中西医结合治疗米库利兹综合征
Treatment of Mikulitz Syndrome by Combination of Traditional Chinese and Western Medicine
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内蒙古自治区中医医院风湿免疫科,呼和浩特 010050
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陈晓彤,吕新亮.中西医结合治疗米库利兹综合征[DB/OL].(2023-12-26)[2023-12-26].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46791960&Fpath=home&index=0&lang=zh
CHEN XiaoTong,LV XinLiang.Treatment of Mikulitz Syndrome by Combination of Traditional Chinese and Western Medicine[J].,
陈晓彤,吕新亮.中西医结合治疗米库利兹综合征[DB/OL].(2023-12-26)[2023-12-26].https://cccl-tcm.cacm.org.cn/thesisDetails?columnId=46791960&Fpath=home&index=0&lang=zh DOI:
CHEN XiaoTong,LV XinLiang.Treatment of Mikulitz Syndrome by Combination of Traditional Chinese and Western Medicine[J]., DOI:.
病史摘要,2,患者因“口干、眼干1年余,加重伴少腹部疼痛3月”入院。患者1年前无明显诱因出现口干、眼干,食硬物需水送服,自行于眼部外用红霉素软膏后,自觉症状缓解不明显,未予规范治疗。3月前,患者感染新型冠状病毒后,口干、眼干加重,伴少腹胀痛,体重减轻20 kg,就诊于当地医院,诊断为:附睾炎,未予治疗。后患者少腹部疼痛进行性加重,伴周身淋巴结肿大,于2023年3月就诊我院,现患者口干、眼干加重,少腹胀痛未缓解,门诊以“瘰疬病”收入科。入院症见: 口干、口苦,食硬物需水送服,眼干,少腹胀痛,走窜不定,乏力、饮食、睡眠可,大小便正常。体重减轻20 kg。入院查体示:舌淡红、苔白腻,叩诊:脉弦滑。无特殊既往史,否认家族遗传病史。中医诊断 瘰疬病(气郁痰凝证)。西医诊断 IgG4相关性疾病;米库利兹综合征;IgG4相关肾病?IgG4相关肺病?肺气肿;支气管炎。干预措施 中医治疗:口服中药治疗,以四逆散为主方,加用白芥子、黄芩、猫爪草等(软坚散结、燥湿化痰之药)。全方温而不燥,凉而不寒,共奏疏肝理气、燥湿化痰、软坚散结之功效。西医治疗:口服甲泼尼龙32mg日1次,嘱出院后规律减量;艾拉莫德片25 mg日2次;吗替麦考酚酯分散片0.5 g日2次。疗效转归 患者规律治疗3周后,双侧颈部、腋下、腹股沟肿大淋巴结明显减小。IgG4、IgE水平及血沉等相关炎性指标较入院时明显下降。出院2周后复查相关指标未见明显升高。
Summary of case history, Chief complaint: Dry mouth, dry eyes for more than 1 year, aggravated with less abdominal pain for 3 months.History of present disease: The patient had dry mouth and dry eyes without obvious causes 1 year ago, and the hard food needed to be taken with water. After applying erythromycin ointment on the eye, the patient felt that the symptoms were not alleviated significantly, and no standard treatment was given. Three months ago, after infection with the novel coronavirus, the patient had aggravated dry mouth and dry eyes, accompanied by less abdominal distension and pain, and lost 20kg in weight. He was admitted to a local hospital and diagnosed as epididymitis, which was not treated. Subsequently, the patient presented to our hospital in March 2023 with progressive aggravation of abdominal pain accompanied by lymph node enlargement throughout the body. He is now referred to our clinic as "scrofula" (Scrofula) with aggravation of dry mouth and dry eyes and unrelieved abdominal distension. Admission symptoms: dry mouth, bitter mouth, hard food needs water to take, dry eyes, less abdominal distension pain, wandering, fatigue, diet, sleep, normal urine and bowel. Weight loss of 20kg. Admission physical examination showed: tongue light red, white greasy fur, percussion: pulse string slippery. No special past history, denied family genetic history.,TCM diagnosis, scrofulosis (qi stagnation and phlegm coagulation syndrome).,Western medicine diagnosis, IgG4-related diseases;Mikulitz syndrome;IgG4-associated nephropathy?IgG4-associated lung disease?emphysema;bronchitis.,Therapeutic methods, 1.Traditional Chinese medicine treatment: oral Chinese medicine treatment: Sini San as the main prescription, plus white mustard seed, Scutellaria baicalensis, cat claw grass and so on (Ruanjian Sanjie, dryness and phlegm resolving medicine). The whole prescription is warm but not dry, cool but not cold, playing the effect of soothing the liver and regulating Qi, dryness and dampness, resolving phlegm, softening and dispersing knots.2.Western medicine treatment: oral methylprednisolone 32mg once a day, regular reduction after discharge; Elamod tablets 25mg twice a day; mycophenolate mofetil dispersible tablets 0.5g twice a day.,Clinical outcomes, After 3 weeks of regular treatment, the enlarged lymph nodes in the bilateral neck, armpit and groin were significantly reduced. The levels of IgG4, IgE and erythrocyte sedimentation rate were significantly lower than those at admission. Two weeks after discharge, no significant increase was found in the relevant indexes.
中西医结合Mikulicz综合征IgG4相关性疾病。
Integration of traditional Chinese and western medicineMikulicz syndromeIgG4-associated disease【Suitable majors】 internal medicine of Chinese medicinerheumatology and immunology
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