和解少阳,清化湿热治疗克罗恩病伴间歇性发热验案1则
Reconciling Shaoyang, Clearing Dampness-heat Treatment of Crohn's Disease with Intermittency Fever was Detected in 1 case
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1.江苏省中医院消化科,南京 210004
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沈洪. 和解少阳,清化湿热治疗克罗恩病伴间歇性发热验案1则[DB/OL].(2023-03-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35702934&Fpath=home&index=0
SHEN Hong. Reconciling Shaoyang, Clearing Dampness-heat Treatment of Crohn's Disease with Intermittency Fever was Detected in 1 case[DB/OL].(2023-03-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35702934&Fpath=home&index=0
沈洪. 和解少阳,清化湿热治疗克罗恩病伴间歇性发热验案1则[DB/OL].(2023-03-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35702934&Fpath=home&index=0 DOI:
SHEN Hong. Reconciling Shaoyang, Clearing Dampness-heat Treatment of Crohn's Disease with Intermittency Fever was Detected in 1 case[DB/OL].(2023-03-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35702934&Fpath=home&index=0 DOI:
薛某,中年女性,以“黏液便间作1年余,再发1月余”于2022年1月19日由江苏省中医院门诊拟溃疡性结肠炎收住入院。患者2021年7月10日于南京市中医院住院诊断为溃疡性结肠炎,予美沙拉嗪缓释颗粒、地塞米松片、蒙脱石散等治疗后症状好转出院。出院后规律服用美沙拉嗪缓释颗粒,间断服用地塞米松。近1月来患者症状反复,入院时见:大便日行1~3次,不成形,夹有黏液,伴里急后重,脐周腹痛,上腹胀,乏力,纳差,夜间低热,体温波动在36.4~37.8°C,带下量多,小便尚调,夜寐欠安。舌红,苔薄黄,脉细弦。干预措施:入院后先后行肠镜检查、小肠核磁、小肠镜检查,结合其病史、症状,明确诊断为克罗恩病,先后予抗炎、抗感染、补液补钾、营养支持、补铁纠正贫血、保护肠粘膜、抑酸护胃等对症处理。中医方面结合辨证,以和解少阳,清化湿热为法,方选蒿芩清胆汤加减。经上述治疗,患者大便成形,无黏液,日行1次,未再发热。腹软,无压痛。舌红,苔薄黄,脉细弦。中医治法 和解少阳,清化湿热中医诊断 久痢(少阳湿热证,兼有脾虚)西医诊断 克罗恩病,贫血,低钾血症,慢性胃炎,肝囊肿干预措施 先予葛根芩连汤加减未效,后改予蒿芩清胆汤加减取效。适合阅读专业:脾胃病科;消化科
Xue, a middle-aged female, was admitted to Jiangsu Province Hospital of Chinese Medicine for ulcerative colitis on January 19th, 2022. The patient was diagnosed with ulcerative colitis in Nanjing Hospital of Chinese Medicine Hospital on July 10th, 2021 and was discharged after treatment with Mesalazine sustained-release granules, dexamethasone tablets and montmorillonite powder. After discharging from the hospital, she regularly took Mesalazine sustained-release granules and took dexamethasone intermittently. The symptoms of the patient have been recurred in the last month, and was admitted to the hospital with : defecate 1-3 times a day, shapeless, with mucus, tenesmus, periumbilical abdominal pain, epigastric distension, fatigue, poor anorexia, low fever at night, body temperature fluctuating at 36.4-37.8 °C. Red tongue, with thin yellow coating, thready wiry pulse. Traditional Chinese medicine diagnosis: Chronic dysentery, Damp-heat syndrome of large intestine with spleen deficiency. Western medicine diagnosis: Crohn's disease; Anemia; Hypokalemia; Chronic gastritis; Liver cyst. Interventions: After admission, colonoscopy, small intestine magnetic resonance, enteroscopy have been done respectively, combined with her medical history and symptoms, a clear diagnosis of "Crohn's disease" was made. Consequently, anti-inflammation, anti-infection, rehydration and potassium supplementation, nutritional support, iron supplement to correct anemia, protection of intestinal mucosa, gastric acid inhibition to protect gastric mucosa was given successively. Combined with syndrome differentiation in traditional Chinese medicine, with the treatment principle of harmonizing Shaoyang and clearing dampness and heat, using addition and subtraction of "Haoqin Qingdan decoction". After the stated treatments, the patient's stool was formed without mucus, and didn't suffer from fevescence again.
克罗恩病发热验案蒿芩清胆汤
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