Analysis of the advantages of traditional Chinese medicine intervention for eczema during pregnancy and comprehensive nursing practice: a typical case report
中医药干预妊娠期湿疹的优势分析及综合护理实践——附1例典型病例报告

摘要

探妊娠期湿疹是常见的妊娠特异性皮肤病，其与妊娠期代谢紊乱（如糖尿病）并存时，病情更为复杂，治疗难度显著增加。本文报告1例孕36⁺⁴周合并妊娠期湿疹、妊娠期糖尿病（A1型）患者的诊疗与护理过程。患者于孕34周左右突发全身散在皮疹、腹部巨大红斑（29cm×33cm），伴剧烈瘙痒、皮肤破溃、渗液及夜间疼痛，严重影响睡眠。初始复硼洗剂治疗无效后，采用中药外敷（马齿苋等）联合硫酸镁湿敷，皮损显著改善（红斑面积由29×33 cm缩小至20×23 cm，破溃结痂愈合）。结果显示，中药外敷联合硫酸镁湿敷能有效控制严重妊娠期湿疹的炎症与渗出，促进创面愈合；结合文献分析，重点阐述中医药治疗妊娠湿疹的特色优势、规范护理要点、心理疏导策略、后期预防措施及个体化饮食指导，为临床提供参考。

Abstract

Eczema during pregnancy is a common pregnancy-specific skin disease. When it coexists with metabolic disorders during pregnancy (such as diabetes), the condition becomes more complicated and the difficulty of treatment increases significantly. This article reports the diagnosis, treatment and nursing process of a patient with gestational eczema and gestational diabetes mellitus (type A1) at 36⁺⁴ weeks of gestation. The patient suddenly developed scattered rashes all over the body, huge erythema on the abdomen (29cm×33cm) around 34 weeks of pregnancy, accompanied by severe itching, skin ulceration, exudation and nocturnal pain, which seriously affected sleep. After the initial treatment with boron compound lotion was ineffective, the application of traditional Chinese medicine externally (such as purslane) combined with wet compress with magnesium sulfate significantly improved the skin lesions (the area of erythema decreased from 29×33 cm to 20×23 cm, and the ulceration and scabbing healed). The results show that external application of traditional Chinese medicine combined with wet compress of magnesium sulfate can effectively control the inflammation and exudation of severe eczema during pregnancy and promote wound healing. Based on literature analysis, this paper focuses on elaborating the characteristic advantages of traditional Chinese medicine in the treatment of pregnancy eczema, key points of standardized nursing, psychological counseling strategies, post-treatment preventive measures and individualized dietary guidance, providing references for clinical practice.