论文部分内容阅读
患者,女性,44岁。因反复牙龈出血、鼻衄1年,腹痛伴呕血4h,门诊以系统性红斑狼疮,继发性血小板减少性紫癜于1994年2月3日收入内科。入院后查:BP135/90mmHg。颜面呈蝶形红斑。心音可,心率80min~(-1),律齐,心尖部可闻及Ⅱ级吹风样收缩期杂音。腹软,肝脏不大。血C反应蛋白(CRP)+,血沉70mm/h,血小板35×10~9/L,查到狼疮细胞。给予激素等药物对症治疗23天,出血停止,自觉症状明显好转。为快速降低血沉,试用中药片姜黄10g,水煎服。第三剂服后3h,病人出现心慌、头痛、眼花、烦燥、全身乏力,BP240/130mmHg,心率120min~(-1)。考虑与服用片姜黄有关,即给硝苯地平10mg,卡托普利12.5mg舌下含化,2h后病人自觉症状消失,BP90/75mmHg,心率96min~(-1)。第二天继服片姜黄,服后3h亦出现上述表现。病人于1994年4月21日第二次入院治疗,改用片姜黄5g,水煎服,服后又出现血压升高,心跳加快等症状。
Patient, female, 44 years old. Due to repeated bleeding gums, epistaxis 1 year, abdominal pain with hematemesis 4h, outpatient to systemic lupus erythematosus, secondary thrombocytopenic purpura in February 3, 1994 income medical. After admission check: BP135 / 90mmHg. Face was butterfly erythema. Heart sound, heart rate 80min ~ (-1), law Qi, apex can be heard and Ⅱ grade hair-style systolic murmur. Abdomen soft, the liver is not big. Blood C-reactive protein (CRP) +, ESR 70mm / h, platelets 35 × 10 ~ 9 / L, found lupus cells. Give symptomatic treatment of hormones and other drugs for 23 days, bleeding stopped, symptoms significantly improved. To quickly reduce erythrocyte sedimentation rate, try traditional Chinese medicine turmeric 10g, Shuijianbi. The third dose after 3h, patients with palpitation, headache, vertigo, irritability, malaise, BP240 / 130mmHg, heart rate 120min ~ (-1). Taking into account the use of turmeric tablets, namely nifedipine 10mg, captopril 12.5mg sublingual, 2h after the patient’s symptoms disappear, BP90 / 75mmHg, heart rate 96min ~ (-1). The following day follow-up tablets turmeric, 3h after service also appeared above performance. The patient was admitted to hospital for the second time on April 21, 1994, and switched to turmeric 5g and Shuijianbi. After the service, blood pressure increased and his heartbeat accelerated.