原发性胆汁性肝硬化74例中医辨证规律的研究

Study on the Law of Syndrome Differentiation of Primary Biliary Cirrhosis by Traditional Chinese Medicine:A 74-case Report

目的观察74例原发性胆汁性肝硬化(PBC)患者的中医证型和辨证规律。方法采用气血津液结合脏腑辨证的方法,将74例PBC患者分为肝郁脾虚证、脾胃气虚证、湿热瘀血证和肝肾阴虚证4类,探讨其与肝功能及免疫球蛋白检测指标的关系。结果 74例的病情程度以肝郁脾虚证和脾胃气虚证较轻,多见于疾病早期或稳定阶段;湿热瘀血证和肝肾阴虚证较重,部分已处于失代偿期。湿热瘀血证的肝功能损害最为明显,反映出肝内胆小管炎症处于活动和进展状态。部分PBC的中医证型证候有动态变化的特点。结论 PBC的中医证型与病情程度和肝功能损害有一定相关性。

To observe the patterns of syndrome and the law of syndrome differentiation in primary biliary cirrhosis （PBC） patients. Methods With the method of syndrome differentiation of qi - blood - body fluid combined with viscera, a total of 74 PBC patients were divided into four categories ： syndrome of liver - depression and spleen - deficiency, qi - deficiency of the spleen and stomach, dampness - heat and blood stasis, and yin - deficiency of liver and kidney, and their relationship between liver function and im- munoglobulin was also investigated. Results As for the degree of pathogenetic condition, syndromes of liver - depression and spleen - deficiency and qi - deficiency of the spleen and stomach were mild, often in early course or stable stage, while syndromes of dampness - heat and blood stasis and yin - deficiency of liver and kidney were severe, and part of them were in discompensation stage. The leision of liver ruction was most obvious in syndrome of dampness - heat and blood stasis, which reflected the intrahepaticcholangiolitichepatitis was in active or progressing stage. Some of TCM patterns of syndrome of PBC had the feature of dynastic variation. Conclusion The TCM patterns of syndrome of PBC were correlated to the degree of pathogenetic condition and leision of liver faction.