A case report of primary angiitis of the central nervous system treated adjuvantly with the dispelling pathogen and reinforcing healthy qi method

ZHANG Xinning; CHEN Zhigang; CAI Yingli; LI Nannan; REN Shan; CHEN Lu; KANG Shenghua

doi:10.3969/j.issn.2095-6606.2023.04.024

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A case report of primary angiitis of the central nervous system treated adjuvantly with the dispelling pathogen and reinforcing healthy qi method

Case Reports | 更新时间：2023-08-07

- A case report of primary angiitis of the central nervous system treated adjuvantly with the dispelling pathogen and reinforcing healthy qi method
- Modern Chinese Clinical Medicine Vol. 30, Issue 4, Pages: 112-116(2023)
- 作者机构：
  
  1.北京中医药大学　北京　100029
  2.北京中医药大学东方医院
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2095-6606.2023.04.024
  CLC： R259
- Published：30 July 2023，
  
  Received：31 August 2022，
- 稿件说明：
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ZHANG Xinning, CHEN Zhigang, CAI Yingli, et al. A case report of primary angiitis of the central nervous system treated adjuvantly with the dispelling pathogen and reinforcing healthy qi method. [J]. Modern Chinese Clinical Medicine 30(4):112-116(2023)
DOI：

ZHANG Xinning, CHEN Zhigang, CAI Yingli, et al. A case report of primary angiitis of the central nervous system treated adjuvantly with the dispelling pathogen and reinforcing healthy qi method. [J]. Modern Chinese Clinical Medicine 30(4):112-116(2023) DOI： 10.3969/j.issn.2095-6606.2023.04.024.

摘要

原发性中枢神经系统血管炎(PACNS)是一种主要累及脑实质、脊髓和软脑膜的中小血管的重度免疫炎性疾病，因该病的罕见性和异质性，目前尚缺乏有效治疗策略。本例PACNS患者在使用激素冲击治疗及免疫抑制治疗后，病情仍持续进展，笔者临证以祛邪扶正为总法，审标本、分主次，以痰、热为主要病邪要素，结合邪实向本虚演变的核心病机变化，先予清热豁痰开窍以祛邪，待患者病势渐缓，又予培元补虚之品加强扶正固本之力。使用中医药祛邪扶正治疗后，患者病情稳定，症状逐渐好转，取得良效，为中医药治疗PACNS提供思路。

Abstract

Primary angiitis of the central nervous system (PACNS) is a severe immunoinflammatory disease mainly affecting small and medium blood vessels in the brain parenchyma

spinal cord and pia mater. Due to its rarity and heterogeneity

effective treatment strategies are currently lacking. In this study

the disease progression was not halted in the patient with PACNS after pulse glucocorticoid therapy and immunosuppressive therapy. In the adjuvant treatment with TCM

the overall principle was to dispel pathogen and reinforce healthy qi

prioritizing the differentiation between the manifestations and root causes and identification of the primary problems. It was consequently found that phlegm and heat were the main pathogenic factors

and the core pathogenesis change was pathogenic excess evolving into deficiency of healthy qi. The first step adopted was to dispel pathogen by clearing heat

eliminating phlegm

and opening the orifices. Qi-nourishing and deficiency-supplementing herbs were used later when the patient’s progression started to slow down. After TCM treatment

the patient’s conditions gradually improved

and remarkable efficacy was achieved

which provided a new perspective for TCM treatment of PACNS.

关键词

原发性中枢神经系统血管炎中医祛邪扶正

Keywords

primary angiitis of the central nervous systemtraditional Chinese medicinedispelling pathogen and reinforcing healthy qi

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