One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema

LIU Zhilin; BA Yichen; MA Jianling; SHI Liqing

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One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema

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One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema
1.Dongfang Hospital of Beijing University of Chinese Medicine,Beijing,100078,China
2.Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences,Beijing 100700,China
DOI：

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LIU Zhilin, BA Yichen, MA Jianling, et al. One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema[DB/OL].（2023-05-09）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36919211&Fpath=home&index=0
DOI：

LIU Zhilin, BA Yichen, MA Jianling, et al. One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema[DB/OL].（2023-05-09）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36919211&Fpath=home&index=0 DOI：

摘要

病史摘要,2,患者，女，80岁，主因“双下肢浮肿8月余”于2018年5月9日就诊于北京中医药大学东方医院呼吸热病科史利卿主任门诊。患者2017年8月31日因“咳嗽、喘憋、反复发热半月余，伴双下肢疼痛进行性加重”至304医院住院，诊断为“多发性肌炎并肺间质病变”，治疗予抗炎抗感染、免疫抑制剂等治疗。出院后继续予口服激素治疗，咳嗽、喘憋症状控制平稳，肌痛、关节疼痛表现不明显。2017年10月因“双下肢水肿进行性加重”于304医院住院，水肿范围自双脚至双足踝上10 cm，足背肿胀明显，小腿轻度可凹性水肿，期间静脉利尿治疗后效果不明显，水肿反复，范围至两膝关节，出院后继续口服利尿剂（至2018年5月），水肿减轻不明显。2018年1月协和医院最终确诊为“抗合成酶抗体综合征并肺间质病变”，建议继续口服激素治疗，并加用免疫抑制剂（未使用）。现患者双下肢水肿较重，为求进一步治疗来门诊就诊。中医诊断　水肿（阳虚水泛证）西医诊断　抗合成酶抗体综合征合并肺间质病变伴水肿干预措施　以温阳化气、宣肺行水为基本治法，予济生肾气丸合越婢加术汤加减治疗。疗效转归　经过八个月治疗，患者咳喘控制平稳，精神好，水肿情况明显改善，可自行步行并进行日常活动。

Abstract

Summary of case history,　The patient, female, 80 years old, presented to the clinic of Director Shi Liqing of the Department of Respiratory Heat Diseases, Oriental Hospital of Beijing University of Chinese Medicine on May 9, 2018 with the main reason of swelling of both lower extremities for more than 8 months. The patient was admitted to 304 Hospital on August 31, 2017 with cough, wheezing, recurrent fever for more than half a month, accompanied by progressive worsening of pain in both lower extremities, and was diagnosed with polymyositis and interstitial lung lesion. He was treated with anti-inflammatory and anti-infective drugs and immunosuppressive drugs. In October 2017, he was hospitalized in 304 Hospital for progressive aggravation of edema in both lower limbs, with edema ranging from both feet to 10 cm above both ankles, with obvious dorsal foot swelling and mild concave edema in the lower legs. In January 2018, Concord Hospital finally confirmed the diagnosis of anti-synthetase antibody syndrome with interstitial lung lesion and recommended to continue oral hormone therapy and add immunosuppressant (not used). The patient now has severe edema in both lower extremities and came to the outpatient clinic for further treatment.,TCM diagnosis,　Edema;syndrome of water overflowing due to yang deficiency,Western medicine diagnosis,　Antisynthetase syndrome with interstitial pulmonary disease and edema,Therapeutic methods,　The basic treatment is to warm the Yang, transform the Qi, promote the lung and move water, and give isheng Shenqi Pill with Yuebi Jiazhu Decoction.,Clinical outcomes,　After eight months of treatment, the patient's cough and asthma were smoothly controlled, her spirits were good, her edema improved significantly, and she could walk and perform daily activities on her own.

关键词

水肿济生肾气丸越婢加术汤抗合成酶抗体综合征

Keywords

EdemaJisheng Shenqi PillYuebi Jiazhu DecoctionAntisynthetase syndrome

references

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