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中西医治疗原发性胆汁性胆管炎研究进展

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原发性胆汁性胆管炎(primary biliary cholangitis,PBC)是一种慢性肝内胆汁淤积性疾病.其病理机制与T淋巴细胞比例(Th1/Th2)失衡、胆管上皮细胞凋亡、雌激素调控IL-12/JAK-STAT信号通路有关.西药治疗PBC的药物主要有熊去氧胆酸和贝特类药物,但是长期使用不良反应明显;与西药相比,中医药治疗PBC疗效确切,安全性强.PBC可归属于中医"积聚""黄疸"等范畴,单味中药及其复方疗效显著,其治疗特色在于天人合一的"整体观"以及因时、因地、因人的辨证施治,其主要治法有疏肝健脾,补肾养血;清热燥湿,祛黄利胆;活血利水,化瘀解毒,可明显提高PBC的临床诊治疗效以及改善患者皮肤瘙痒、腹胀等症状.文章针对中西医治疗PBC研究予以综述,以期为学者临床诊治PBC提供新的思路和理论依据.
Research progress in the treatment of PBC with traditional Chinese and western medicine
Primary biliary cholangitis(PBC)is a chronic intrahepatic cholestasis disease.Its pathological mechanism is re-lated to the imbalance of T lymphocyte ratio(Th1/Th2),apoptosis of bile duct epithelial cells,and estrogen regulation of IL-12/JAK-STAT signal pathway.The drugs used to treat PBC mainly include ursodeoxycholic acid and beta drugs,but the side effects of long-term use are obvious;Compared with western medicine,traditional Chinese medicine is effective and safe in the treatment of PBC,which can be attributed to the category of"accumulation"and"jaundice"of traditional Chinese medicine.Single traditional Chinese medicine and its compound medicine have significant curative effects.Its treatment features are the"holistic view"of the unity of heaven and man,and the treatment based on time,place and person,Its main treatment methods include soothing the liver and strengthening the spleen,tonifying the kidney and nourishing blood;Clear heat and dry dampness,dispel jaundice and promote gallbladder;It can promote blood circulation,promote diuresis,remove blood stasis and detoxify,which can significantly improve the clinical treatment effect of PBC and improve the symptoms of skin itching,abdominal disten-sion and other symptoms of patients.Therefore,this article reviews the research on the treatment of PBC with traditional Chinese and western medicine in order to provide new ideas and theoretical basis for the clinical diagnosis and treatment of PBC.

Chinese medicineprimary biliary cholangitistreatmentpathological mechanism

杨子轩、卢秉久

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辽宁中医药大学,辽宁沈阳 110847

辽宁中医药大学附属医院,辽宁沈阳 110032

中医药 原发性胆汁性胆管炎 治疗 病理机制

2024

实用中医内科杂志
辽宁省中医药学会,中华中医药学会,辽宁省中医药研究院

实用中医内科杂志

影响因子:0.421
ISSN:1671-7813
年,卷(期):2024.38(5)