何晓瑾辨治干燥综合征合并淋巴瘤和类风湿关节炎验案一则
Treatment of Sjogren's Syndrome Complicated with Lymphoma and Rheumatoid Arthritis by He Xiaojin: A Case Report
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1.苏州市中西医结合医院,苏州 215100
2.南京中医药大学研究生院,南京 210023
3.江苏省中医院风湿科, 南京 210029
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袁芳, 王敏, 何晓瑾. 何晓瑾辨治干燥综合征合并淋巴瘤和类风湿关节炎验案一则[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43394308&Fpath=home&index=0
YUAN Fang, WANG Min, HE Xiaojin. Treatment of Sjogren's Syndrome Complicated with Lymphoma and Rheumatoid Arthritis by He Xiaojin: A Case Report[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43394308&Fpath=home&index=0
袁芳, 王敏, 何晓瑾. 何晓瑾辨治干燥综合征合并淋巴瘤和类风湿关节炎验案一则[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43394308&Fpath=home&index=0 DOI:
YUAN Fang, WANG Min, HE Xiaojin. Treatment of Sjogren's Syndrome Complicated with Lymphoma and Rheumatoid Arthritis by He Xiaojin: A Case Report[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43394308&Fpath=home&index=0 DOI:
病史摘要,2,患者杨某,女性,67岁,2022年4月23日因“口眼干燥40余年,四肢关节疼痛5年,左肺腺癌术后1个月”就诊。40余年前患者出现眼干口干,未予重视。2010年劳累后出现扁桃体肿大、盗汗、消瘦、乏力,外院诊断为“淋巴瘤”,先后行化疗、放疗及中药口服治疗。近5年来患者口眼干燥明显,伴四肢关节疼痛,外院诊断为“干燥综合征、类风湿关节炎”,予雷公藤多苷片、艾拉莫德片、白芍总苷等药物治疗后便溏日益加重,并伴有上腹部隐痛、灼热感间作。1个月前患者行“左上肺叶切除术”,术后患者乏力、便溏更甚,伴胸闷气短。四诊信息:患者口眼干燥,双手、双肩、双膝、双腕、双足关节疼痛,周身乏力,胸闷气短,盗汗频作,时感头晕,伴有发作性短暂意识丧失,上腹部隐痛、灼热感间作,纳食欠馨,大便4-6次/日、质不成形,小便频,夜尿多,夜寐易醒。舌质暗红、边有齿印,苔薄白,脉弦细。中医诊断 燥痹(气阴亏虚、痰瘀互结证)。西医诊断 干燥综合征。干预措施 中医治疗以益气养阴,化痰祛瘀为法,予健脾润燥通络方加减治疗。疗效转归 临床缓解。
Summary of case history, Patient Yang, female, 67 years old, visited the hospital on April 23, 2022 due to "dry mouth and eyes for more than 40 years, joint pain in limbs for 5 years, and postoperative adenocarcinoma of left lung for 1 month". More than 40 years ago, the patient developed dry eyes and dry mouth, which was not paid attention to. In 2010, after fatigue, tonsillar enlargement, night sweats, emaciation and fatigue occurred. The patient was diagnosed as "lymphoma" in another hospital, and chemotherapy, radiotherapy and oral treatment with traditional Chinese medicine were successively performed. In recent 5 years, the patient's mouth and eyes were obviously dry, accompanied by joint pain in limbs. The patient was diagnosed as "Sjogren's syndrome and rheumatoid arthritis" in other hospitals. After treatment with Tripterygium Glycosides Tablets, Iramod Tablets and Total Glucosides of Radix Paeoniae Alba, loose stool became increasingly aggravated, accompanied by dull pain in upper abdomen and burning sensation. One month ago, the patient underwent left upper lobectomy, after which fatigue and loose stool became worse, accompanied by chest distress and shortness of breath. Symptoms and signs: dry mouth and eyes, pain in joints of hands, shoulders, knees, wrists and feet, general weakness, chest distress and shortness of breath, frequent night sweats, dizziness from time to time, accompanied by paroxysmal temporary loss of consciousness, dull pain in upper abdomen, burning sensation, poor food intake, stool 4-6 times/day, poor quality, frequent urination, nocturnal urination, easy waking up at night. Tongue quality dark red, edge has teeth mark, moss thin white, pulse string fine. .,TCM diagnosis, dryness (qiyin deficiency, phlegm and blood stasis interjunction syndrome).,Western medicine diagnosis, sjogren syndrome.,Therapeutic methods, traditional Chinese medicine treatment is based on supplementing qi and nourishing yin, resolving phlegm and removing blood stasis, and is treated with modified formulas for invigorating the spleen, moistening dryness, and unblocking collaterals.,Clinical outcomes, clinical remission.
干燥综合征类风湿关节炎淋巴瘤燥痹
sjogren's syndromerheumatoid arthritislymphomadry arthralgia
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