中西結合治療全身性紅斑性狼瘡病例報告

本病例是一位16歲女孩，因食慾不佳、小便泡沫多、體重下降及嚴重掉頭髮至本院求診，風濕免疫科診斷為全身性紅斑性狼瘡。由於擔心類固醇之副作用，此患者轉診至本院中西免疫風濕聯合門診接受中西醫結合治療。此患者同時服用西藥hydroxychloroquine sulfate、prednisolone，及中藥知柏地黃丸加味。治療三個月後抽血檢驗，抗雙鏈DNA抗體1018.7 IU/mL及紅血球沉降係數ESR 46 mm/hr大幅下降至125.1 IU/mL及23 mm/hr，且補體C3、C4數值31.2和2.3 mg/dL回升至87.5和9.09 mg/dL，其後追蹤檢查，六個月後抗雙鏈DNA抗體及紅血球沉降係數持續下降至88.3 IU/mL及16 mm/hr，補體C3、C4持續穩定87.7和8.57 mg/dL，且蛋白尿和掉髮現象明顯改善，顯示出中西結合治療全身性紅斑性狼瘡急性期之療效。另外，我們也發現病患陰虛內熱（陽亢）的證型與補體減少和自體抗體增加的表現相一致。

關鍵字

紅斑狼瘡；知柏地黃丸；抗雙鏈DNA抗體

並列摘要

This case is a 16-year-old girl, who visited our hospital because of poor appetite, proteinuria, loss of weight and hair. The medical diagnosis by the Rheumatology/ Immunology Division of Western Medicine was systemic lupus erythematosus. She was transferred to the Chinese Medicine and Rheumatology/Immunology union outpatient service and took the treatment of both Chinese medicine and Western medicine (hydroxychloroquine sulfate, prednisolone and Jhih Bo Di Huang Wan). After three-month treatment, the levels of anti-double-strand DNA antibody (anti-ds DNA antibody, 1018.7 IU/mL) and erythrocyte sedimentation rate (ESR, 46 mm/hr) were significantly decreased to 125.1 IU/mL and 23 mm/hr, respectively. And the levels of C3 and C4 complements (31.2 and 2.3 mg/dL) were significantly increased to 87.5 and 9.09 mg/dL, respectively. The data of antids DNA antibody, ESR and complements C3 and C4 kept improving later (88.3 IU/L, 16mm/hr, 87.7 and 8.57 mg/dL, respectively). The hair loss and proteinuria also subsided. Therefore, the integrated treatment of traditional Chinese medicine and modern Western medicine was efficacious in this case. In addition, we found this patient's syndrome of yi-deficiency and yang-hyperactivity corresponded to the deficiency of the complements and hyperactivity of anti-ds DNA antibody.

並列關鍵字

systemic lupus erythematosus ； Jhih Bo Di Huang Wan ； integration of Chinese and western medicine

國際替代計量

中西結合治療全身性紅斑性狼瘡病例報告

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