基于肝络病理论治疗儿童胆管消失综合征

Treatment of vanishing bile duct syndrome in children based on the theory of hepatic collateral disease

儿童胆管消失综合征(VBDS)是指肝内胆管局灶或弥漫性消失,临床上以胆汁淤积为主要病理特点,以黄疸为主要临床表现的综合征。西医尚无特效疗法。文章在临床实践基础上,结合肝络的生理及病理特点,从胆管的结构、生理功能、与肝血管之间的联系、肠肝循环的特点等方面,探讨了胆管与肝络气血之间关系,提出了肝络气滞血瘀、正虚邪滞是儿童胆管消失综合征的主要病机。在治疗上,须重视行气活血、化瘀通络之法。文章从肝络病理论为指导治疗儿童VBDS提供了理论依据,并附一则验案与同道共飨。

Vanishing bile duct syndrome(VBDS)is a syndrome of focal or diffuse loss of intrahepatic bile ducts characterized by cholestasis and jaundice.Western medicine has no specific treatment.On the basis of clinical practice and combining with the physiological and pathological characteristics of hepatic collaterals,this paper discusses the relationship between bile duct and hepatic collateralise,from the structure,physiological function,the connection between bile duct and hepatic vessels,the characteristics of enterohepatic circulation,etc..The main pathogenesis of VBDS in children was put forward.In the treatment,we should attach importance to the method of activating qi and removing blood stasis.Through this study,it provides theoretical basis and clinical experience for guiding the treatment of children VBDS from the theory of hepatic collateral disease.