| 本文已被：浏览 1041次 下载 629次 |
码上扫一扫！ |
|
|
| 原发性胆汁性胆管炎微观病机探析 |
|
张燕洁1, 孔海霞1, 李悦1, 杜泽姗1, 贺俊芝1, 杜宏波2,3
|
|
1.北京中医药大学第一临床医学院, 北京 100700;2.北京中医药大学东直门医院脾胃病科, 北京 100700;3.北京中医药大学肝病研究所, 北京 100700
|
|
| 摘要: |
| 原发性胆汁性胆管炎早中期症状轻微，基于传统宏观辨证推求的病机一直未能形成共识，临床效果提升困难。然而，该病微观病理分期清晰，疾病进展具有较好的规律性，基于现有研究及临床实践，围绕该病最本质的微观病理变化对其病机进行探讨，强调卫气郁滞与胆毒内损胆汁络在该病中的重要性，认为卫气郁滞胆汁络是该病的早期独立病机和全程推进因素，而胆毒内损胆汁络是该病进展期的关键病机。并对传统胆腑与胆汁络加以区分，指出新病直起于胆汁络是该病的病位特点；胆汁络郁热，日久成瘀是该病的重要局部病理特点之一。此外，还针对卫气郁滞、胆毒内损胆汁络的微观病机提出相应治法上的指导，以冀为中医辨治该病提供新思路。 |
| 关键词: 肝硬化 胆汁性 微观病机 毒损胆汁络 卫气郁滞 理论探讨 |
| DOI：10.11656/j.issn.1672-1519.2021.04.12 |
| 分类号:R657.45 |
| 基金项目:十三五计划国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治专项（2018ZX10725-505）。 |
|
| Analysis of microscopic pathogenesis of primary biliary cholangitis |
|
ZHANG Yanjie1, KONG Haixia1, LI Yue1, DU Zeshan1, HE Junzhi1, DU Hongbo2,3
|
|
1.The First Clinical School of Beijing University of Chinese Medicine, Beijing 100700, China;2.Department of Spleen and Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;3.Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing 100700, China
|
| Abstract: |
| The symptoms of primary biliary cholangitis are mild in the early and middle stage,and the pathogenesis based on traditional macroscopic syndrome differentiation has not reached a consensus,so it is difficult to improve the clinical effect. However,the microscopic pathological stage of the disease is clear and the progress of the disease has a good regularity. Based on the existing research and clinical practice,our team discussed the pathogenesis of the disease around the most essential microscopic pathological changes of the disease. It emphasizes the importance of wei-qi stagnation and bile collateral damage in the disease,and believes that wei-qi stagnation and bile collaterals are the early independent pathogenesis and whole-course advancing factors of the disease. The damage of bile collaterals in biliary toxicity is the key pathogenesis of the disease. And this article distinguishes the traditional gallbladder and the biliary collaterals,and points out that the new disease starts directly from the biliary collaterals as the location feature of the disease. The stagnation of heat in the bile collaterals and the stasis over time are one of the important local pathological features of the disease. In addition,it also puts forward the corresponding guidance on the treatment of the micro-pathogenesis of wei-qi stagnation and internal damage of bile collaterals,in order to provide new ideas for the diagnosis and treatment of the disease in traditional Chinese medicine. |
| Key words: liver cirrhosis biliary microscopic pathogenesis toxic damage to the biliary collaterals wei-qi stagnation theoretical discussion |
