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患者女,65a,因服“龙马丹”开口、行走困难2mo,高烧10d收入院.患者于70d前因双手拇食指掌指关节间歇性红肿痛,活动受限la,查血常规血沉,X光片无异常,血RF(+)、CRP(+),诊断为类风湿性关节炎.服用“龙马丹”(组方:马钱子15Og、广地龙500克炮制后共份制水丸),每日早晚各服1次,每次8粒(每日马钱子0.852g、广地龙2.8g),服至15d时出现马钱子中毒症状.继续服至60d(马钱子总量50g、广地龙168g),病人中毒症状逐渐加重卧床不起(此期间未服其他任何药物),60d时体温开始逐渐升至40℃.收入某医院给予抗感染及支持疗法10d,仍有间歇高烧而转入我院.查体:t40℃,一般情况较差,精神萎靡,颜面、四肢浮肿紫绀,开口困难,言语不清,心肺无特殊,由平软,脾大至济下3cm,质软有压病,左腹股沟淋巴结肿大,质软有压痛,四肢肌张力升高,皮肤散在出血点,胜反射活跃,胸骨压病.辅助检查:胸片(一),ECG窦速.B超牌大.肝肾功能、血糖血脂电解质、血沉血培养出凝血时间无异常,RF、CRP(+),血浆蛋白、免疫蛋白、血浆纤维蛋白原定量低,凝血酶原时间延长.血常规示WBCBC55.7×10~9/L、Hb90g/L、PLT66×10~9/L、
The female patient, 65 years, was convinced with the “Longmadan” opening, difficulty walking for 2 months, and was hospitalized with high fever for 10 days. The patient had intermittent redness and swelling of the metacarpophalangeal joint due to the metacarpophalangeal joints of his hands before 70 days. No abnormalities in light, blood RF (+), CRP (+), diagnosed as rheumatoid arthritis. Taking “Longmadan” (group prescription: 15g of Maqinzi, 500g of Guangdi Long, processed water pill together) , Each morning and evening each serving 1, each 8 tablets (0.852g daily Ma Zizi, Guangdi Dragon 2.8g), served to 15d when the symptoms of streaky poisoning. Continue to serve 60d (the total amount of Strychnos 50g, Guangdilong 168g), the patient’s symptoms of poisoning gradually increased in bed (not during this period to take any other drugs), body temperature began to gradually rise to 40 °C 60d. Income from a hospital given anti-infective and supportive therapy 10d, there are still intermittent High fever and transfer to our hospital. Physical examination: t40 °C, poor general condition, listlessness, facial edema, purpura purpura, difficulty opening, unclear words, no special cardiopulmonary, from soft, splenomegaly to 3 kg, quality Soft and pressure disease, left inguinal lymphadenopathy, tender softness, tenderness, increased muscle tone of the extremities, scattered skin at the point of bleeding, active reflexes, sternal compression disease. Auxiliary examination: chest X-ray (A), ECG sinus Speed. B super card large. Liver and kidney function, blood glucose and lipid electrolytes, blood clotting blood culture no abnormal clotting time, RF, CRP (+), plasma protein, immune protein, plasma fibrinogen, low, prolonged prothrombin time. The blood shows WBCBC 55.7×10~9/L, Hb90g/L, PLT66×10~9/L,