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[1]郝娟,周扬,邢枫,等.原发性胆汁性胆管炎的中医证候分析[J].环球中医药,2017,10(12):1438-1442.[doi:10.3969/j.issn.1674-1749.2017.12.005]
　HAO Juan,ZHOU Yang,XING Feng,et al.Analysis of TCM syndrome of primary biliary cholangitis[J].,2017,10(12):1438-1442.[doi:10.3969/j.issn.1674-1749.2017.12.005]
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原发性胆汁性胆管炎的中医证候分析()
     
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《环球中医药》[ISSN:1006-6977/CN:61-1281/TN]

卷:
第10卷
期数:
2017年12期
页码:
1438-1442
栏目:
论著
出版日期:
2017-12-06

文章信息/Info

Title:
Analysis of TCM syndrome of primary biliary cholangitis
作者:
郝娟; 周扬; 邢枫; 朱春雾; 陶艳艳; 刘成海
201203 上海中医药大学附属曙光医院肝病研究所[郝娟(博士研究生)、周扬、邢枫、朱春雾(硕士研究生)、陶艳艳、刘成海]
Author(s):
HAO Juan;  ZHOU Yang;  XING Feng;  et al.
Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
关键词:
原发性胆汁性胆管炎;  中医药;  证候
Keywords:
Primary biliary cholangitis;  Traditional Chinese Medicine;  Syndrome
分类号:
R657.4+5
DOI:
10.3969/j.issn.1674-1749.2017.12.005
文献标志码:
A
摘要:
目的 研究原发性胆汁性胆管炎(primary biliary cholangitis,PBC)的中医证型分布特点。方法 采用临床流行病学调查方法对329例PBC患者四诊信息进行采集,运用快速聚类法对中医症状变量进行聚类,基于变量均值和中医证候判别标准鉴定证型,并比较证型在疾病不同分期中的分布。结果(1)329例PBC患者聚为8类:脾气亏虚证(30.40%)、肝肾阴虚证(28.88%)、肝血虚证(14.59%)、肝气郁结证(13.98%)、气虚血瘀证(5.17%)、气阴两虚证(3.34%)、肝郁脾虚证(3.04%)和肝胆湿热证(0.61%);(2)脾气亏虚证在各临床分期中均较多见,此外,临床前期和无症状期多见肝血虚证,症状期多见肝肾阴虚证,肝功能不全期多见肝血虚证;(3)超声评分低时以肝气郁结证为主,评分高时以肝肾阴虚和脾气亏虚证为主;(4)脾气亏虚证贯穿于各个病理分期,此外,Ⅰ期和Ⅱ期多见肝气郁结证,Ⅲ期多见肝肾阴虚证,Ⅳ期以肝血虚证多见;(5)各中医证型ALB和TBIL水平比较有统计学差异(P<0.05)。结论 脾气亏虚证、肝肾阴虚证和肝血虚证是PBC患者常见的中医证型,证型分布与疾病阶段有密切关系。
Abstract:
Objective To study the distribution characteristics of traditional Chinese medicine(TCM)syndromes of primary biliary cholangitis(PBC). Methods The clinical information of 329 patients with primary biliary cholangitis was investigated by clinical epidemiology, and the results were analyzed by K-Means Cluster. Based on TCM syndromes criteria and the mean value of variables to identify TCM syndromes, and then, to compare the distribution of syndromes in different stages. Results(1)329 PBC patients were divided into eight kinds of TCM syndromes, including spleen qi deficiency(30.40%), liver and kidney yin deficiency(28.88%), liver blood deficiency(14.59%), liver qi stagnation(13.98%), qi deficiency and blood stasis(5.17%), qi and yin deficiency(3.34%), liver depression and spleen deficiency(3.04%)and liver and gallbladder damp-heat(0.61%).(2)Spleen qi deficiency syndrome was common throughout the clinical period, in addition, liver blood deficiency syndrome was common in the preclinical and asymptomatic period, and liver and kidney yin deficiency syndrome is common in the symptoms stage, and liver blood deficiency syndrome is common in liver dysfunction stage.(3)The liver qi stagnation syndrome was common when ultrasound score was low, and liver and kidney yin deficiency and spleen qi deficiency syndrome were common when ultrasound score was high.(4)Spleen qi deficiency syndrome runs through each pathological stage. In addition, liver qi stagnation syndrome was common in phase I and II, and liver and kidney yin deficiency syndrome was common in phase III, while liver blood deficiency syndrome was common in phase IV.(5)There were significant differences in ALB and TBIL levels in TCM syndromes(P<0.05). Conclusion Spleen qi deficiency, liver and kidney yin deficiency and liver blood deficiency are the common TCM syndromes of PBC patients. The distribution of syndrome types is closely related to the stage of disease.

