中藥治療修格蘭氏症候群合併系統性紅斑狼瘡病例報告

The Therapeutic Effect of Chinese Herbal Medicine for Sjögren's syndrome Combined with Systemic Lupus Erythematosus: A Case Report

黃偉勝(Wei-Sheng Huang) ； 林虹均(Hong-Chun Lin) ； 曾偉婷(Wei-Ting Tseng) ； 張清貿(Ching-Mao Chang)

《中醫藥雜誌》 31卷2期 (2020/12) Pp. 124-136

https://doi.org/10.6940/JCM.202012_31(2).08

摘要

57歲女性患有修格蘭氏症候群（Sjögren's syndrome）合併系統性紅斑狼瘡（Systemic Lupus Erythematosus）， 併發抗磷脂抗體症候群（Antiphospholipid syndrome）及間質性肺病（Interstitial lung disease）。主要症狀表現為眼乾、口乾、慢性乾咳和運動性呼吸困難，該患者於2019年06月14日開始於臺北榮民總醫院傳統醫學部門診就診，主訴全身麻刺痛感症狀，遇熱、緊張時、排便前症狀會加重，範圍從舌頭開始有不適感並漫延至全身，持續時間長達8年。中醫辨證為肝腎陰虛、火熱傷津、風溼入絡瘀滯，治則為滋陰潤燥、清熱解毒、活血通絡。持續追蹤治療6次後，有效改善全身麻刺痛感症狀，並緩解眼乾、口乾症狀。本病例報告顯示合併中藥治療可以有效緩解修格蘭氏症候群併發系統性紅斑狼瘡患者之複雜症狀，可提供另一種中西醫整合療法之思維。

關鍵字

修格蘭氏症候群 ； 系統性紅斑狼瘡 ； 抗磷脂抗體症候群 ； 間質性肺病 ； 滋陰潤燥 ； 活血通絡

並列摘要

A 57-year-old female who has Sjögren's syndrome combined with Systemic lupus erythematosus, and also has the complication of Antiphospholipid syndrome and Interstitial lung disease. Her initial symptoms included dry eyes, dry mouth, chronic cough and dyspnea on exertion. The first time she came to Taipei Veterans General Hospital was on June 14th, 2019 for Tradition Chinese Medicine (TCM) therapy, and her chief complaint was numbness with tingling sensation through the whole body. The symptom could exacerbate by anxiety, high temperature, or defecation, the numbness started from tongue and then spread through the whole body, which has lasted for over 8 years. TCM pattern diagnoses include ＂Liver and kidney yin deficiency＂, ＂Body fluid impairment by fire and heat＂, and ＂Wind-dampness blocking collateral with stasis＂, and the following treatments are ＂Nourishing yin and moistening dryness＂, ＂Clearing heat and resolving toxin＂, and ＂Promoting blood and resolving stasis＂. After following up for 6 times, the symptoms of which numbness and tingling sensation relieved profoundly, and symptoms of dry eyes and dry mouth were also relieved. This case report shows that TCM therapy not only could relieve the complicated symptoms of Sjögren's syndrome combined with Systemic lupus erythematosus, and it could also provide another new concept for integrated TCM and Western medicine therapy.

並列關鍵字

Sjögren's syndrome ； Systemic Lupus Erythematosus ； Antiphospholipid syndrome ； Interstitial lung disease ； Nourishing yin and moistening dryness ； Promoting blood and resolving stasis

參考文獻

Henkin R. I., Talal N., Larson A. L., Mattern C. F. Abnormalities of taste and smell in Sjogren's syndrome. Ann. Intern. Med., 1972; 76: 375-383.

Brito-Zeron P., Baldini C., Bootsma H., Bowman S. J., Jonsson R., Mariette X., Sivils K., Theander E., Tzioufas A., Ramos-Casals M. Sjögren syndrome. Nat. Rev. Dis. Primers., 2016; 2: 16047.

Nocturne G., Mariette X. Advances in understanding the pathogenesis of primary Sjogren's syndrome. Nat. Rev. Rheumatol., 2013; 9: 544-556.

Kroese F. G., Bootsma H. Biomarkers: new biomarker for Sjogren's syndrome--time to treat patients. Nat. Rev. Rheumatol., 2013; 9: 570-572.

Kramer J. M. Early events in Sjogren's Syndrome pathogenesis: the importance of innate immunity in disease initiation. Cytokine. 2014; 67: 92-101.