| ObjectiveThrough the retrospectively study of medical records of ininpatients with severe drug eruption(SDE)in Guangdong Province Traditional Chinese Medical Hospital from January 2010-December 2017,analyzing the clinical characteristics and diagnosis and treatment,etc.,and summarizing the relevant clinical experience,to provide reference and mirror for standardized treatment of integrated traditional Chinese and western medicine with SDE.MethodsCollecting and collating medical records of inpatients with SDE in Guangdong Province Traditional Chinese Medical Hospital from January 2010 to December 2017,making list of registered from general information,history of drug allergy,sensitization drugs,starting symptoms,complications,skin rashes,tongue and pulse syndromes of TCM,treatment of TCM and Western medicine and prognosis of disease.All data analysis was performed using statistical software SPSS 21.0.Results1.A total of 44 inpatients were enrolled in the study,male female ratio was 1:1.2,and the average age of 52.89±19.14 years old.SJS was more common among inpatients with SDE,accounting for 56.82%(25/44).The sensitizers were mainly anti-gout drugs,antipyretic analgesics,antibiotics and antiepileptic drugs,and the number of allopurinol was the first,accounting 47.73%(21/44).The latent period of allopurinol was the longest,with an average of 19.43±5.19 days,with a high renal damage rate of 80.95%.Among the four types,the mucosal damage rate of TEN and SJS was the highest,all of which were 100%,while that of ED is minimum,accounting 14.29%.Secondary infection is a common complication of SDE,including oral cavity,wound surface,lung,intestinal tract,urinary tract,blood and other infections.The length of stay of TEN was(33.00 + 14.65)days,the medical cost of TEN was 108792.40 + 25679.61,and daily maximum used of corticosteroids of TEN was(4.13±3.58)mg/kg,which was higher than the other three groups.2.The disease character is based on the excess syndrome,which is mainly hot,wet and poisonous.In the admission,the main pattern of syndrome usually is dampness-heat,rheumatic fever syndrome,toxic heat flourishing and the deficiency syndrome increased after admission.The tongue is ranked from high to low is red,dark red,pale dark;the coating is ranked from high to low is yellow greasy,white,white greasy and yellow;the top four pulse condition are string pulse,rapid pulse,slip pulse and thready.3.95.45% of the inpatients were treated with integrated traditional Chinese and Western medicine,the total effective rate was 93.18%.Glucocorticoids are the basic drugs for SDE,some inpatients combined with immunoglobulin,antibiotics,antihistamines,hemodialysis according to their needs.At the same time,combining with the decoction of Chinese medicine,at the early stay,clearing heat and expelling damp were the main,nourishing qi and yin,later to restore deficiency;main medicines including dampness drug,heat-clearing drug and tonic drug.Conclusion1.The severity of drug eruption is closely related to the types of SDE.TEN is the most dangerous,and early actively methylprednisolone treatment can rapidly improve the symptoms,control the disease,reduce complications.2.Practice suggests that hemodialysis may play a positive and effective role in rescuing SDE inpatients with renal failure and extending their survival time.3."Wet" and "hot" play an important role on the pathogenesis of SDE,clearing away damp and flexible application of heat therapy is an important means to TCM for the treatment of SDE,and main medicines including dampness drug,heat-clearing drug and tonic drug.The deficiency syndrome in the discharge certificate is slightly increased,and the deficiency syndrome may be the development trend of the later stage of the disease.4.The therapy of our hospital in combining TCM and western medicine of SDE have certain characteristics,mainly with hormone + antihistamine + Chinese medicine decoction,hormone + immunoglobulin + antihistamine + Chinese medicine decoction. |
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