中藥飲片配合貼敷青珠膏治療大水泡類天皰瘡病例報告

Combing Therapy of Chinese Herbal Medicine and Indigo Pearl Ointment Solving Bullous Pemphigoid for Elder Patient with Dementia : A Case Report

10.6516/TJTCM.201803_21(1).0016

陳柏谷(Po-Ku Chen)；陳亭安(Ting-An Chen)；林榮志(Jung-Chih Lin)

中藥飲片 ； 貼敷 ； 青珠膏 ； 類天皰瘡(pemphigoid) ； Chinese Herbal Medicine ； herbal plaster ； indigo peal ointment ； pemphigoid

中醫藥研究論叢

21卷1期（2018 / 03 / 30）

203 - 213

繁體中文

本研究針對中藥飲片與貼敷青珠膏搭配療法治療大水泡類天皰瘡。治療情況評估是比較治療前後皮膚狀況。患者為一位八十九歲男性患者，因缺血性中風導致失智及右側偏癱，其後雙脅下、少腹、小腹、鼠蹊部及雙大腿內側出現水泡，經西醫診斷確診為類天皰瘡。透過中藥飲片及貼敷青珠膏治療，使其傷口癒合且減低復發機率及水泡數目，最後水泡傷口完全癒合。

General description: The therapeutic effect of curingbullous pemphigoid with Chinese Herbal Medicine and indigo peal ointment is evident in this research. The evaluationestimated bythe number of blister after receiving treatment. Objective: An 89-year-old male with vascular dementia suffered from bullous pemphigoid with blisters over his limbs, flank, and groin for five months. Methods: Taking Chinese Medicine is to clear heat for cooling the blood and draining dampness while applying indigo peal ointment on affected area. Result: The number of blisters and wounds become smaller after receiving treatment tor four months; no bullous pemphigoid is recurring in the last six months after the treatment completed. Commentary: Combined treatment of Chinese herbal medicine and indigo pearl ointment is an effective approach for bullous pemphigoid.

1. Bastuji-Garin, S,Joly, P,Lemordant, P(2011).Risk factors for bullous pemphigoid in the elderly: a prospective case-control study.J Invest Dermatol,131,637-43.
2. Chalmers, JR,Wojnarowska, F,Kirtschig, G,Nunn, AJ,Bratton, DJ,Mason, J,Foster, KA,Whitham, D,Williams, HC,BLISTER study group(2015).A randomized controlled trial to compare the safety and effectiveness of doxycycline (200 mg daily) with oral prednisolone (0.5 mg kg (-1) daily) for initial treatment of bullous pemphigoid: a protocol for the Bullous Pemphigoid Steroids and Tetracyclines (BLISTER) Trial.Br J Dermatol,173(1),227-34.
3. Cordel, N,Chosidow, O,Hellot, MF(2007).French Study Group of Bullous Diseases. Neurological disorders in patients with bullous pemphigoid.Dermatology,215,187-91.
4. Fichel, F,Barbe, C,Joly, P,Bedane, C,Vabres, P,Truchetet, F,Aubin, F,Michel, C,Jegou, J,Grange, F,Antonicelli, F,Bernard, P(2014).Clinical and immunologic factors associated with bullous pemphigoid relapse during the first year of treatment: a multicenter, prospective study.JAMA Dermatol,150(1),25.
5. Joly, P,Roujeau, JC,Benichou, J,Delaporte, E,D'Incan, M,Dreno, B,Bedane, C,Sparsa, A,Gorin, I,Picard, C,Tancrede-Bohin, E,Sassolas, B,Lok, C,Guillaume, JC,Doutre, MS,Richard, MA,Caux, F,Prost, C,Plantin, P,Chosidow, O,Pauwels, C,Maillard, H,Saiag, P,Descamps, V,Chevrant-Breton, J,Dereure, O,Hellot, MF,Esteve, E,Bernard, P(2009).A comparison of two regimens of topical corticosteroids in the treatment of patients with bullous pemphigoid: a multicenter randomized study.J Invest Dermatol,129(7),1681.
6. Joly, P,Roujeau, JC,Benichou, J,Picard, C,Dreno, B,Delaporte, E,Vaillant, L,D'Incan, M,Plantin, P,Bedane, C,Young, P,Bernard, P,Bullous Diseases French Study Group(2002).A comparison of oral and topical corticosteroids in patients with bullous pemphigoid.N Engl J Med.,346(5),321-7.
7. Langan, SM,Smeeth, L,Hubbard, R(2008).Bullous pemphigoid and pemphigus vulgaris-incidence and mortality in the UK: population based cohort study.BMJ,337,a180.
8. Lloyd-Lavery, A,Chi, CC,Wojnarowska, F,Taghipour, K(2013).The associations between bullous pemphigoid and drug use: a UK case-control study.JAMA Dermatol,149,58-62.
9. Roujeau, JC,Lok, C,Bastuji-Garin, S(1998).High risk of death in elderly patients with extensive bullous pemphigoid.Arch Dermatol,134,465-9.
10. Savin, JA(1979).The events leading to the death of patients with pemphigus and pemphigoid.Br J Dermatol,101,521-34.
11. Savin, JA(1987).Death in bullous pemphigoid.Clin Dermatol,5,52-9.
12. Schmidt, E,Zillikens, D(2013).Pemphigoid diseases.Lancet,381,320-32.
13. Stavropoulos, PG,Soura, E,Antoniou, C(2014).Drug-induced pemphigoid: a review of the literature.J Eur Acad Dermatol Venereol,28,1133.
14. Taghipour, K,Chi, CC,Vincent, A(2010).The association of bullous pemphigoid with cerebrovascular disease and dementia: a casecontrol study.Arch Dermatol,146,1251-4.
15. Venning, VA,Wojnarowska, F(1992).Lack of predictive factors for the clinical course of bullous pemphigoid.J Am Acad Dermatol,26,585-9.
16. 毛詠旻、曾國武(2004)。珍珠粉治療創面潰瘍55 例療效觀察。浙江中醫學院學報，28，5。
17. 王世民(2008)。石膏的外用方法。山西中醫學院學報，9，4。
18. 李東、武彥舒、王燦、孫琴(2011)。青黛鎮痛、抗炎藥效學研究。中國實驗方劑學雜誌，17，13。
19. 張志禮(2001)。張志禮皮膚病臨床經驗輯要。北京:中國醫藥科技出版社。
20. 張群、鄒愛東、闞玉梅(2004)。青黛的臨床應用與不良反應。實用藥物與臨床，7，3。
21. 董娜、梁婧、劉雨晴、馬堃、呂道玉、金黎明、胡文忠(2011)。珍珠粉中微量元素測定。Journal of Anhui Agri. Sci.，39(1)，315-316。