瘀血痹胶囊相关严重过敏反应

Severe anaphylactic reactions associated with Yuxuebi capsules(瘀血痹胶囊)

1例54岁女性患者因类风湿关节炎、骨关节病服用来氟米特20 mg,1次/d。5个月后加服瘀血痹胶囊4粒,3次/d。第2次服用瘀血痹胶囊后约5 h,患者体温升高至38.8℃,手掌出现红疹并迅速遍及全身,伴咽痛、头晕、胸闷、乏力、视觉异常,血压86/47 mm Hg(1 mm Hg=0.133kPa)。给予葡萄糖酸钙、维生素C、氢化可的松琥珀酸钠、氯雷他定等抗过敏治疗,并服用中药煎剂。入院第2天实验室检查:外周血白细胞计数18.3×10^(12)/L,中性粒细胞0.96;C反应蛋白148 mg/L;降钙素原2.16 ng/ml;丙氨酸转氨酶54 U/L,天冬氨酸转氨酶55 U/L,直接胆红素7.8μmol/L,尿素11.2 mmol/L,肌酐209μmol/L。X线胸片示肺部感染,给予头孢西丁钠静脉滴注。入院第3天,患者体温恢复正常,出现过敏性口炎。给予康复新液口服,并用复方氯己定含漱液漱口。入院第8天,患者过敏症状消失。

A 54-year-old female patient with rheumatoid arthritis,osteoarthropathy received leflunomide 20 mg,once daily.After 5 months of therapy,4 Yuxuebi capsules thrice daily was added to her regimen.About five hours after took the second dose of Yuxuebi,the patient＇s body temperature rose to 38.8 ℃,red rashes appeared on her palm and rapidly progressed to involve her entire body,accompanied by pharyngeal pain,dizziness,chest distress,asthenia,abnormal vision.Her blood pressure was 86/47 mm Hg.He received anti-allergic treatment such as calcium gluconate,vitamin C,hydrocortisone sodium succinate,and loratadine combined with Chinese herbal decoction.On day 2 of admission,laboratory tests showed the following values：white blood cell count 18.3 × 1012/L,neutrophils 0.96,C-reactive protein 148 mg/L,procalcitonin 2.16 ng/ml,alanine aminotransferase 54 U/L,aspartate aminotransferase 55 U/L,direct bilirubin 7.8 μ mol/L,urea 11.2 mmol/L,and creatinine 209 μmol/L.X-ray showed lung infection.An Ⅳ infusion of cefoxitin sodium was given.On day 3 of admission,the patient＇s body temperature returned to normal,and she developed allergic stomatitis.She was treated with oral Kangfuxin Ye （康复新液） and gargled with compound chlorhexidine gluconate gargle.On day 8 of admission,her anaphylactic symptoms disappeared.