【摘要】：目的研究原發(fā)性膽汁性肝硬化的臨床特征、中醫(yī)證候分布規(guī)律與病機演變規(guī)律。方法收集2012年6月至2014年9月在北京地壇醫(yī)院就診的96例原發(fā)性膽汁性肝硬化患者,調(diào)查并記錄患者一般情況、主要癥狀及體征、中醫(yī)四診信息,統(tǒng)計不同疾病階段(慢性肝炎、肝纖維化、肝硬化)癥狀、證候分布特征。結果 96例患者病位證素以肝、脾、腎為主,部分涉及膽;病性證素有10種,出現(xiàn)頻次前5位的依次是氣虛(78)、氣滯(64)、濕(48)、陰虛(34)、血瘀(33),濕、熱表現(xiàn)相對不突出;臟腑失調(diào)證素有10種,出現(xiàn)頻次前5位的依次是,脾虛(63)、肝郁(57)、肝陰虛(23)、腎陰虛(23)、腎虛(9)、脾陽虛(3)。不同疾病階段病位證素均以肝、脾為主,后期影響至腎;病性方面,氣虛、氣滯貫穿全程,陰虛、血瘀漸進加重,濕與熱在肝纖維化期最突出;臟腑失調(diào)方面,脾虛、肝郁全程較高,肝陰虛、腎陰虛逐漸加重,其中脾虛表現(xiàn)最為突出。結論原發(fā)性膽汁性肝硬化患者以氣虛、氣滯、陰虛、血瘀較為突出,病位以肝、脾、腎為主。
[Abstract]:Objective to study the clinical characteristics, TCM syndromes distribution and pathogenesis of primary biliary cirrhosis. Methods from June 2012 to September 2014, 96 patients with primary biliary cirrhosis were collected from The Temple of Earth Hospital in Beijing. The distribution of symptoms and syndromes in different disease stages (chronic hepatitis, liver fibrosis, liver cirrhosis) was analyzed. Results in 96 patients, liver, spleen and kidney were the main syndromes, some of them were involved in gallbladder, 10 of them were found in the disease syndrome, the first five were qi deficiency (78), qi stagnation (64), dampness (48), yin deficiency (34), blood stasis (33), and the performance of dampness and heat was relatively insignificant. There were 10 kinds of syndromes of viscera disorders, the first five were spleen deficiency (63), liver depression (57), liver yin deficiency (23), kidney deficiency (9), spleen yang deficiency (3). In different disease stages, the main syndromes are liver and spleen, which affect the kidney at the later stage. In the aspect of disease, Qi deficiency, Qi stagnation runs through the whole process, Yin deficiency, blood stasis gradually aggravation, dampness and heat are most prominent in liver fibrosis period; viscera disorder, spleen deficiency, Liver depression is higher in the whole process, liver yin deficiency, kidney yin deficiency gradually aggravation, among which spleen deficiency is the most prominent. Conclusion Qi deficiency, qi stagnation, yin deficiency, blood stasis are more prominent in patients with primary biliary cirrhosis, and liver, spleen and kidney are the main diseases.
【作者單位】： 北京中醫(yī)藥大學東直門醫(yī)院;首都醫(yī)科大學附屬北京地壇醫(yī)院;首都醫(yī)科大學研究生部;北京中醫(yī)藥大學研究生部;
【基金】：北京市中醫(yī)管理局中醫(yī)藥科技項目(JJ2012-15);北京市中醫(yī)管理局人才培養(yǎng)項目([2011]-146)
【分類號】：R259

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