1例大疱性类天疱疮患者的中医护理体会

Nursing experience of a patient with bullous pemphigoid with traditional Chinese medicine

大疱性类天疱疮是一种累及皮肤黏膜的自身免疫性表皮内水疱的大疱性皮肤病,中医古籍中,称其为“天疱疮”“火赤疮”等。天疱疮是一种复发率高的重症性皮肤病,由于大部分患者为老年人,常伴有基础疾病,因此在疗效、药物不良反应等方面尚存在较多问题。中医治疗此类患者有较大优势。根据中华中医药学会皮肤科分会于2017年颁布的《天疱疮中医诊疗指南》中指出,其中强调辨证施护以饮食护理、局部皮肤护理与神志护理为主的观点。本文通过回顾分析北京市鼓楼中医医院收治的1例天疱疮患者临床资料,其中运用中医护理方法包括:疱液抽吸、邮票贴敷、中药外治等进行干预,达到促进创面愈合,减轻疼痛与瘙痒,缓解焦虑和抑郁,提高患者生活质量,降低复发风险的发生率。经过38 d积极治疗和护理,患者痊愈出院,一年后随访无复发。进而探讨一种安全且疗效确切的中医护理方法,为今后护理此类患者提供参考和借鉴。

Bullous pemphigoid is a bullous skin disease with autoimmune intraepidermal blisters involving skin and mucous membranes,which is called"pemphigus"and"fire red sore"in ancient books of traditional Chinese medicine.Pemphigus is a serious skin disease with high recurrence rate.Because most of the patients are elderly and often accompanied by underlying diseases,there are still many problems in efficacy and adverse drug reactions.Traditional Chinese medicine has great advantages in the treatment of such patients.According to the guidelines for the diagnosis and treatment of pemphigus issued by the Dermatology Branch of the Chinese Society of traditional Chinese Medicine in 2017,it emphasizes the relationship between syndrome differentiation and diet care,local skin care and conscious care.Through a retrospective analysis of the clinical data of a patient with pemphigus treated in Beijing Gulou Traditional Chinese Medicine Hospital,the nursing methods of traditional Chinese medicine including blister fluid aspiration,stamp application and external treatment of traditional Chinese medicine were used to promote wound healing and relieve pain and itching.Relieve anxiety and depression,improve patients'quality of life and reduce the risk of recurrence.After 38 days of active treatment and nursing,the patient was cured and discharged from hospital,and there was no recurrence after one year's follow-up.Furthermore,to explore a safe and effective traditional Chinese medicine nursing method,in order to provide reference for nursing such patients in the future.