|
|
Professor Lü Wenliang’s experience in treating primary biliary cholangitis from liver and spleen |
YU Yingying LYU Wenliang |
Department of Infectious Diseases, Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053,China
|
|
|
Abstract 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 Lü Wenliang 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.
|
|
|
|
|
[1] Beuers U,Gershwin ME,Gish RG,et al. Changing nomenclature for PBC:from ‘cirrhosis’ to ‘cholangitis’ [J]. J Hepatol,2015,63(5):1285-1287.
[2] Pandit S,Samant H. Primary biliary cholangitis [M]. Treasure Island(FL):StatPearls Publishing,2022.
[3] Warnes TW,Roberts SA,Smith A,et al. Portal hypertension in primary biliary cholangitis:prevalence,natural history and histological correlates [J]. Eur J Gastroenterol Hepatol,2021, 33(12):1595-1602.
[4] Liu H,Liu Y,Wang L,et al. Prevalence of primary biliary cirrhosis in adults referring hospital for annual health check-up in Southern China [J]. BMC Gastroenterol,2010, 10:100.
[5] Heathcote EJ. Management of primary biliary cirrhosis. The American Association for the Study of Liver Diseases practice guidelines [J]. Hepatology,2000,31(4):1005-1013.
[6] 尤红,段维佳,李淑香,等.原发性胆汁性胆管炎的诊断和治疗指南(2021)[J].临床肝胆病杂志,2022,38(1):35- 41.
[7] 郭元彪,应海峰,徐佳悦,等.熊去氧胆酸联合非诺贝特对原发性胆汁性胆管炎的临床疗效及安全性[J].现代生物医学进展,2021,21(14):2670-2674,2692.
[8] 吴姗姗,王振常,黎妍,等.中药复方壮肝逐瘀煎对肝纤维化模型大鼠微循环的影响[J].中华中医药学刊,2020, 38(1):151-156,277.
[9] 黄祎,许国圣,杨浦娟,等.滋水涵木利胆方联合熊去氧胆酸胶囊治疗原发性胆汁性胆管炎临床研究[J].中西医结合肝病杂志,2021,31(1):47-49.
[10] 王瑛,袁鹤立,赵利,等.清热利胆自拟方联合熊去氧胆酸对原发性胆汁性胆管炎患者肝功能、免疫功能及炎症因子的影响[J].现代中西医结合杂志,2021,30(15):1606-1610.
[11] Virgile J,Marathi R. Cholangitis [M]. Treasure Island (FL):StatPearls Publishing,2022.
[12] Schaefer TJ,John S. Acute Hepatitis [M]. Treasure Island (FL):StatPearls Publishing,2022.
[13] 王海琦,芦曦.原发性胆汁性胆管炎的瘙痒机制及治疗进展[J].实用临床医药杂志,2022,26(6):128-133.
[14] Bergasa NV. Pruritus of Cholestasis [M]. Boca Raton (FL):CRC Press/Taylor & Francis,2014.
[15] 幸鹭,郝娟,邢枫,等.基于数据挖掘初探自身免疫性肝病中医证候特点及用药规律分析[J].世界中医药,2020, 15(19):2857-2863.
[16] 牛作虎,贠张君,彭红叶,等.姚树坤教授诊治原发性胆汁性胆管炎临床经验[J].中国医药导报,2022,19(7):128-131.
[17] 耿晓萱,卢秉久.卢秉久教授基于“肝体阴用阳”辨治原发性胆汁性胆管炎[J].中医临床研究,2022,14(5):70-73.
[18] 马翠翠,施卫兵.施卫兵治疗原发性胆汁性胆管炎经验[J].中医药临床杂志,2020,32(4):632-635.
[19] 周才英,李京涛,刘永刚,等.常占杰教授从虚瘀论治原发性胆汁性胆管炎经验[J].中西医结合肝病杂志,2021, 31(9):848-850.
[20] 周希禛,黄大未,程朝霞,等.张玮教授治疗原发性胆汁性胆管炎经验[J].中国中医急症,2019,28(12):2228- 2231.
[21] 刘衡,陆伦根.复杂胆汁淤积性疾病的遗传学研究[J].肝脏,2014,19(1):56-58.
[22] 胡伶姿,吕文良,周文慧,等.玉屏风散防治肝病的研究进展[J].世界中医药,2018,13(9):2357-2361.
[23] Zhang X,Xu Y,Chen JM,et al. Huang Qi Decoction prevents BDL-induced liver fibrosis through inhibition of notch signaling activation [J]. Am J Chin Med,2017,45(1):85-104.
[24] Shahzad M,Shabbir A,Wojcikowski K,et al. The antioxidant effects of Radix Astragali (Astragalus membranaceus and related species) in protecting tissues from injury and disease [J]. Curr Drug Targets,2016,17(12):1331-1340.
[25] 朱波,郭丽颖,沈南兰,等.贾建伟教授重用生黄芪治疗肝衰竭临床验案[J].中国中医急症,2014,23(3):463- 464.
[26] 姜付泉,张秋香,孙凤霞,等.黄芪化纤汤对慢性乙型肝炎患者肝功能与肝纤维化指标的影响[J].世界中医药,2022,17(1):104-107,111.
[27] 王岗,朱琦,陈新,等.利水消臌膏联合肝病治疗仪治疗乙肝肝硬化顽固性腹水的临床研究[J].中国实验方剂学杂志,2022,28(22):123-130.
[28] 孙艳梅.80例肝硬化并发自发性细菌性腹膜炎患者的病原学分析[J].临床医学,2022,42(4):45-47.
[29] 王广宇,陈潇潇,侯显良.基于16S rDNA测序检测原发性胆汁性胆管炎患者肠道菌群的变化[J].中国现代医生,2021,59(19):139-143,封3.
[30] 黄晶晶,王小娇,钟跃学,等.鳖甲煎丸的临床运用研究进展[J].中国医药科学,2021,11(2):30-32.
[31] Yao L,Yao ZM,Weng H,et al. Effect of rat serum containing Biejiajian oral liquid on proliferation of rat hepatic stellate cells [J]. World J Gastroenterol,2004,10(13):1911- 1913.
[32] Bai G,Yan G,Wang G,et al. Anti-hepatic fibrosis effects of a novel turtle shell decoction by inhibiting hepatic stellate cell proliferation and blocking TGF-β1/Smad signaling pathway in rats [J]. Oncol Rep,2016,36(5):2902- 2910. |
|
|
|