钱英教授治疗自身免疫性肝炎经验

The experience of professor Qian Ying in the treatment of autoimmune hepatitis

本文从病因病机、临床思辨、常用方剂、擅用药物等方面阐述钱英教授治疗自身免疫性肝炎经验。钱英教授认为自身免疫性肝炎的基本病因病机为先天禀赋不足、后天体质虚弱,因情志不遂、感受风邪、湿邪、毒邪等邪而发病;瘀血、痰浊、水饮等病理产物促进自身免疫性肝炎(AIH)复杂加重。治疗前应辨别体质,纠其偏颇,及早预防;治疗方法强调体用同调、肝肾同治,顾护中州、扶正祛邪。其中扶正以健脾胃、滋肾水、养肝阴、和肝血、柔肝体为主,祛邪以疏肝气、解肝郁、逐肝瘀、通肝络、调肝用为主。方药常选用一贯煎合四物汤加减,擅用金雀根调节免疫、保肝护肝。

The article elaborates the clinical experience of professor Qian Ying in the treatment of autoimmune hepatitis(AIH) in terms of etiology and pathogenesis, clinical speculation, frequently-used prescriptions and medicines. Professor Qian believes that the basic etiology and pathogenesis of AIH is congenital deficiencies and acquired physical weakness. The onset of AIH is due to emotional failure and external evils of wind, dampness and poison. Moreover, the aggravation of AIH is promoted by the pathological products, including blood stasis, phlegm turbidity and retained fluid. We should distinguish the constitution, investigate the bias, prevent it as soon as possible, coregulate liver entity and function, cotreat liver and kidney, harmonize spleen and stomach, strengthen the health and eliminate pathogenic factors. The treatment of strengthening mainly focus on spleen and stomach, nourishing kidney water and liver yin, harmonizing liver blood and softening liver body. The treatment of eliminating pathogenic factors mainly focus on soothing liver and relieving depression, expel blood stasis, dredge collaterals and regulate liver functions.Simultaneously, it is necessary to inhibit immunity and avoid overuse of diuretic and detoxifying medicines.The Yi Guan Jian and Si Wu decoction are commonly used, and the canary root is beneficial for regulating immunity and protecting liver.