中医药应用于重症急性胆管炎术后研究述评

A Review of Postoperative Research on Traditional Chinese Medicine in Severe Acute Cholangitis

重症急性胆管炎(acute cholangitis of severe gype,ACST)导致的肝功能损害,术后将持续较长时间才得以恢复,机体恢复较慢,容易产生并发症,所以ACST术后肝功能恢复是关键。从中医角度分析ACST属"黄疸""胆胀",以目黄、身黄、小便黄为主症,其病机是肝胆湿热,郁久化毒入血,耗伤阴液,肝胆疏泻失职,发为"黄疸"。目前ACST患者术后恢复治疗的中医治法各异,尚无统一指导原则。治则治法总体上包括:疏肝利胆、行气活血、健脾益气、脏腑同治、扶正驱邪、清热解毒、通里泻热排脓、凉血养阴、利湿退黄等。处方常用中药大致包括:茵陈、龙胆草、郁金、山栀、黄芩、金钱草、陈皮、柴胡、大黄、赤芍、人参、丹参、北沙参、麦冬、五味子、附子、干姜、黄连、金银花、栀子、芒硝、山药、白术、茯苓、甘草、当归、枳壳、鸡内金、白扁豆、虎杖、生地黄、生石膏、青皮、陈皮、半夏、枳实、白芍、香附、木香、败酱草、白头翁、玄参、蒲公英、野菊花、白花蛇舌草、红花等。

Hepatic dysfunction caused by severe acute cholangitis（ ACST） can be recovered after a long period of time. The recovery of liver function after ACST is essential. From the perspective of Chinese medicine,ACST is described as ＂ jaundice＂ or ＂ Dan Zhang＂,with yellow of eyes,body and urine as the main performance and the pathogenesis is damp-heat of liver and gallbladder,poisoning the blood and consuming Yin of body. There are various treatment of ACST with TCM such as soothing liver and draining gallbladder to subside jaundice,promoting Qi and blood circulation,supplementing spleen Qi,purging to clear heat,expelling toxic and draining pus,and cooling blood with nourishing Yin,etc. TCM that commonly used to treat cholangitis are as follows： capillaris,gentian,turmeric,gardenia,scutellaria,money grass,dried tangerine peel,bupleurum,rhubarb,red peony,ginseng,ginseng,northern sand ginseng,Ophiopogon japonicus,Schisandra,Ginger,berberine,ginkgo biloba,almonds,alderia,aldera,licorice,angelica,angelica,fructus aurantium,jellyfish,lentils,Polygonum cuspidatum,habitat,gypsum,green tangerine peel,Pinellia,citrus aurantium,Attached,woody,Patrinia,Pulsatilla,Scrophulariaceae,Dandelion,wild chrysanthemum,Hedyotis diffusa,safflower and so on.