中西医结合治疗胰腺导管内乳头状黏液性肿瘤术后腹泻合并IgG4相关性疾病1例  

Integrated Chinese and Western Medicine Treatment of A Case of IgG4-Related Disease Complicated with Diarrhea after Operation for Pancreatic Intraductal Papillary Mucinous Neoplasm

作　　者：张佳[1] 施丽婕[1] ZHANG Jia;SHI Lijie(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300380,China)

机构地区：[1]天津中医药大学第一附属医院国家中医针灸临床医学研究中心,天津300380

出　　处：《基层中医药》2023年第11期63-66,共4页Basic Traditional Chinese Medicine

摘　　要：本文主要探讨1例胰腺导管内乳头状黏液性肿瘤(IPMN)术后腹泻合并IgG4相关性疾病(IgG4-RD)的诊断及治疗。腹泻是IPMN术后常见并发症,大部分腹泻为脂肪泻,会导致患者体重下降及严重的营养不良,给患者的身体及心理带来较大负担,需要引起临床医师的注意。目前术后的慢性腹泻通常应用益生菌或止泻药等对症处理,部分患者疗效欠佳,长期腹泻会影响患者生活。近年来中医药对缓解肿瘤术后症状,提高生活质量具有一定的优势,但针对IPMN术后腹泻的治疗经验较少。而IgG4-RD是2003年首次报道的临床罕见病,缺乏特异性表现,容易漏诊、误诊。因此,将我院收治的1例IPMN术后腹泻合并IgG4-RD患者的诊断过程及辩证诊治经验报告如下,以飨同道。This paper mainly discusses the diagnosis and treatment of a case of diarrhea complicated with IgG4-related disease(IgG4-RD)after operation for pancreatic intraductal papillary mucinous neoplasm(IPMN).Diarrhea is a common complication after IPMN surgery,and most diarrhea cases are fatty diarrhea,which will lead to weight loss and severe malnutrition and cause great burden to patients’physical and psychological health,requiring attention of clinicians.At present,patients with chronic postoperative diarrhea are usually treated with probiotics or antidiarrheal drugs,which show poor therapeutic efects in some patients,while long-term diarrhea will afect the life of patients.In recent years,traditional Chinese medicine has demonstrated advantages in alleviating postoperative symptoms of tumors and improving the quality of life,whereas there is little experience in treating diarrhea after operation for IPMN.IgG4-RD is a rare clinical disease frst reported in 2003,which lacks specifc manifestations and is easy to be missed and misdiagnosed.Therefore,this paper reports the diagnostic process,syndrome differentiation,and treatment experience of 1 case of diarrhea complicated with IgG4-RD after operation for IPMN in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,serving as a reference for peers.

关 键 词：胰腺导管内乳头状黏液性肿瘤 IGG4相关性疾病 术后腹泻 

分 类 号：R73[医药卫生—肿瘤]