Department of Respiratory Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Department of Respiratory Medicine, The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing 100029, China.
Department of Respiratory Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
J Integr Med. 2020 Nov;18(6):530-534. doi: 10.1016/j.joim.2020.08.004. Epub 2020 Aug 26.
Adult-onset Still's disease (AOSD) is a rare but clinically well-known, polygenic, and systemic autoinflammatory disease, which is characterized by spiking fever, evanescent skin rash, arthralgia, and sore throat. The application of non-steroidal anti-inflammatory drugs and glucocorticoids, which are first-line therapies of AOSD, is limited due to their side effects such as liver injury or disorder of blood glucose. Therefore, patients who suffer from systemic diseases in China prefer to seek help from Chinese herbal medicine (CHM), which is an important part of complementary and alternative medicine. In this case, we report a 28-year-old male badminton coach presenting with a 15-day history of fever and skin rash, accompanied by sore throat, fatigue, myalgia and chills. Additionally, hepatosplenomegaly, multiple lymphadenopathies, aminotransferase abnormality, and elevated inflammatory factor levels were observed during hospitalization. Infectious diseases, solid tumors, hematological diseases, and common autoimmune diseases were excluded. Not benefitting from antibiotic therapy, the patient was finally diagnosed with AOSD, after a careful examination, then showed rapid remission after a six-week treatment with CHM granules based on Xiaochaihu Decoction and Yinqiao Powder. After stopping the treatment, there was no relapse within a 15-month follow-up period. To the best of our knowledge, this is the first well-documented case of this successful treatment. The present case report suggests that CHM is a reliable choice for complementary and alternative therapy for AOSD, but confirming the utility of CHM for AOSD requires further support from prospective studies.
成人Still 病（AOSD）是一种罕见但临床特征明确的多基因、系统性自身炎症性疾病，其特征为高热、一过性皮疹、关节炎和咽痛。由于非甾体抗炎药和糖皮质激素具有肝损伤或血糖紊乱等副作用，因此它们在 AOSD 的一线治疗中的应用受到限制。因此，患有系统性疾病的中国患者更倾向于寻求中草药（CHM）的帮助，这是补充和替代医学的重要组成部分。在这种情况下，我们报告了一名 28 岁的男性羽毛球教练，他有 15 天的发热和皮疹病史，伴有咽痛、疲劳、肌痛和寒战。此外，住院期间还观察到肝脾肿大、多发淋巴结病、转氨酶异常和炎症因子水平升高。排除了传染病、实体瘤、血液病和常见自身免疫性疾病。由于抗生素治疗无效，经过仔细检查，该患者最终被诊断为 AOSD，在接受基于小柴胡汤和银翘散的 CHM 颗粒治疗六周后迅速缓解。停药后 15 个月的随访期内无复发。据我们所知，这是首例对此成功治疗进行详细记录的病例。本病例报告表明，CHM 是 AOSD 补充和替代治疗的可靠选择，但需要前瞻性研究进一步支持 CHM 对 AOSD 的疗效。
