成人斯蒂尔病并发肝损伤8例中西医临床特征分析

目的 总结成人斯蒂尔病并发肝损害患者的中西医临床特征，提高对本病中西医结合治疗的认识。方法 回顾性分析2013至2016年收治的8例成人斯蒂尔病并发肝损害患者的中西医资料包括人口学特征、临床表现、实验室指标、中医辨证论治、治疗及转归情况。结果 临床表现：8例患者主要为发热、黄疸、淋巴结肿大、肝脾肿大；肝功能损伤：肝损伤与急性肝细胞损伤类似，6例患者重度肝损伤，2例患者亚急性肝衰竭；中医辨证分型：8例患者归属黄疸阳黄范畴，7例患者湿重于热，1例患者热重于湿；治疗方法在西医规范治疗基础上联合茵陈五苓散或甘露消毒丹，同时加用中药灌肠。结论 成人斯蒂尔病并发肝损伤从黄疸论治，阳黄为主，湿热致病，可以运用中西医结合方法治疗以尽早截断病势。

Clinical features of adult-onset Still's disease with liver injury in traditional Chinese medicine and western medicine: analysis of 8 cases

Objective To summarize the clinical features of adult-onset Still's disease (AOSD) with liver injury in traditional Chinese medicine (TCM) and western medicine. Methods The clinical data from 8 patients with AOSD and liver injury from 2013 to 2016 were collected and retrospectively analyzed, which included the demographic data, clinical manifestation, laboratory examination and TCM syndrome types. Results The 8 patients all presented fever, jaundice, lymphadenopathy, hepatomegaly and splenomegaly and liver dysfunction (which was similar to acute liver injury). Five cases were with severe liver injury, 2 of which progressed into acute liver failure. The TCM syndrome of all 8 cases belonged to yang jaundice. Seven cases presented more damp than fever, while 2 cases presented more fever than damp. The combined treatment of the western medicine and the herbal enema was applied in the early stage of disease. Conclusion AOSD with liver injury is caused by damp and fever which leads to yang jaundice. Early combined therapy of western medicine and TCM might help the patients recover quickly.