四妙勇安汤加减治疗热毒蕴结型白塞病1例
The Treatment of Heat-toxic type of Behcet's Disease with Simiaoyong 'an Decoction
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1.云南省中医医院/云南省中医皮肤病专科医院皮肤科,云南昆明,650021
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王金容, 张佩莲, 欧阳晓勇. 四妙勇安汤加减治疗热毒蕴结型白塞病1例[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43053297&Fpath=home&index=0
WANG Jinrong, ZHANG Peilian, OUYANG Xiaoyong. The Treatment of Heat-toxic type of Behcet's Disease with Simiaoyong 'an Decoction[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43053297&Fpath=home&index=0
王金容, 张佩莲, 欧阳晓勇. 四妙勇安汤加减治疗热毒蕴结型白塞病1例[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43053297&Fpath=home&index=0 DOI:
WANG Jinrong, ZHANG Peilian, OUYANG Xiaoyong. The Treatment of Heat-toxic type of Behcet's Disease with Simiaoyong 'an Decoction[DB/OL].(2023-10-26)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43053297&Fpath=home&index=0 DOI:
病史摘要,2,患者为33岁男性,因“双下肢红丘疹、斑块、破溃1月”就诊,症见双小腿散在大小不一紫红斑、丘疹,中央破溃、结痂,表面脱屑,活动时疼痛明显,病程中无发热盗汗,无咳嗽咽痛,无腹痛腹泻,无结膜充血等症状,纳眠可,二便正常,舌红,苔薄根部微黄腻,脉弦数。近2年口腔溃疡发作频繁,平均1次/月;辅助检查示PPD试验、T-Spot阴性,组织病理示毛囊周围及毛囊内见中性粒细胞、核尘、淋巴细胞、组织细胞浸润,毛囊内脓肿形成,真皮全层血管、附属器周围见淋巴细胞、组织细胞浸润,未见肉芽肿,PAS染色、抗酸染色阴性。中医诊断 狐惑病(热毒蕴结)西医诊断 白塞病干预措施 初发时予秋水仙碱片0.5 g po bid+四妙勇安汤加减(忍冬藤60 g, 玄参60 g, 当归40 g, 甘草20 g, 路路通10 g, 水蛭5 g, 炒枳实15 g, 土茯苓30 g, 淮牛膝30 g,5剂,二诊时加黄芪30 g)经治疗明显好转自行停服中药,停中药后复发予秋水仙碱片0.5 g po bid+加沙利度胺50 mg po tid治疗。疗效转归 秋水仙碱片0.5 g po bid+四妙勇安汤加减治疗10天疗效与秋水仙碱片0.5 g po bid+加沙利度胺50 mg po tid治疗3周疗效相当,说明四妙勇安汤加减起效快,疗效佳。
Summary of case history, A 33 year-old male patient, because of the "red papules, plaques, and ulceration of both lower limbs for 1 month" sees a doctor, patients with double leg purple patches in sizes, papules, central has burst, scabby, surface desquamation, activities in obvious pain, in the course of the disease without fever and night sweats, no cough, sore throat, abdominal pain diarrhea, the symptom such as no conjunctival congestion, he sleeps, mainland is normal, red tongue, yellow and greasy moss thin root, Pulse number. Oral ulcer attacks were frequent in the past 2 years, with an average of once a month. Histopathology showed infiltration of neutrophils, nuclear dust, lymphocytes and histiocytes around and in the hair follicle, abscess formation in the hair follicle, infiltration of lymphocytes and histiocytes around the full-thickness vessels and appendages of the dermis, no granuloma, PAS staining and acid-fast staining were negative.,TCM diagnosis, fox isbemusing(heat-toxic type),Western medicine diagnosis, behcet's disease,Therapeutic methods, Colchicine tablets 0.5 g Po bid+ Simiaoyong an decoction (Honeysuckle vine 60 g, Radix ginseng 60 g, angelica 40 g, licorice 20 g, Lulutong 10 g, Leech 5 g, fried Fructus aurantii 15 g, soil Tuckaho 30 g, Huainiu bidentum 30 g, 5 doses, Astragalus 30 g was added at second diagnosis). After treatment, the patient stopped taking traditional Chinese medicine and relapsed with colchicine tablets 0.5 g Po bid and gazalidomide 50 mg Po tid.,Clinical outcomes, The treatment effect of colchicine tablets 0.5 g Po bid+ simiaoyong 'an decoction for 10 days is similar to that of colchicine tablets 0.5 g Po bid+ gazalidomide 50 mg Po tid for 3 weeks, indicating that simiaoyong 'an decoction has a fast and good effect.
白塞病四妙勇安汤
behcet's diseasesimiaoyong 'an decoction
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