中西医结合治疗类风湿关节炎、干燥综合征合并继发性血管炎病案一则
A Case of Integrated Traditional Chinese Medicine and Western Medicine in the Treatment of Rheumatoid Arthritis, Sjogren's Syndrome Combined with Secondary Vasculitis
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1.广州中医药大学第二附属医院(广东省中医院)风湿科,广州 510120
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蔡晓, 徐侦雄, 何晓红, 等. 中西医结合治疗类风湿关节炎、干燥综合征合并继发性血管炎病案一则[DB/OL].(2023-10-11)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=42812809&Fpath=home&index=0
CAI Xiao, XU Zhenxiong, HE Xiaohong, et al. A Case of Integrated Traditional Chinese Medicine and Western Medicine in the Treatment of Rheumatoid Arthritis, Sjogren's Syndrome Combined with Secondary Vasculitis[DB/OL].(2023-10-11)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=42812809&Fpath=home&index=0
蔡晓, 徐侦雄, 何晓红, 等. 中西医结合治疗类风湿关节炎、干燥综合征合并继发性血管炎病案一则[DB/OL].(2023-10-11)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=42812809&Fpath=home&index=0 DOI:
CAI Xiao, XU Zhenxiong, HE Xiaohong, et al. A Case of Integrated Traditional Chinese Medicine and Western Medicine in the Treatment of Rheumatoid Arthritis, Sjogren's Syndrome Combined with Secondary Vasculitis[DB/OL].(2023-10-11)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=42812809&Fpath=home&index=0 DOI:
病史摘要,2,患者为中青年男性,以“口干眼干30余年,关节肿痛14年,双下肢破溃9年”为主诉。患者2005年开始无明显诱因下出现全身关节肿痛,累及双手、双腕、双肩、双膝等关节,诊断为“类风湿关节炎”。2010年无明显诱因下出现左侧小腿内侧皮肤破损,伴局部瘙痒、疼痛,局部皮肤色素沉着,查深静脉彩超提示左下肢深静脉血栓形成。其后左侧小腿皮肤溃疡反复发作,多次门诊住院治疗,症状反复。刻下神清,精神稍疲倦,双下肢小腿皮肤大量色素沉着,左足背内侧局部可见破溃,局部皮肤瘙痒疼痛,局部肤温高,双下肢热辣感,夜甚,冲洗冷水后稍缓解,行走活动、劳累后疼痛加重;右小腿内侧皮肤局部可触及波动感,表皮无破溃;口干、眼干,时胸闷心慌,暂无关节疼痛,无恶寒发热,无头晕头痛,无腹痛腹泻,无恶心呕吐,无口腔、外阴溃疡,无脱发,纳可,眠差,二便调。舌红,苔白腻;脉细。中医诊断 尪痹;燥痹;痈疽(阴虚阳亢证)西医诊断 类风湿关节炎;干燥综合征;血管炎(继发性);下肢深静脉血栓形成干预措施 中医以标本兼治为则,以滋阴清热、扶正托毒为法,方药以当归六黄汤加减。西医予甲泼尼龙抗炎,硫酸羟氯喹片、吗替麦考酚酯片抑制免疫,局部换药。疗效转归 溃口愈合。
Summary of case history, This article introduces a case of integrated traditional Chinese medicine and Western medicine in the treatment of rheumatoid arthritis and Sjogren's syndrome combined with secondary vasculitis. The patient was a middle-aged and young man, with "dry mouth and dry eyes for more than 30 years, joint swelling and pain for 14 years, and both lower limbs ruptured for 9 years". In 2010, his skin of the left inner calf broke down without obvious causes, accompanied by local itching, pain, and local skin pigmentation, and the deep vein ultrasound suggested deep vein thrombosis of his left lower limb. Afterwards, the skin ulcers on the left side of the calf recurred, and he was hospitalised for many times, with repeated symptoms. The patient was clear, slightly tired, with a lot of pigmentation on the skin of both lower limbs, local ulceration on the dorsum of the left foot, itching and pain on the skin, high skin temperature, hot and spicy sensation on both lower limbs, even at night, slightly relieved by rinsing with cold water, and the pain was aggravated by walking activities and exertion; fluctuating sensation could be touched on the skin of the inner side of the right lower leg, and there was no ulceration on the epidermis; dry mouth and eyes, chest tightness, panic, no pain in the joints for the time being, no fever, no dizziness, no headache, no deep venous thrombosis, and no cold or fever. No dizziness or headache, no abdominal pain or diarrhoea, no nausea or vomiting, no ulcers in the mouth or on the vulva, no hair loss, nausea, poor sleep, bowel movement. Tongue red, moss white and greasy; pulse fine.,TCM diagnosis, Wangbi; Zaobi; Carbuncle (yin deficiency and yang hyperactivity),Western medicine diagnosis, Rheumatoid arthritis; Sjogren's syndrome ; Vasculitis (secondary); Deep vein thrombosis of the lower extremities.,Therapeutic methods, Traditional Chinese medicine takes both the symptoms and the root cause as the rule, nourishing the yin and clearing the heat, supporting the right and supporting the poison as the method, and the prescription medicine is added and subtracted from Danggui Liuhuang decoction. Western medicine gives methylprednisolone anti-inflammatory, hydroxychloroquine sulfate tablets, mycophenolate tablets to suppress immunity, and strengthen local dressing changes.,Clinical outcomes, The ulcer healed
类风湿关节炎干燥综合征血管炎溃疡中西医结合
Rheumatoid arthritisSjogren's syndromeVasculitisUlcerIntegration of traditional and western medicine
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