青黛相关缺血性结肠黏膜损伤的内镜及临床特点分析  

The endoscopic and clinical features of Indigo Naturalis-associated ischemic lesions of colonic mucosa

作　　者：索宝军[1] 周丽雅[2] 丁士刚[2] 吕愈敏[2] 顾芳[2] 林三仁[2] 郑亚安[1] 

机构地区：[1]北京大学第三医院急诊科,100191 [2]北京大学第三医院消化科,100191

出　　处：《中华内科杂志》2011年第8期646-649,共4页Chinese Journal of Internal Medicine

摘　　要：目的 分析青黛所致缺血性结肠黏膜损伤的临床特点,提高对该疾病的认识及防治效果.方法 收集北京大学第三医院2005年12月至2010年12月因服用含青黛成分中成药后出现缺血性结肠黏膜损伤的13例患者资料,对其临床及内镜表现进行分析,总结该型结肠黏膜损伤的特点.结果 患者的年龄为（60.6±14.1）岁,男女比例为1：1.6.患者因银屑病或特发性血小板减少性紫癜（11P）服用复方青黛丸（胶囊）或升血小板胶囊,平均服药时间为（3.6±2.3）个月.临床表现为腹痛及血便,13例患者中8例便血前有排水样便的表现.肠镜下病变形态、病理活检符合缺血性损伤的表现,病变较重,并呈慢性炎表现.扩血管治疗疗效明确,平均止血时间（1.7±0.8）d,预后良好.随访3个月均无复发.结论 银屑病和ITP患者服用含青黛成分中成药可导致结肠黏膜损伤,严重者可致缺血性黏膜损伤,临床应用该类药物时应进行认真评估及观察.Objective By analysing the clinical features of Indigo Naturalis-associated ischemic lesion of colon mucosa to improve the precautionary and therapeutic level of the disease.Methods Thirteen patients diagnosed as Indigo Naturalis-associated ischemic lesion of colon mucosa in Peking University Third Hospital from 2005 to 2010 were reviewed.The endoscopic and clinical features were analysed.Results The 13 patients with an average age of（60.6±14.1）years old were prescribed Chinese traditional medicine containing Indigo Naturalis for psoriasis or idiopathic thrombocytopenic purpura（ITP）.The ratio of males to females was 1：1.6.The typical manifestations were abdominal pain and bloody stool with watering diarrhea before bloody stool in 61.5%patients.Endoscopic and pathological characteristics were coincident with ischemic lesion and more like a chronic index.Vasodilatic medicine was effective and the average hemostatic time was（1.7±0.8）days.The prognosis was well and no recurrence was found during 3 months follow-up.Conclusions Patients having psoriasis or ITP treated with Chinese traditional medicine containing Indigo Naturalis have an inclination to colon mucosa lesions, even ischemic lesion. Careful assessment and observation before prescribing arc necessary in these patients.

关 键 词：青黛 银屑病 紫癜 血小板减少性 特发性 肠镜 缺血性结肠黏膜损伤 

分 类 号：R595.3[医药卫生—内科学]