中西医结合治疗坏疽性脓皮病合并溃疡性结肠炎1例

A Case of Pyoderma Gangrenosum Complicated with Ulcerative Colitis Treated by Integrated Traditional Chinese and Western Medicine

报告1例坏疽性脓皮病合并溃疡性结肠炎患者的诊疗过程,采用中西医结合的方法,在常规西医抗炎、补钾等对症治疗的基础上,中医初期注重患者整体状态,辨证为肝郁脾虚证,治以疏肝解郁、健脾除湿,方用柴胡疏肝散合参苓白术散加减;中后期结合皮损红肿热痛等外在表现,以及结肠溃疡等主要症状,辨证为湿热毒蕴证,治以清热除湿、解毒止痛,方用仙方活命饮加减,配合外用金黄膏促进阳证痈肿快速溃脓成熟,复方黄柏液消肿祛腐,取得良好临床疗效,内外合治,使患者创面愈合,随访未见腹痛、腹泻复发。

To report the diagnosis and treatment of a case of pyoderma gangrenosum complicated with ulcerative colitis.The method of combining traditional Chinese and Western medicine was adopted.On the basis of symptomatic treatment such as anti-inflammation and potassium supplementation in conventional Western medicine,the initial stage of traditional Chinese medicine syndrome differentiation focused on the overall state of the patient,and the syndrome differentiation was liver depression and spleen deficiency.The treatment was to relieve liver depression,strengthen spleen and dehumidification.The prescription was Chaihu Shugan San and Shenling Baizhu San.In the middle and late stage of the disease,combined with the external manifestations of skin lesions,swelling,heat and pain,as well as the main symptoms of colonic ulcers,the syndrome differentiation was the syndrome of dampness and heat toxicity,and the treatment was to clear heat and dehumidify,detoxify and relieve pain.Xianfang Huoming Yin was prescribed,cooperating with the external golden paste to promote the rapid abscess and maturity of carbuncle,and the compound phellodendri liquid to remove swelling and rot,achieved good clinical efficacy.Combined internal and external treatment,the wound was heal,and no recurrence of abdominal pain or diarrhea during follow-up.