中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
8期
646-649
,共4页
索宝军%周丽雅%丁士刚%吕愈敏%顾芳%林三仁%郑亚安
索寶軍%週麗雅%丁士剛%呂愈敏%顧芳%林三仁%鄭亞安
색보군%주려아%정사강%려유민%고방%림삼인%정아안
青黛%银屑病%紫癜,血小板减少性,特发性%肠镜%缺血性结肠黏膜损伤
青黛%銀屑病%紫癜,血小闆減少性,特髮性%腸鏡%缺血性結腸黏膜損傷
청대%은설병%자전,혈소판감소성,특발성%장경%결혈성결장점막손상
Indigo Naturalis%Psoriasis%Purpura,thrombocytopenic,idiopathic%Enteroscopy%Ischemic lesion of colon mucosa
目的 分析青黛所致缺血性结肠黏膜损伤的临床特点,提高对该疾病的认识及防治效果.方法 收集北京大学第三医院2005年12月至2010年12月因服用含青黛成分中成药后出现缺血性结肠黏膜损伤的13例患者资料,对其临床及内镜表现进行分析,总结该型结肠黏膜损伤的特点.结果 患者的年龄为(60.6±14.1)岁,男女比例为1:1.6.患者因银屑病或特发性血小板减少性紫癜(11P)服用复方青黛丸(胶囊)或升血小板胶囊,平均服药时间为(3.6±2.3)个月.临床表现为腹痛及血便,13例患者中8例便血前有排水样便的表现.肠镜下病变形态、病理活检符合缺血性损伤的表现,病变较重,并呈慢性炎表现.扩血管治疗疗效明确,平均止血时间(1.7±0.8)d,预后良好.随访3个月均无复发.结论 银屑病和ITP患者服用含青黛成分中成药可导致结肠黏膜损伤,严重者可致缺血性黏膜损伤,临床应用该类药物时应进行认真评估及观察.
目的 分析青黛所緻缺血性結腸黏膜損傷的臨床特點,提高對該疾病的認識及防治效果.方法 收集北京大學第三醫院2005年12月至2010年12月因服用含青黛成分中成藥後齣現缺血性結腸黏膜損傷的13例患者資料,對其臨床及內鏡錶現進行分析,總結該型結腸黏膜損傷的特點.結果 患者的年齡為(60.6±14.1)歲,男女比例為1:1.6.患者因銀屑病或特髮性血小闆減少性紫癜(11P)服用複方青黛汍(膠囊)或升血小闆膠囊,平均服藥時間為(3.6±2.3)箇月.臨床錶現為腹痛及血便,13例患者中8例便血前有排水樣便的錶現.腸鏡下病變形態、病理活檢符閤缺血性損傷的錶現,病變較重,併呈慢性炎錶現.擴血管治療療效明確,平均止血時間(1.7±0.8)d,預後良好.隨訪3箇月均無複髮.結論 銀屑病和ITP患者服用含青黛成分中成藥可導緻結腸黏膜損傷,嚴重者可緻缺血性黏膜損傷,臨床應用該類藥物時應進行認真評估及觀察.
목적 분석청대소치결혈성결장점막손상적림상특점,제고대해질병적인식급방치효과.방법 수집북경대학제삼의원2005년12월지2010년12월인복용함청대성분중성약후출현결혈성결장점막손상적13례환자자료,대기림상급내경표현진행분석,총결해형결장점막손상적특점.결과 환자적년령위(60.6±14.1)세,남녀비례위1:1.6.환자인은설병혹특발성혈소판감소성자전(11P)복용복방청대환(효낭)혹승혈소판효낭,평균복약시간위(3.6±2.3)개월.림상표현위복통급혈편,13례환자중8례편혈전유배수양편적표현.장경하병변형태、병리활검부합결혈성손상적표현,병변교중,병정만성염표현.확혈관치료료효명학,평균지혈시간(1.7±0.8)d,예후량호.수방3개월균무복발.결론 은설병화ITP환자복용함청대성분중성약가도치결장점막손상,엄중자가치결혈성점막손상,림상응용해류약물시응진행인진평고급관찰.
Objective By analysing the clinical features of Indigo Naturalis-associated ischemic lesion of colon mucosa to improve the precautionary and therapeutic level of the disease.Methods Thirteen patients diagnosed as Indigo Naturalis-associated ischemic lesion of colon mucosa in Peking University Third Hospital from 2005 to 2010 were reviewed.The endoscopic and clinical features were analysed.Results The 13 patients with an average age of(60.6±14.1)years old were prescribed Chinese traditional medicine containing Indigo Naturalis for psoriasis or idiopathic thrombocytopenic purpura(ITP).The ratio of males to females was 1:1.6.The typical manifestations were abdominal pain and bloody stool with watering diarrhea before bloody stool in 61.5%patients.Endoscopic and pathological characteristics were coincident with ischemic lesion and more like a chronic index.Vasodilatic medicine was effective and the average hemostatic time was(1.7±0.8)days.The prognosis was well and no recurrence was found during 3 months follow-up.Conclusions Patients having psoriasis or ITP treated with Chinese traditional medicine containing Indigo Naturalis have an inclination to colon mucosa lesions, even ischemic lesion. Careful assessment and observation before prescribing arc necessary in these patients.
