Mononucleosis

Introduction	Back to Top
Mononucleosis is an acute infectious disease caused by the Epstein-Barr virus. It is characterized by a fever, pharyngitis, swelling of the liver, spleen and lymph nodes, an increase in heterotype lymphocytes in the peripheral blood, the appearance of heterophilic agglutinin, and an increase in specific antibodies in the serum. The disease is benign. However, sometimes it is accompanied by severe complications, and occasionally results in death. In traditional Chinese medicine, it belongs to the category of “epidemic febrile disease”, “pestilence”, “subcutaneous nodule”, “jaundice”, "zhengji lump” etc.

Etiology/Pathogenisis	Back to Top
Mononucleosis is an acute infectious disease caused by the Epstein-Barr virus. It is characterized by a fever, pharyngitis, swelling of the liver, spleen and lymph nodes, an increase in heterotype lymphocytes in the peripheral blood, the appearance of heterophilic agglutinin, and an increase in specific antibodies in the serum. The disease is benign. However, sometimes it is accompanied by severe complications, and occasionally results in death. In traditional Chinese medicine, it belongs to the category of “epidemic febrile disease”, “pestilence”, “subcutaneous nodule”, “jaundice”, "zhengji lump” etc.

Primary Treatments with Medicinal Herbs	Back to Top
Qing Wen Bai Du Yin Lu Jian Er treated 30 cases of infectious mononucleosis in children using the principle of clearing away heat and toxic material and promoting blood circulation to dissipate the stagnancy. A Modified Qing Wen Bai Du Yin (antipyretic and antitoxic decoction) was used. The decoction was composed of Shi Gao (Gypsum), Zhi Mu (Anemarrhena), Huang Lian (Coptis), Shui Niu Jiao Fen (Buffalo Horn powder), Huang Qin (Scutellaria), Zhi Zi (Gardenia), Gan Gao (licorice), Sheng Di Huang (Rehmannia Root), Chi Shao (Peony Red), Mu Dan Pi (Moutan), Xuan Sheng (Scrophularia), and Lian Qiao (Forsythia). The total effective rate was 97%.(1)

