Killedar Ramesh S, Gupta Shivay, Shindhe Pradeep
Dept of Shalya Tantra, KAHER'S Shri B M Kankanawadi Ayurveda Mahavidhyalaya, Shahapur, Belagavi, Karnataka, India.
Dept of Shalya Tantra, KAHER'S Shri B M Kankanawadi Ayurveda Mahavidhyalaya, Shahapur, Belagavi, Karnataka, India.
J Ayurveda Integr Med. 2021 Jan-Mar;12(1):165-168. doi: 10.1016/j.jaim.2020.07.004. Epub 2020 Sep 4.
Administration of intramuscular, intraarterial or subcutaneous injection of particular drugs ends up into a rare entity known as Nicolau syndrome (NS). The viscous nature of these drugs sometimes triggers acute vasospasm and even arterial embolism. There is no consensus on treatment of NS so far. Phasic treatments depend on the extent of the necrotic lesion and ranges from medication to surgical debridement. Here we report a case of 60 year female known case of Knee Osteoarthritis who was dependent on Diclofenac injection IM for relief of pain. She presented with complaints of fever with chills, rigors, discoloration of skin at the gluteal region right side, later turned into necrosis of skin and adipose tissue, pus formation and associated with loss of appetite, dryness of mouth, pedal oedema. The case was diagnosed as NS according to contemporary science and Kotha (Gangrene) as per Ayurveda. The case was treated successfully with Chedana karma (Surgical debridement) followed by Vrana shodhana (making free from undesirable healing factors), Ropana (Closure of wound) and oral medications.
肌肉注射、动脉内注射或皮下注射特定药物有时会引发一种罕见的病症，即尼科劳综合征（NS）。这些药物的黏性有时会引发急性血管痉挛甚至动脉栓塞。目前对于NS的治疗尚无共识。阶段性治疗取决于坏死病变的程度，范围从药物治疗到手术清创。在此，我们报告一例60岁女性膝骨关节炎患者，她一直依赖双氯芬酸肌肉注射来缓解疼痛。她出现发热、寒战、右侧臀部皮肤变色的症状，随后发展为皮肤和脂肪组织坏死、形成脓液，并伴有食欲不振、口干、足部水肿。根据现代医学，该病例被诊断为NS，而根据阿育吠陀医学则诊断为Kotha（坏疽）。该病例通过切达那疗法（手术清创），随后进行创口净化（去除不良愈合因素）、创口闭合和口服药物治疗，最终成功治愈。
