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中国中医科学院西苑医院风湿病科(北京 100091)
张皓瑜,男,硕士研究生,主要从事风湿性疾病的临床诊疗研究工作
韩淑花,副主任医师; E-mail:hanshuhuasmile@126.com
纸质出版日期:2024-12-10,
收稿日期:2024-06-11,
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张皓瑜,陈子敏,唐今扬,等.房定亚教授分期论治幼年皮肌炎经验撷菁[J].上海中医药杂志,2024,58(12):105-108.
ZHANG Haoyu,CHEN Zimin,TANG Jinyang,et al.Professor Fang Dingya's experience in treating juvenile dermatomyositis by stages[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(12):105-108.
张皓瑜,陈子敏,唐今扬,等.房定亚教授分期论治幼年皮肌炎经验撷菁[J].上海中医药杂志,2024,58(12):105-108. DOI: 10.16305/j.1007-1334.2024.z20240611003.
ZHANG Haoyu,CHEN Zimin,TANG Jinyang,et al.Professor Fang Dingya's experience in treating juvenile dermatomyositis by stages[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(12):105-108. DOI: 10.16305/j.1007-1334.2024.z20240611003.
幼年皮肌炎是一种多系统受累的风湿免疫性疾病,目前其西医治疗以糖皮质激素、免疫抑制剂等为主,不良反应较多。房定亚教授根据本病的不同阶段进行分期论治。在急性期,本病表现为热毒内蕴血分,治疗原则为清热解毒、凉血通络,方用犀角地黄汤合四妙勇安汤加减。在缓解期,则根据临床表现进行分型论治:对于皮疹顽固者,采用四神煎加减,以益气养阴、解毒通络;对于肌肉无力较重者,则采用地黄饮子加减,以补益脾肾。房教授衷中参西治疗本病,收效较佳。并附验案1则。
Juvenile dermatomyositis (JDM) is a rheumatic immune disease with multi-system involvement. The current Western medical treatment of JDM is mainly by glucocorticosteroids and immunosuppressants, which have many adverse effects. Professor Fang Dingya has proposed a staging treatment of the disease based on different stages. In the acute stage, the disease manifests itself as heat and toxicity embedded in the blood, and the principal objective of treatment is to clear heat and remove toxins, cool the blood and unblock the collatenals. Modified Xijiao Dihuang Decoction combined with Simiao Yong'an Decoction are used as prescriptions. In the remission stage, the treatment is classified based on the clinical manifestations. For those with a persistent rash, modified Sishen Decoction is used to benefit the qi and nourish the yin, detoxify the toxins and unblock the collatenals. For those with heavy muscle weakness, modified Dihuang Yinzi is used to nourish the spleen and kidney. Professor Fang's integration of traditional Chinese medicine and Western medicine has yielded promising results. One proven case is attached.
幼年皮肌炎风湿病自身免疫性疾病名医经验中医药疗法
juvenile dermatomyositisrheumatismautoimmune diseaseexperience of famous doctortraditional Chinese medicine therapy
中华医学会儿科学分会风湿病学组, 中国医师协会风湿免疫科医师分会儿科学组, 海峡两岸医药卫生交流协会风湿免疫病学专业委员会儿童学组,等. 幼年皮肌炎诊断与治疗专家共识[J]. 中华实用儿科临床杂志, 2022, 37(10): 726-732.
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DALAKAS M C, HOHLFELD R. Polymyositis and dermatomyositis[J]. Lancet, 2003, 362(9388): 971-982.
AOUIZERATE J, DE ANTONIO M, BADER-MEUNIER B, et al. Muscle ischaemia associated with NXP2 autoantibodies: a severe subtype of juvenile dermatomyositis[J]. Rheumatology (Oxford), 2018, 57(5): 873-879.
PREUBE C, ALLENBACH Y, HOFFMANN O, et al. Differential roles of hypoxia and innate immunity in juvenile and adult dermatomyositis[J]. Acta Neuropathol Commun, 2016, 4(1):45.
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王永祥,周宁,刘通,等. 生地黄凉血作用的肺脏代谢组学研究[J]. 中华中医药杂志, 2023, 38(7): 3296-3302.
刘琪琪,王春柳,支文冰,等. 基于网络药理学和分子对接技术探讨药对赤芍-牡丹皮治疗银屑病的作用机制[J]. 世界中医药, 2021, 16(14): 2061-2066.
薛俊茹,何录文,孙晖,等.四妙勇安汤药理作用及作用机制研究进展[J]. 中医药信息, 2020, 37(5): 113-118.
王伟,林宇城,王玉兰,等. 金银花提取物对小鼠免疫功能的影响[J]. 沈阳药科大学学报, 2022, 39(2): 164-173.
吴相春,王少卿,唐璐,等. 地黄饮子加减方与化痰通络汤对MCAO大鼠神经功能的影响[J]. 中国中西医结合杂志, 2016, 36(11): 1352-1357.
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