Other Treatments with Medicinal Herbs	Back to Top
Re Du Jin Liu Li Ge, et al. treated infectious mononucleosis with Re Du Jin (a decoction for clearing toxic fever). The decoction was composed of Huang Qi (Astragalus), Qing Dai (Natural Indigo), Zi Cao (Lithospermum), Huang Qin (Scutellaria), Mu Dan Pi (Moutan), E Zhu (Zedoaria), Dang Gui (Dang Gui), and Tao Ren (Persica). One dose per day after boiling with water was given for 7-10 days. This comprised one course of treatment. The results were that the body temperature returned to normal within 2-12 days after initial admission, and other abnormal symptoms and laboratory tests recovered gradually.(2) Qing Kai Lin Li Kai treated infectious mononucleosis with an injection of a Qing Kai Lin solution. The formula contained Niu Huang (Cow-bezoar), Shui Niu Jiao (Buffalo Horn), Zhen Zhu Mu (Nacre), Huang Qin (Scutellaria), Zhi Zi (Gardenia), Jin Yi Hua (Lonicera Flower), and Ban Lan Gen (Isatis Root). For children between ages 5-15 yrs, 10-20ml of this formula was added into 250ml of a 10% glucose solution. For those older than 16yrs, 20-40ml of the injection solution was added to 500ml of a 10% glucose solution for intravenous infusion. One dose was taken per day. All cases were resolved after 10-40 days of treatment.(3) Qing Xin Liang Ge Han Guan Qing believes that in the early stage, the diseased is at wei fei and qi fei and should be treated with the principle of clearing qi to cleaning up wei, and detoxifying to dissipate heat. The formula used is a modification of Qing Xin Liang Ge Powder (a classical powder formula for fever). In the intermediate stage, there is intense heat in both qi and ying system, and severe toxic heat. It should be treated by principles of clearing away heat and toxin, promoting blood circulation, and resolving the stagnancy. The formula used is a modification of Liang Ying Qing Qi Decoction (decoction for cooling down ying to clearing up qi). The advanced stage involves recovering residual heat that was not cleared away, and damage to lungs and stomach yin. It should be treated with a nourishing yin to help zhen. The formula used is a modified Sha Shen Mai Meng Dong Tang (decoction made up of Glehnia Root and Ophiopogon) or a modified Yi Wei Tang (decoction for nourishing the stomach). The total effective rate is 96.3% after a treatment period of 12-49 days.(4) Hua's Mononucleosis Formula Li Qiang Hua believes that mononucleosis belongs to the category of “infectious disease” in traditional Chinese medicine. He treated infectious mononucleosis in children according to a differential analysis, in three categories. The first category is characterized by intense heat in both qi and the blood system. It is most commonly seen in the early and intermediate stages. The formula used consists of Sang Ye (Mulberry Leaf), Ju Hua (Chrysanthemum), Jin Yin Hua (Lonicera Flower), Lian Qiao (Forsythia), Shi Gao (Gypsum), Niu Bang Zi (Arctium), Pu Gong Ying (Dandelion), Huang Qin (Scutellaria), Mu Dan Pi (Moutan), Xu Shen (Scrophularia), Hei Jing Jie (Black Schizonepeta), and Zhi Mu (Anemarrhena). The second category is characterized by yin deficiency with remaining of pathogen type. It is most commonly seen in the advanced stage. It should be treated with Qin Hao (Sweet Wormwood), Bie Jia (Tortoise Plastron), Zhi Mu (Anemarrhena), Sheng Di Huang (Rehmannia Root), Xi Yang Shen (American Ginseng), Shi Hu (Dendrobium), Mai Dong (Ophiopogon Root), Bai Wei (Blackend Swallowend Root), Xuan Shen (Scrophularia), and San Qi (Notoginseng). The third category is characterized by the accumulation of phlegm and stagnancy. The formula used consists of Duan Mu Li (processed Oyster Shell), Tao Ren (Persica), Hong Hua (Carthamus), Chi Shao (Peony Red), Bie Jia (Tortoise Plastron), San Qi (Notoginseng), and Dan Shen (Salvia). The formulas were taken once daily for one month. This constituted one course of treatment. Among 36 cases treated for 1-2 courses, the results indicated that the body temperature decreased to normal level within 8 days, on average. The total effectiveness rate of this treatment was 97.1%.(5)

Other Treatments	Back to Top
Cheng Chun Ying treated infectious mononucleosis with combination of Western medicine and Chinese traditional medicine. A Shuang Huang Lian Fen injection solution (60mg/kg/day) was added to a 10% glucose solution for intravenous dripping. The resulting concentration is less than 1%. Virazole (10-15mg/kg/d) was added into a 10% glucose solution for intravenous dripping. No adreno-cortico hormones are used. 7-10 days constituted one course. Treatment was modified according to symptoms. Results showed that all 18 cases were resolved.(6)

Footnotes	Back to Top
¹ Yu Jian Er, et al. Treating infectious mononucleosis in childhood with modified Qin Wen Bai Du Ying. Shanghai Journal of Traditional Chinese Medicine and Herbs. 2000;34(6):24-25. ² Liu Li Ge, et al. Treating 46 cases of infectious mononucleosis with Re Du Jing. Journal of Traditional Chinese Medicine. 1993;34(11):669-670. ³ Li Kai. Treating 10 cases of infectious mononucleosis (virulent pathogen) with Qing Kai Lin injection solution. Journal of Beijing College of TCM. 1992;15(2):125-126. ⁴ Han Gui Qing, et al. Clinical analysis on 58 cases of infectious mononucleosis. Journal of Traditional Chinese Medicine. 1989;30(11):30-31. ⁵ Li Qiang Hua. Therapeutic observation on treating 36 cases of infectious mononucleosis of childhood by differential analysis. Journal of New TCM. 1998;30(5):16-18. ⁶ Cheng Chun Ying. Clinical observation on treating infectious mononucleosis by combination of western medicine and Chinese traditional medicine. Journal of Tianjing College of TCM. 1999;18(2):34.