Treatment options for Kawasaki disease

Many parents neglect their children's health problems, which often leads to the occurrence of some diseases. If not treated in time, the disease will be delayed for a long time and bring more adverse factors. Take Kawasaki disease as an example. Below are several options for the treatment of Kawasaki disease. I hope it will be helpful to everyone.

1. Western medicine treatment of Kawasaki disease

Acute treatment: medication within 10 days of onset. Early oral aspirin can control the acute inflammatory process, and intravenous immunoglobulin plus oral aspirin treatment can reduce the incidence of Kawasaki disease coronary artery aneurysms.

1. Immunoglobulin

Administer 400 mg/kg of immunoglobulin intravenously every day, infused over 2 to 4 hours, for 4 consecutive days; at the same time, take 50 to 100 mg/kg•d of aspirin orally, divided into 3 to 4 times, for 4 consecutive days, and then reduce it to 5 mg/kg•d, taken all at once.

2. Aspirin

The dosage is 30-100 mg•kg per day, divided into 3-4 times. After taking it for 14 days, reduce it to 3-5 mg/kg per day, taken once, after the fever subsides, to achieve the antiplatelet aggregation effect.

3. Corticosteroids

Prednisone and aspirin can be used in combination for treatment. Corticosteroids are generally not used alone to control the early inflammatory response of Kawasaki disease. Prednisone, oral, adults start with 15mg to 40mg/day, which can be increased to 60mg/day when needed, taken in divided doses, and gradually reduced after the condition stabilizes. The maintenance dose is 5mg to 10mg/day.

Recovery treatment

1. Anticoagulant therapy

Take aspirin 3-5 mg/kg per day, once a day, until the erythrocyte sedimentation rate and platelets return to normal. If there is no coronary artery abnormality, the drug is generally stopped 6-8 weeks after the onset of the disease. For patients with chronic residual coronary artery disease, long-term anticoagulant drugs and close follow-up are required. Patients with small single coronary artery aneurysms should take aspirin 3-5 mg/kg per day for a long time until the aneurysm disappears. For those who are intolerant to aspirin, 3-6 mg/kg per day can be used, divided into 2-3 doses. Patients with giant tumors are prone to thrombosis, coronary artery stenosis or occlusion, and oral warfarin anticoagulants can be used.

2. Thrombolytic therapy

Patients with myocardial infarction and thrombosis are given drugs intravenously or by percutaneous catheter puncture into the coronary artery to promote coronary recanalization and myocardial reperfusion. Urokinase 20,000u/kg is injected within 1 hour of intravenous thrombolysis, followed by 3,000-4,000u/kg per hour. Urokinase 1,000u/kg is injected within 1 hour of coronary artery administration. Streptokinase can also be used. Streptokinase 10,000u/kg is injected within 1 hour of intravenous thrombolysis, and it can be used again half an hour later. The above drugs quickly dissolve fibrin, with good effects and no adverse reactions.

3. Coronary angioplasty

In recent years, the use of balloon catheters to dilate coronary artery stenosis has been successful.

4. Surgical treatment

The indications for coronary artery bypass grafting are: ① high-grade occlusion of the left main trunk; ② high-grade occlusion of multiple branches; ③ high-grade occlusion of the left anterior descending branch. For cases of severe mitral regurgitation, medical treatment is ineffective, valvuloplasty or valve replacement can be performed.

5. Cardiogenic shock occurs.

Heart failure and arrhythmias should be treated accordingly.

Kawasaki disease diagnosis and treatment

2. Chinese medicine treatment

1. For acute onset of disease

Continuous high fever, no aversion to cold, or slight aversion to wind, thirsty and willing to drink, no sweat, cough, red eyes and throat, flushed palms and soles, initial rash on face and trunk, swollen lymph nodes in neck, loss of appetite, red tongue, thin white fur, and floating pulse. It is necessary to dispel wind and heat, expel evil and detoxify.

[Prescription] Yinqiao powder with modifications: 12g each of honeysuckle and forsythia, 7g of mint, 12g each of burdock, Scrophularia, Indigo, and reed root, and 7g of raw licorice. For flushing of the palms and soles, add raw rehmannia and scutellaria; for swollen lymph nodes in the neck, add Fritillaria cirrhosa and goat milk root; for those with high fever, add raw gypsum.

2. For persistent fever

Symptoms of mild symptoms during the day and severe symptoms at night, restlessness, or drowsiness, skin rashes, red throat and eyes, dry and cracked lips (oral mucosal congestion, conjunctival congestion), swollen lymph nodes in the neck, or swollen and painful joints, hard and swollen hands and feet, peeling, red tongue shaped like bayberry, thin fur, and strong pulse. It is necessary to clear the Qi and cool the Ying, detoxify and protect the Yin.

[Prescription] Qingwen Baiduyin with modifications, 30g of buffalo horn (pre-decocted), 6-12g each of raw rehmannia root, moutan bark, scrophularia, anemarrhena, honeysuckle, forsythia, scutellaria, and coptis root, 12-16g of raw gypsum, and 7g of light bamboo leaf. For those who still have symptoms of the exterior, increase the dosage of honeysuckle and forsythia. If the yin fluid has been depleted, add fresh dendrobium, ophiopogon, and radix trichosanthis. For those with visceral solidity, use raw rhubarb to clear the bowels. In addition, Qingying Decoction, Huaban Decoction, Xijiao Dihuang Decoction, etc. can also be used at this stage.