自身免疫性肝病中医发病机制的风邪作用探讨

Role of Pathogenic Wind in TCM Pathogenesis of Autoimmune Liver Disease

自身免疫性肝病在中医属黄疸、积聚、胁痛、鼓胀等肝胆病证范筹,二者不仅在临床特征、病变过程及预后转归方面有较强的一致性,病因病机也应高度相关,即一般认为的湿、热、瘀、虚。此外,中医六淫病因之一的风邪在其发病机制中起了不可忽视的作用,通过从风邪的致病特性与肝脏生理病理(中医学)及自身免疫性肝病的临床特征相关、风药治肝的历史、以及风药类皮质激素样作用抑制自身免疫反应四方面进行阐述,强调将风邪因素纳入自身免疫性肝病的理法方药体系中,有益于拓展辩证思路,丰富治疗手段,提高临床疗效。

Autoimmune liver disease is in the category of liver and gallbladder disorders in TCM,such as jaundice,hypochondriac pain and abdominal distention and fullness. Both liver disorder and gallbladder disorder are highly consistent in terms of clinical symptoms,sickness process,prognosis and outcome and are highly correlative in terms of etiology and pathogenesis,meaning generally damp,heat,stasis and deficiency. Additionally,the pathogenic wind,one of the six pathogenic factors in TCM cannot be neglected in pathogenesis. In the paper,the four aspects were explained,named the correlation between the characteristics of pathogenic wind and the clinical characteristics of autoimmune reaction,the correlation between it and liver physiology and pathology（ TCM）,the treatment history of wind drugs for liver disease and the corticosteroid effect of wind drugs for the inhibition of autoimmune reaction. It is emphasized that the pathogenic wind should be involved in the system of theory,principle,method and drug in the treatment of autoimmune liver disease,which benefits the approach to syndrome differentiation,enriches therapeutic methods and improves clinical efficacy.