中西医结合治疗多系统萎缩伴抗利尿激素分泌失调综合征合并中枢性发热1例

A case of multiple system atrophy with inappropriate antidiuretic hormone secretion syndrome combined with central fever treated with integrated traditional Chinese and Western medicine

多系统萎缩(MSA)是一种少见的,进展相对快速的神经变性疾病,主要累及自主神经、锥体外系和小脑三大系统。抗利尿激素分泌失调综合征(SIADHS),是由于抗利尿激素(ADH)过量分泌导致体内水分潴留、稀释性低钠血症、尿钠和尿渗透压升高的临床综合征。MSA合并SIADHS患者报道罕见,合并中枢性发热则预后更差,西医治疗效果不佳,临床显示中西医结合治疗比单纯西医治疗效果更好。本文报道了1例MSA伴抗利尿激素分泌不当综合征合并中枢性发热患者的中西医诊治过程,显示青蒿鳖甲汤对本病治疗起到良好效果,同时进行了文献回顾,以期加强对本病的认识,同时探索中医药治疗本病的优势。

Multiple system atrophy(MSA)is a rare and relatively rapid neurodegenerative disease involving the three major systems of autonomic nervous system,extrapyramidal system and cerebellum.Syndrome of inappropriate antidiuretic hormone secretion(SIADHS)is a clinical syndrome in which excessive secretion of antidiuretic hormone(ADH)leads to body water retention,dilutional hyponatremia,and elevated urine sodium and urine osmotic pressure.Case reports of MSA combined with SIADHS are rare.Combined with central fever,the prognosis is worse.Western medicine treatment is not effective.Clinically,it has been shown that combined traditional Chinese and Western medicine is more effective than Western medicine alone.This article reports the diagnosis and treatment process of a case of MSA with inappropriate antidiuretic hormone secretion syndrome combined with central fever treated with mtegrated traditional Chinese and Western medicine,showing that Qinghao Biejia Decoction has a good effect on the treatment of this disease.At the same time,a literature review is carried out in order to strengthen the understanding of the disease and to explore the advantages of traditional Chinese medicine in the treatment of the disease.