范永升教授治疗难治性嗜酸性肉芽肿性多血管炎验案一则OA

[Objective]To analyze Professor FAN Yongsheng's clinical experience in medication for treating eosinophilic granulomatosis with polyangiitis(EGPA),and to explore its diagnosis and treatment strategies,aiming to improve the understanding,diagnosis and treatment level of young clinicians regarding this disease.[Methods]By reviewing the diagnosis and treatment process of one case of refractory EGPA,it analyzes the etiology,pathogenesis and clinical medication in different stages of the disease,summarizes Professor FAN Yongsheng's clinical medication experience in treating EGPA.[Results]The patient had suffered from EGPA for many years with a recurrent and prolonged condition,requiring long-term treatment with glucocorticoids and immunosuppressants.Reducing the gluco-corticoids dosage was difficult,and the disease relapsed multiple times after reduction,characterizing a case of refractory EGPA.During the acute phase(BVAS 21 points),integrated traditional Chinese medicine and western medicine treatment was applied.Chinese medicine focused on expelling wind,tonifying the lungs,draining dampness and detoxification,reflecting the strategy of"focusing on attacking pathogenic factors in acute cases".During the chronic recurrent phase(relapse after glucocorticoids reduction),the treatment principle shifted to reinforcing healthy Qi and consolidating the base,warming Yang and unblocking orifices,using modified formulations based on Yupingfeng Powder and Guizhi Decoction.In the prolonged phase,the emphasis was placed on clearing and draining dampness-heat from the Sanjiao by using modified Maxing Yigan Decoction combined with Huopo Xialing Decoction,achieving the goal of"treating both manifestation and root cause of disease,and regulating Qi movement".[Conclusion]EGPA is a rare disease with an annual incidence of(1.0～2.7)/100,000.Integrated traditional Chinese medicine and western medicine treatment can not only stabilize the condition but also effectively improve patient prognosis and quality of life.EGPA patients often present with complex conditions,therefore,clinical treatment requires combination of disease diagnosis and syndrome differentiation,treatment based on syndrome differentiation,and adjusted based on the syndrome presentation.