摘要
作者报道在同一个月内所接诊的 3例复发性多软骨炎 ,并探讨其治疗方案。3例均为女性 ,均曾被误诊多时 ,血沉及血清IgM均高于正常。1例侵犯双侧耳廓 ,1例侵犯单侧耳廓及双侧杓状软骨 ,另 1例侵犯鼻中隔、眼并有头面、耳后、小腿结节性红斑。作者试用了雷公藤及类固醇治疗方案 ,即在急性发作期间 ,口服雷公藤多甙片 6 0～ 90mg/d、强的松片 30～ 6 0mg/d、软骨痛区局部注射得宝松(长效二丙酸倍他米松及倍他米松磷酸脂钠) 1ml(5mg)。3例症状明显缓解后雷公藤多甙及强的松均逐步减量 ,前者 30～ 6 0mg/d ,后者 10～2 0mg/d,维持 4个月。结果显示 ,3例均在半个月之内症状明显缓解 ;随访 2 2个月 ,病变部位均无红肿痛 ,1例遗有左耳廓轻度畸形 ,1例遗有轻度鞍状鼻。作者认为 ,耳鼻喉科医师应提高对复发性多软骨炎的认识 ,以期避免漏诊误诊 ,做到及早诊断 ,抢在软骨塌陷之前施以正确而充分的治疗 ;
Aim: To report 3 cases of relapsing polychondritis admitted within a month, and to explore the therapeutic programme. Methods: Based on therapeutic effect of traditional immuno suppressant and their side effects, the programme was designed as follows: During acute episode, 60～90mg of tripterygium glucosides and 30～60mg of prednisone were medicated orally every day and 1ml(5mg) of diprospan was injected into the painful cortilaginous areas. After the symptoms subsided, the daily dosages of oral drug were gradually decreased to 30～60mg of tripterygium glucosides and 10～20mg of prednisone for four months' course. Results: All the 3 cases′ symptoms were obviously subsided within a half month. All of them were followed up for 22 months. hyperemia, swelling or pain were not fou and in all suffering areas. One case remained a mild cauliflower ear and another case a mild saddle nose. Conclusions: Otorhinolaryngologists need to improve the capabillity of detecting the relapsing polychondritis, in order to make the diagnosis and treatment as early and correctly as possible. Tripterygium wiifordii and steroid have a good therapeutic effect for relapsing polychondritis.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2002年第8期726-727,共2页
Medical Journal of Chinese People's Liberation Army
关键词
雷公藤
类固醇
复发性多软骨炎
治疗方法
tripterygium wifordii
steroid
treatment
relapsing polychodritis