参考文献/References:

[1] E J Carey,A H Ali,K D Lindor. Primary biliary cirrhosis[J]. Lancet,2015,386(10003):1565-1575.
[2] G Rada,M Mac-Namara. Is ursodeoxycholic acid effective in primary biliary cirrhosis?[J]. Medwave,2014,14(8):e6019.
[3] J S Rudic,G Poropat,M N Krstic,et al. Ursodeoxycholic acid for primary biliary cirrhosis[J]. Cochrane Database Syst Rev,2012,(1):CD000551.
[4] 葛琴. 八珍汤合化积丸加减联合熊去氧胆酸治疗原发性胆汁性肝硬化疗效观察[J]. 现代中西医结合杂志,2016,25(2):184-186.
[5] 叶小丹,朱肖鸿. 中西医结合治疗肝郁脾虚型原发性胆汁性肝硬化患者的疗效观察[J]. 中医药学报,2013,41(4):116-117.
[6] 师建平,郭静. 中医辨证论治理论体系的研究现状与发展趋势[J]. 中华中医药杂志,2013,28(9):2508-2511.
[7] E J Heathcote. The American Association for the Study of Liver Diseases practice guidelines. Management of primary biliary cirrhosis[J].Hepatology,2000,31(4):1005-1013.
[8] 陈成伟,成军,窦晓光,等. 原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J]. 临床肝胆病杂志,2015,31(12):1980-1988.
[9] 邓铁涛.中医诊断学[M].上海:上海科学技术出版社,2013.
[10] J Ludwig,E R Dickson,G S McDonald. Staging of chronic nonsuppurative destructive cholangitis(syndrome of primary biliary cirrhosis)[J]. Virchows Arch A Pathol Anat Histol,1978,379(2):103-112.
[11] 张福奎,张影,王宝恩. 原发性胆汁性肝硬化的自然史[J]. 肝脏,2009,14(3):251-253.
[12] 刘文莉. 原发性胆汁性肝硬化中医证型分布规律研究[J]. 中国卫生标准管理,2015,6(8):64-65.
[13] 李娜. 原发性胆汁性肝硬化中医证型分布规律研究[D].哈尔滨:黑龙江中医药大学,2012.
[14] 杨将领,张美珠,张斌. 74例原发性胆汁性肝硬化患者中医证型及临床特征分析[J]. 中西医结合肝病杂志,2015,25(4):209-211.
[15] 程良斌,吴凡. 原发性胆汁性肝硬化中医临床分析[J]. 湖北中医杂志,2011,33(2):13-14.
[16] 刘颖,董振华. 董振华教授治疗原发性胆汁性肝硬化的经验[J]. 中国临床医生杂志,2015,43(1):85-86.

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备注/Memo

备注/Memo:
基金项目: 上海市进一步加快中医药事业发展三年行动计划(ZY3-CCCX-2-1003)
作者简介:郝娟(1985- ),女,2014级在读博士研究生。研究方向:中西医结合防治慢性肝病。E-mail:haojuan111111@163.com
通信作者:刘成海(1965- ),博士,教授,博士生导师。研究方向:中西医结合防治慢性肝病。E-mail:chenghailiu@hotmail.com
更新日期/Last Update: 2017-11-06