[臨床病例報告]
中西醫整合治療紅斑性狼瘡腎炎病例報告
題目：Integrated Therapy Improve Urinary Total Protein in Patients with Lupus Nephritis: A Case Report
期刊：Complementary Therapies in Medicine
(本論文後續追蹤持續報告為Stabilityof a Lupus Nephritis Case after One Year of Integrated Therapy. EC Gastroenterology and Digestive System. 2020)
本病例是一位55歲女性，自民國89年確診為紅斑性狼瘡(Systemic Lupus Erythematosus, SLE)，接受口服類固醇治療，規律追蹤至民國105年初，開始出現雙小腿水腫，抽筋，反覆泌尿道感染，以及小便伴隨泡沫，經風濕免疫科診斷為狼瘡性腎炎(Lupus Nephritis, LN)，患者服用西藥同時併用中醫藥治療，有效改善水腫以及24小時尿液蛋白(Urine Total Protein, M-TP)明顯減少，從1367.9 mg/24 h 減少至 143.6 mg/24 h.，病情趨於好轉。
這是我第一篇投稿國際SCI期刊的Systemic Lupus Erythematosus 紅斑性狼瘡病例報告，也是我指導學生完成的第一篇PAPER，這幾天正式獲國際期刊接受並刊出。
中醫藥治療腎炎很困難，治療免疫性疾病造成的腎炎更是困難。
雖然只是一篇小小的病例報告，但其實讓我想起我剛念碩士班的時候，一開始是做過敏性鼻炎，後來被張恒鴻指導教授指派去接手SLE-LC複方中醫藥臨床試驗，然後試驗完成才開始正式進行博士班修格蘭氏症中醫藥臨床試驗。
因為指導教授安排我回去幫大學生上課，主題為「大學生如何進行中醫專題研究」，讓我回顧了這10年來我到底在幹麻？沒想到我SLE還做了不少，從SLE問卷一致度、中藥改善狼瘡性腎炎資料庫、LC複方改善SLE患者血管內皮細胞，到這一篇的中西醫整合治療紅斑性狼瘡腎炎病例報告，
最近回顧發現，
1.Systemic Lupus Erythematosus 紅斑性狼瘡研究進行了：資料庫、臨床試驗、臨床病例報告
2.Sjögren's syndrome 修格蘭氏症研究進行了：資料庫、臨床試驗
不管是Systemic Lupus Erythematosus 紅斑性狼瘡還是Sjögren's syndrome 修格蘭氏症研究，都從資料庫一直做到臨床，一直朝著我的理想中研究邁進，也能夠將研究轉譯轉化為臨床回饋給患者，再從臨床患者轉饋回研究，相輔相成。
非常感謝各位受試者和臨床門診患者的支持與鼓勵，希望能持續努力，為中醫藥實證醫學與中醫藥治療風濕免疫疾病能墊上一塊磚！
--------------------------------------------
https://www.sciencedirect.com/science/article/pii/S0965229918301948
Complementary Therapies in Medicine. 2018
Objectives
To report on the potential effectiveness of Chinese herbal medicine (CHM) as part of an integrated treatment for lupus nephritis.
Clinical features and outcome
A 55-year-old female with systemic lupus erythematosus had experienced bilateral lower-limbs edema for half a year. Her urinary total protein (M-TP) was 1367.9 mg/24 h. Lupus nephritis (LN) was suspected by the Division of Rheumatology without a renal biopsy. Oral corticosteroid medication did not improve the edema; therefore, the patient requested CHM for integrated therapy, and was subsequently treated for seven months with a modified CHM prescription mainly composed of Zhi-Bo-Di-Huang-Wan, Gui-Shao-Zhi-Mu-Tang, and Zhu-Ling-Tang. After three days of CHM, her bilateral lower-limbs edema significantly improved, and after 143 days, her M-TP decreased from 1367.9 mg/24 h to 143.6 mg/24 h.
Conclusions
Integrated therapy could significantly improve proteinuria by reducing this LN patients’ urinary total protein, which further implies that CHM may have a protective effect against the progression of LN in this patient.
最近回顧發現，
1.Systemic Lupus Erythematosus 紅斑性狼瘡研究進行了：資料庫、臨床試驗、臨床病例報告
2.Sjögren's syndrome 修格蘭氏症研究進行了：資料庫、臨床試驗
不管是Systemic Lupus Erythematosus 紅斑性狼瘡還是Sjögren's syndrome 修格蘭氏症研究，都從資料庫一直做到臨床，一直朝著我的理想中研究邁進，也能夠將研究轉譯轉化為臨床回饋給患者，再從臨床患者轉饋回研究，相輔相成。
非常感謝各位受試者和臨床門診患者的支持與鼓勵，希望能持續努力，為中醫藥實證醫學與中醫藥治療風濕免疫疾病能墊上一塊磚！
--------------------------------------------
https://www.sciencedirect.com/science/article/pii/S0965229918301948
Complementary Therapies in Medicine. 2018
Integrated Therapy Improve Urinary Total Protein in Patients with Lupus Nephritis: A Case Report
Pei-Wen Wu, Po-Hsuan Shih, Yen-Ying Kung, Fang-Pey Chen, Ching-Mao Chang*
Objectives
To report on the potential effectiveness of Chinese herbal medicine (CHM) as part of an integrated treatment for lupus nephritis.
Clinical features and outcome
A 55-year-old female with systemic lupus erythematosus had experienced bilateral lower-limbs edema for half a year. Her urinary total protein (M-TP) was 1367.9 mg/24 h. Lupus nephritis (LN) was suspected by the Division of Rheumatology without a renal biopsy. Oral corticosteroid medication did not improve the edema; therefore, the patient requested CHM for integrated therapy, and was subsequently treated for seven months with a modified CHM prescription mainly composed of Zhi-Bo-Di-Huang-Wan, Gui-Shao-Zhi-Mu-Tang, and Zhu-Ling-Tang. After three days of CHM, her bilateral lower-limbs edema significantly improved, and after 143 days, her M-TP decreased from 1367.9 mg/24 h to 143.6 mg/24 h.
Conclusions
Integrated therapy could significantly improve proteinuria by reducing this LN patients’ urinary total protein, which further implies that CHM may have a protective effect against the progression of LN in this patient.
沒有留言:
張貼留言
感謝您的寶貴意見，張清貿醫師