purpura

Attention should be paid to identifying whether the disease is allergic purpura or thrombocytopenic purpura.

1. Before the onset of allergic purpura, there may be upper respiratory tract infections or taking certain drugs, food and other incentives. Purpura is more common in the lower extremities, hips, and joints. It is bright red to dark red pimples, erythema, or urticaria higher than the skin. They are of different sizes, mostly symmetrical, and appear in batches without fading. May be accompanied by abdominal pain, vomiting, bloody stools and other gastrointestinal symptoms, migraine swelling and pain, hematuria, proteinuria and so on. Platelet count, bleeding, clotting time, and clot contraction time were all normal. Attention should be paid to regular review of urine routine, often with microscopic hematuria and proteinuria.

2. There are petechiae and petechiae in the skin and mucosa of thrombocytopenic purpura. The petechiae are mostly needle-like in size, generally not higher than the skin surface, and more asymmetric, which can spread throughout the body, but are more common in the extremities and head and face. May be associated with epistaxis, dentition, hematuria, blood in the stool, and so on. Severe cases may be complicated by intracranial hemorrhage. Platelet counts are significantly reduced. The acute type is generally lower than 20 times 10 / L and the chronic type is generally between 9 times / L at 30 × 10 and 9 times / L at 80 × 10. Prolonged bleeding time, poor clot contraction, and positive beam arm test.

Dialectical treatment of purpura

Syndromes of Purpura

According to the onset, course of disease, purpura color, etc. Acute onset, short course of disease, purpura color is more true than the bright ones; slow onset, recurrent disease, lingering disease course, purpura color is mostly weak. Those with fever, bad wind, throat swelling and other evidence of wind-heat symptoms are wind-heat injury; those who are troubled with thirst, constipation, urinary redness, and even rhinoplasty, dentition, blood in the stool, and blood in the urine are blood heat. People with fatigue, dizziness, palpitations, and loss of appetite are not blood-sucking; those with low fever, night sweats, hot hands and feet, and red tongue and less pain are yin deficiency fire.

Pay attention to the severity of the condition. The amount of bleeding and whether it is accompanied by kidney damage or intracranial hemorrhage were used as the basis for judging the severity. Those with less bleeding were mild; severe bleeding was accompanied by a large amount of blood in the stool, hematuria, significant proteinuria, or headache, coma, and convulsions.

Purpura treatment principles

The treatment of this disease is mainly based on clearing heat and cooling blood; the deficiency syndrome is mainly based on nourishing qi and blood, nourishing yin and reducing fire. During the clinical trial, attention should be paid to the mutual transformation of the syndromes or the simultaneous appearance. It is advisable to distinguish between primary and secondary and take overall consideration into consideration during treatment.

Treatment of Purpura Syndrome

Wind-heat injury

Symptoms: the onset is rapid, the whole body is purpuric, especially the lower extremities and buttocks, which are symmetrically distributed, bright red in color, different in size, or accompanied by itching, and may have fever, abdominal pain, joint swelling, hematuria, etc. Quality red, thin yellow fur, floating pulse.

Governing Law: Shufeng disperses evil.

Recipe: Forsythia sclerotium powder addition and subtraction.

Commonly used medicines: peppermint, windproof, burdock, forsythia, mandrill, scutellariae, cohosh, black ginseng, chinese bellflower, angelica, red peony, safflower.

Blood heat delusion

Symptoms: the onset is more rapid, petechiae appear on the skin, and the color is bright red, or accompanied by epistaxis, dentition, vomiting blood, blood in the stool, urine, bright red or purple blood. Also see upset, thirsty, constipation, or with abdominal pain, or fever, red tongue, and strong pulse.

Governing Law: clearing heat and detoxifying, cooling blood to stop bleeding.

Recipe: Xijiao Dihuang Decoction.

Commonly used medicines: rhino horn (generation of buffalo horn), habitat, tannin, red sedge, purple grass, black ginseng, scutellaria baicalensis, raw licorice.

3. Breathless

Symptoms: slow onset, prolonged course, recurrence of purpura, bruises, petechiae, often with nasal rash, dentition, pale skin, tiredness, loss of appetite, dizziness, palpitation, pale tongue, thin veins, thin pulses Powerless.

Governing Law: Strengthen the spleen and heart, and nourish qi and blood.

Recipe: Guipi Decoction.

Commonly used drugs: Codonopsis, Atractylodes, Poria, Licorice, Astragalus, Angelica, Polygala, Jujube Kernel, Longan Root, Woody Fragrant, Ginger, Jujube.

4. Yin deficiency fire

Symptoms: Onset and onset of purpura, epiphyseal palpitations, bright red blood, low fever, night sweats, less upset, dry stools, yellow urine, red tongue, light tongue, few moss, and pulse count.

Governing Law: Nourishing Yin and lowering fire, cooling blood to stop bleeding.

Recipe: Dabuyin Pills.

Commonly used drugs: cooked land, turtle board, cork, Zhimu, pig spinal cord, honey.

Purpura other treatments

Acupuncture

1. Main point: Quchi, Zusanli. Preparing points: Hegu, Blood Sea. Puncture the main acupoint first. Have abdominal pain plus stab Sanyinjiao, Taichong, Neiguan. For allergic purpura.

2. Take points in Liaoning and Yaoyangguan. Ai Zhu separated ginger moxibustion. Each point of moxibustion is 45 minutes, once a day. Used for qi not taking blood.

3. Acupuncture Yushu and Spleen Shu at an angle of 45 ° toward the spine. Quickly insert the needle, twist and lift, and hold the needle for 5 minutes after the gas is obtained. After the needle is inserted into the sea of blood and Sanyinjiao, leave the needle after the gas is injected directly. minute. Once a day, half a month is a course of treatment. Used for qi not to take blood and yin deficiency and fire.

Purpura preventive care

Purpura prevention

1. Actively participate in sports activities to enhance physical fitness and improve disease resistance.

2. All possible causes of allergic purpura should be identified. Actively prevent and treat upper respiratory tract infections, control tonsillitis, dental caries, and sinusitis, expel various parasites in the body, and avoid eating diets and drugs that are likely to cause allergies.

3. For thrombocytopenic purpura, we must pay attention to prevent diseases such as respiratory infections, measles, chickenpox, rubella and hepatitis, otherwise it is easy to induce or aggravate the disease.

Purpura Care

1. When the acute phase or the amount of bleeding is large, bed rest is required to limit the child's activities and eliminate their fear and nervousness.

2. Avoid trauma and collision, so as not to cause bleeding.

3. When the platelet count is less than 9 times / L of 20x10, it is necessary to closely observe the change of the condition to prevent various trauma and intracranial hemorrhage.

4. The diet should be light, nutritious and easy to digest. Hematemesis and blood in the stool should enter a half-flow diet, avoid hard food and crude fiber food. Avoid spicy food. Sons of patients with thrombocytopenic purpura can eat foods such as peanuts and red dates with clothing.

Purpura Literature Abstract

"Symptoms of Various Diseases · Children's Miscellaneous Diseases · Spot Diseases": "The disease of spot poisoning is the heat into the stomach, and the main muscle of the stomach is the heat poison which accumulates in the stomach and the poisonous gas fumes in the muscles. It looks like a mosquito and flea, with erythema, and it turns around. "

"Guidelines for the Treatment of Symptoms and Ulcers": "People with purpura who have purple spots on their skin and the skin from their skin, but also those who do not have itching. This is rheumatism and qi. If the camp guard is astringent, the air cooling is between the muscles, so the color is purple. "

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