中医不是慢郎中,危急重症起沉疴——周仲瑛辨治皮肌炎合并肺间质病变伴感染验案赏析
TCM Can be Used to Treat Severe and Emergency ConditionsTreatment of Dermatomyositis with Pulmonary Interstitial Disease and Infection by ZHOU Zhongying: A Case Report
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1.南京中医药大学附属医院风湿免疫科,南京 210000
2.南京中医药大学周仲瑛工作室,南京 210000
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方樑, 周学平, 周仲瑛, 等. 中医不是慢郎中,危急重症起沉疴——周仲瑛辨治皮肌炎合并肺间质病变伴感染验案赏析[DB/OL].(2023-05-09)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36918660&Fpath=home&index=0
FANG Liang, ZHOU Xueping, ZHOU Zhongying, et al. TCM Can be Used to Treat Severe and Emergency ConditionsTreatment of Dermatomyositis with Pulmonary Interstitial Disease and Infection by ZHOU Zhongying: A Case Report[DB/OL].(2023-05-09)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36918660&Fpath=home&index=0
方樑, 周学平, 周仲瑛, 等. 中医不是慢郎中,危急重症起沉疴——周仲瑛辨治皮肌炎合并肺间质病变伴感染验案赏析[DB/OL].(2023-05-09)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36918660&Fpath=home&index=0 DOI:
FANG Liang, ZHOU Xueping, ZHOU Zhongying, et al. TCM Can be Used to Treat Severe and Emergency ConditionsTreatment of Dermatomyositis with Pulmonary Interstitial Disease and Infection by ZHOU Zhongying: A Case Report[DB/OL].(2023-05-09)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36918660&Fpath=home&index=0 DOI:
病史摘要,2,患者王某,女性,42岁,2012年8月31日因“反复皮疹1年,咳嗽10天,胸闷气喘3天”入院。2011年9月患者无明显诱因出现腹部及前胸部多发暗红色皮疹,后逐渐累及双手指,当地医院治疗效果不佳。2012年6月出现双侧上眼睑及颜面部鼻翼两侧紫红色片状皮疹,伴眶周水肿,就诊中国医学科学院皮肤病医院,检查后诊断为“皮肌炎”,予激素和雷公藤多苷片治疗,病情得到控制。10天前患者无明显诱因出现咳嗽,3天前出现胸闷气喘,活动后加重,就诊于南京鼓楼医院,经激素及抗生素治疗,感染未见明显控制,出现呼吸衰竭,遂于2012年9月5日转入南京鼓楼医院重症医学科(ICU)。次日延请周仲瑛教授会诊,寻求中西医综合治疗。中医诊断 皮痹、暴喘(邪气闭肺证)。西医诊断 皮肌炎;肺间质病变;肺部感染。干预措施 中医从邪气闭肺、郁肺、阻肺论治;西医予无创通气呼吸支持、抗感染、免疫支持等治疗。疗效转归 患者病情好转,从ICU转入普通病房后出院,后定期门诊随访。
Summary of case history, The patient Wang, a 42-year-old female, was admitted to hospital on August 31, 2012 because of "repeated rash for 1 year, cough for 10 days, chest tightness and asthma for 3 days". In September 2011, there was no obvious inducement for the patient to develop multiple dark red skin rashes on the abdomen and front chest, and then gradually involved both hands and fingers. The treatment effect of the local hospital was poor. In June 2012, a purplish red flaky rash appeared on both sides of the upper eyelid and the nose wing of the face, accompanied by periorbital edema. She went to the Dermatology Hospital of the Chinese Academy of Medical Sciences and was diagnosed as "dermatomyositis" after examination. She was treated with glucocorficord and tripterygium glycoside tablets, and the condition was controlled. The patient developed cough without obvious inducement 10 days ago, chest tightness and asthma 3 days ago, which worsened after exercises. After treatment with glucocorficord and antibiotics, the infection was not obviously controlled and respiratory failure occurred. Therefore, she was transferred to the ICU of Nanjing Gulou Hospital on September 5, 2012. The next day, Professor Zhou Zhongying was invited to consult for comprehensive treatment of traditional Chinese and western medicine,.TCM diagnosis, Pi Bi-syndrome, Sudden asthma (Pathogenic factors shutting Lung Qi syndrome).,Western medicine diagnosis, Dermatomyositis, interstitial lung disease, pulmonary infection.,Therapeutic methods, Traditional Chinese medicine treats the disease from pathogenic qi to close the lung, stagnate the lung and block the lung; Western medicine provides non-invasive ventilation, respiratory support, anti-infection and immune support,Clinical outcomes, The patient's condition improved, and she was transferred from ICU back to the general ward. After discharge, she was followed up regularly in the outpatient department.
周仲瑛皮肌炎肺间质病变感染急症
Zhou Zhong-yingDermatomyositisInterstitial lung diseaseInfectionEmergency
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