刘健治疗系统性红斑狼疮糖皮质激素不良反应经验  

Liu Jian's Experience in Treating Adverse Reactions of Glucocorticoids in the Treatment of Systemic Lupus Erythematosus

作　　者：万磊[1] 黄传兵[1] 曹云祥[1] 谌曦[1] 汪元[1] 刘健(指导)[1] Wan Lei;Huang Chuanbing;Cao Yunxiang;Chen Xi;Wang Yuan;Liu Jian(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,Anhui,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《贵州中医药大学学报》2024年第2期22-27,共6页Journal of Guizhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局第七批全国老中医药专家学术经验继承项目,项目编号:国中医药人教函[2022]76号;国家自然科学基金面上项目,项目编号:81973655;国家自然科学基金面上项目,项目编号:82274501;安徽省高校优秀青年人才支持计划项目,项目编号:皖教秘人[2022]11号;新安医学教育部重点实验室,项目编号:2020xayx04。

摘　　要：糖皮质激素具有抗炎、抗免疫等作用,广泛应用于风湿免疫性疾病的临床治疗中,但糖皮质激素亦是一把双刃剑,风湿病特别是系统性红斑狼疮患者长期服用糖皮质激素,副作用明显。糖皮质激素具有类似中医“壮火”样副作用。刘健教授应用中医药理论辨治糖皮质激素不良反应疗效显著。刘健教授认为糖皮质激素引起的不良反应与中医脾肾有关。脾胃为后天之本、气血生化之源,肾为水火之脏、五脏阴阳之根,长期大量使用糖皮质激素可出现阴虚火旺、脾肾气阴两虚,甚至脾肾阴阳两虚。临床上通过培补脾土、温壮肾气可以起到激发脾肾之气的作用,逐步消除对糖皮质激素的依赖,从而达到取代外源性激素之目的。根据糖皮质激素易产生感染、消化性溃疡、骨质疏松、瘀点瘀斑等不良反应,刘师采用“扶正祛邪”的方法进行治疗,临床疗效显著。Glucocorticoid is widely used in treating rheumatic immune diseases because of its effects of anti-inflammation and anti-immunity.However,glucocorticoid is a double-edged sword,and patients with rheumatism,especially systemic lupus erythematosus,who take glucocorticoids for a long time have obvious side effects.Glucocorticoids have side effects similar to"invigorating fire"in traditional Chinese medicine.Professor Liu Jian's application of traditional Chinese medicine in treating adverse reactions of glucocorticoid is remarkable.Professor Liu Jian believes that in the traditional Chinese medicine,the adverse reactions caused by glucocorticoids are related with spleen and kidney.The spleen and stomach are the root of the acquired constitution,the source of Qi and blood formation.While the kidney is the water and fire viscera,and the root of the five viscera,and Yin and Yang.Long-term use of large amounts of glucocorticoids can lead to Yin deficiency fire,spleen kidney qi Yin deficiency,and even spleen kidney Yin and Yang deficiency.In clinical practice,nourishing spleen-earth and warming and strengthening kidney Qi can stimulate the qi of spleen and kidney,gradually eliminate the dependence on glucocorticoids,and thus achieve the purpose of replacing exogenous hormones.According to adverse reactions of glucocorticoid,such as easy to cause infection,peptic ulcer,osteoporosis,petechial ecchymosis and etc.,Professor Liu adopted the treatment of"Supporting right and dispelling evil",and the effect is remarkable.

关 键 词：中医药辨治 糖皮质激素 风湿痹病 临床经验 刘健 系统性红斑狼疮 

分 类 号：R22[医药卫生—中医基础理论] R593.241[医药卫生—中医学]