小兒腹瀉之中藥敷臍文獻探討

Literature Review of Chinese Medicine Umbilical Paste in Pediatric Diarrhea

腹瀉是全球兒童死因的第二名，每年造成約一百五十萬名兒童死亡。這當中，病毒性腹瀉是最主要的一群。全球兩歲以下兒童的嚴重腹瀉主因是輪狀病毒感染，好發於11月到3月之間。若腹瀉持續兩週以上則屬於慢性腹瀉。嚴重的腹瀉與嘔吐可能造成小兒脫水，會增加死亡的風險。敷臍法是中醫治療小兒腹瀉的獨特方式，被廣泛地在臨床上使用。根據中醫的傳統理論與現有臨床資料，目前許多研究證實了使用敷臍法的合理性。回顧近年小兒腹瀉敷臍治療的相關文獻可以發現，輪狀病毒感染常見的證型為：風寒型、濕熱型、脾虛型，常用的藥物為藿香、木香、黃連、丁香、肉桂、吳茱萸。而慢性腹瀉則是以脾虛證為主，常用藥物為白朮、乾薑、黨參、吳茱萸、丁香、肉桂、山藥為主。我們仍須更進一步的研究結果，來提供腹瀉的小兒病患更有效且安全的中醫敷臍治療法。 Diarrheal disorders account for an estimated 1.5 million deaths worldwide every year making it the second leading cause of childhood mortality. Amongst these, viral diarrheas form the most important cluster. Globally, rotaviruses are the most common cause of severe diarrhea in children younger than 2 years and infections occur most commonly from November through March. When diarrhea lasts longer than 2 weeks, it is considered to be chronic. Severe diarrhea and vomiting may cause dehydration, which is associated with a higher risk of mortality. Umbilical paste therapy is a unique method to treat infant diarrhea in traditional Chinese medicines and widely applied in clinical practice. Currently, many researchers have proved the rationality of the therapy based on the traditional Chinese medicine mechanism and on the data from clinical practice. Reviewing research on recent literature of pediatric diarrhea: the common patterns of rotavirus infection are wind-cold、damp-heat、spleen-vacuity, and the most common herbs used in umbilical paste treatment are pogostemon cablin、rosa banksiae、coptis chinensis、syzygium aromaticum、cinnamomum cassia、 tetradium ruticarpum. The common patterns of chronic diarrhea is spleen-vacuity, and atractylodes macrocephala、rhizoma zingiberis、codonopsis pilosula、 tetradium ruticarpum、syzygium aromaticum、cinnamomum cassia、rhizoma dioscoreae are used most often. Further research is needed to provide evidence of effectiveness and safety of Chinese medicine umbilical paste for children with diarrhea.

Diarrheal disorders account for an estimated 1.5 million deaths worldwide every year making it the second leading cause of childhood mortality. Amongst these, viral diarrheas form the most important cluster. Globally, rotaviruses are the most common cause of severe diarrhea in children younger than 2 years and infections occur most commonly from November through March. When diarrhea lasts longer than 2 weeks, it is considered to be chronic. Severe diarrhea and vomiting may cause dehydration, which is associated with a higher risk of mortality. Umbilical paste therapy is a unique method to treat infant diarrhea in traditional Chinese medicines and widely applied in clinical practice. Currently, many researchers have proved the rationality of the therapy based on the traditional Chinese medicine mechanism and on the data from clinical practice. Reviewing research on recent literature of pediatric diarrhea: the common patterns of rotavirus infection are wind-cold、damp-heat、spleen-vacuity, and the most common herbs used in umbilical paste treatment are pogostemon cablin、rosa banksiae、coptis chinensis、syzygium aromaticum、cinnamomum cassia、 tetradium ruticarpum. The common patterns of chronic diarrhea is spleen-vacuity, and atractylodes macrocephala、rhizoma zingiberis、codonopsis pilosula、 tetradium ruticarpum、syzygium aromaticum、cinnamomum cassia、rhizoma dioscoreae are used most often. Further research is needed to provide evidence of effectiveness and safety of Chinese medicine umbilical paste for children with diarrhea.