中医内外同治抗合成酶抗体综合征合并肺间质病变伴水肿1例

刘智霖; 白逸晨; 马建岭; 史利卿

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中医内外同治抗合成酶抗体综合征合并肺间质病变伴水肿1例

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中医内外同治抗合成酶抗体综合征合并肺间质病变伴水肿1例
One Case Report of Internal and External Treatment of Chinese Medicine in the Treatment of Antisynthetase Syndrome with Interstitial Pulmonary Disease and Edema
1.北京中医药大学东方医院呼吸热病科，北京 100078
2.中国中医科学院中医药信息研究所，北京 100700
DOI：

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刘智霖, 白逸晨, 马建岭, 等. 中医内外同治抗合成酶抗体综合征合并肺间质病变伴水肿1例[DB/OL].（2023-05-09）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=36919211&Fpath=home&index=0

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
刘智霖, 白逸晨, 马建岭, 等. 中医内外同治抗合成酶抗体综合征合并肺间质病变伴水肿1例[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

Hoogendijk J E, Amato A A, Lecky B R, et al. 119th ENMC international workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Netherlands[J]. Neuromuscul Disord, 2004, 14(5): 337-345.

Selva-O'Callaghan A, Pinal-Fernandez I, Trallero-Araguas E, et al. Classification and management of adult inflammatory myopathies[J]. Lancet Neurol, 2018, 17(9): 816-828.

Zamora A C, Hoskote S S, Abascal-Bolado B, et al. Clinical features and outcomes of interstitial lung disease in anti-Jo-1 positive antisynthetase syndrome[J]. Respir Med, 2016, 118: 39-45.

Witt L J, Curran J J, Strek M E. The Diagnosis and Treatment of Antisynthetase Syndrome[J]. Clin Pulm Med, 2016, 23(5): 218-226.

Lundberg I E, Tjarnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups[J]. Ann Rheum Dis, 2017, 76(12): 1955-1964.

余雯文,吴立琴,戴元荣. 抗Jo-1抗体综合征研究进展[J]. 国际呼吸杂志, 2019(21): 1670-1671.

Marie I, Josse S, Hatron P Y, et al. Interstitial lung disease in anti-Jo-1 patients with antisynthetase syndrome[J]. Arthritis Care Res (Hoboken), 2013, 65(5): 800-808.

Aggarwal R, Cassidy E, Fertig N, et al. Patients with non-Jo-1 anti-tRNA-synthetase autoantibodies have worse survival than Jo-1 positive patients[J]. Ann Rheum Dis, 2014, 73(1): 227-232.

Hervier B, Devilliers H, Stanciu R, et al. Hierarchical cluster and survival analyses of antisynthetase syndrome: phenotype and outcome are correlated with anti-tRNA synthetase antibody specificity[J]. Autoimmun Rev, 2012, 12(2): 210-217.

Connors G R, Christopher-Stine L, Oddis C V, et al. Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years?[J]. Chest, 2010, 138(6): 1464-1474.

Harlow L, Fernandez I, Soejima M, et al. Characterization of TLR4-mediated auto-antibody production in a mouse model of histidyl-tRNA synthetase-induced myositis[J]. Innate Immunity, 2012, 18(6): 876-885.

李然,李向培. 结缔组织病相关的肺间质病变研究进展[J]. 安徽医学, 2012, 33(4): 503-505.

于小林,李思敏,崔晋伟,等. 化湿清营活血法治疗抗合成酶抗体综合征探析[J]. 中华中医药杂志, 2020, 35(9): 4505-4507.

金李,谷帮杰,李传芝,等. 中药寒热药性与其现代药理作用关联研究[J]. 亚太传统医药, 2020, 16(6): 161-163.

刘芬芬,羊维,黄琳,等. 中医学对糖皮质激素主治功效的药性认识[J]. 中华中医药杂志, 2015, 30(4): 1268-1270.

王海英. «金匮要略»蒲灰散中蒲灰用药考略[J]. 时珍国医国药, 2007(11): 2839.

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