吕文良教授从肝脾论治原发性胆汁性胆管炎的经验

Professor LüWenliang’s experience in treating primary biliary cholangitis from liver and spleen

原发性胆汁性胆管炎是一种慢性肝内胆汁淤积性疾病,随着病情进展可出现肝硬化。治疗上存在免疫不应答,减药和停药时病情复发等问题。吕文良教授基于多年临床实践经验认为本病肝脾肾脏腑功能失调为本,而又以肝脾两脏为重。肝郁脾虚,湿热、毒、瘀、虚内结是其核心病机。据此提出了三大重要治则,其一柔肝健脾,顾护胃气;其二化湿解毒,祛除邪气;其三消瘀通络,调和气血。顺应脏腑生理特性,调其中气,使之和平,从而起到防治病情进展的效果。并附医案一则,以期为原发性胆汁性胆管炎的中医治疗提供思路和方法。

Primary biliary cholangitis is a chronic disease of intrahepatic cholestasis,with cirrhosis occurring as the disease progresses.There are problems such as immune non-response and relapse when reducing or stopping drugs.Based on years of clinical experience,Professor LüWenliang believes that the dysfunction of zang-fu organs such as liver,spleen,kidney is the basis of the disease,the liver and spleen are more important.Liver depression and spleen deficiency,damp-heat,poison,blood stasis,and deficiency internal knot are the core pathogenesis.On this basis,three important treatment principles are put forward:first is to soften liver and strengthen spleen,protect stomach qi;second is to clear damp detoxification and dispel evil;third is to eliminate stasis and dredge collaterals,reconcile qi and blood.Adapt to the physiological characteristics of zang-fu organs,adjust qi to make it peaceful,so as to prevent the progress of the disease.A medical case is attached in order to provide ideas and methods for traditional Chinese medicine treatment of primary biliary cholangitis.