利湿化浊法治疗急性发热性嗜中性皮病8例临床分析  

Clinical Analysis of the way of Removing Dampness and Turbidity to Cure Acute Febrile Neutrophilic Dermatosis

作　　者：李凯[1] 李婧娇 夏凡[1] 陈梅花[1] 夏云[1] 周小勇[1] 段逸群[1] LI Kai;LI Jingjiao;XIA Fan;CHEN Meihua;XIA Yun;ZHOU Xiaoyong;DUAN Yiqun(Department of Dermatology,the First Hospital of Wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院皮肤科,湖北武汉430022

出　　处：《中国皮肤性病学杂志》2020年第7期830-833,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的 分析急性发热性嗜中性皮病的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法 对8例确诊的急性发热性嗜中性皮病患者的临床表现、组织病理、中医证候、中医治则、方药、预后进行回顾性分析。结果 8例患者中男 4 例,女 4 例,平均年龄 41.67 岁,平均病程28.52 d。皮疹局限者3例(右上肢2例,左小腿1例),面、四肢、躯干泛发5例。发热6例,无发热2例。所有患者经过病理确诊,病理特征为组织病理见真皮内中性粒细胞浸润,而无白细胞碎裂性血管炎改变。8例患者均符合湿热蕴结证。中医治则均采用利湿化浊之法。方药均选用甘露消毒丹加减。8例患者皮损均完全消退。随访1年,除1例合并再生障碍性贫血患者出现重症感染死亡外,余均预后良好,6例单用中药患者无复发,1例合并系统性红斑狼疮患者目前仍在糖皮质激素维持治疗中。结论 利湿化浊法在急性发热性嗜中性皮病治疗中疗效肯定,并能明显降低复发率,值得进一步研究。Objective To analyze the feature of traditional Chinese medicine syndrome and to improve the diagnosis and differentiating zheng level of acute febrile neutrophilic dermatosis.Methods The clinical manifestations,histopathology,traditional Chinese medicine syndrome,therapeutic principles,prescription and prognosis of eight patients with acute febrile neutrophilic dermatosis were retrospectively analyzed.Results There were eight patients in this group,including four males and 4 females,with an average age of 41.67 years and an average course of 28.52 days.There were three cases of limited rash,including two cases of the right epipodite,one case of the left lower extremity.On the other hand,one case was widespread, 6 cases had fever symptom,while two cases had no fever symptom.All of the eight cases had been made a definite diagnosis by histopathology.Histopathology characteristic including a large number of neutrophil infiltration could be seen in the dermis without alteration of leukocytoclastic vasculitis.All patients were consistant with accumulated dampness-heat Zheng.All patients were used therapeutic principles of removing dampness and turbidity,and all patients were prescribed prescription with addition and subtraction of Ganlu disinfection pill.The rash of the eight patients had complete regression.After a year followed up,one case with aplastic anemia died from bloodsucking symptom and severe infection while the other seven cases had good eusemia.No recurrence in six patients with traditional Chinese medicine alone.One patient with systemic lupus erythematosus was still on glucocorticoid maintenance.Conclusion Treatment of acute febrile neutrophilic dermatosis with the method of removing dampness and turbidity have affirmative effect,which can reduce the recurrence rate obviously.It is worth a further study.

关 键 词：急性发热性嗜中性皮病 利湿化浊法 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]