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态靶结合构建胆石症辨治新体系

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态靶结合辨治理论指导下构建胆石症"病-类-态-证"辨治新体系.胆石症分为实态类与虚态类两种类别,实态类可包含"郁态、热态、瘀态"3种基本态势,虚态类可包含"虚态"这一种基本态势.郁态分证为肝郁气滞证;热态分证为肝胆湿热证、热毒炽盛证;瘀态分证为瘀血阻滞证;虚态分证为肝阴不足证、肝郁脾虚证.根据疾病临床表现,可概括胆石症的标靶为胆结石、白细胞升高、胆汁反流、转氨酶升高、胆红素升高;症靶为胁痛、发热、黄疸、口苦.西医理论中胆石症合并慢性胆囊炎、慢性胆管炎多为郁态、瘀态、虚态;胆石症合并急性胆囊炎、急性化脓性胆管炎多见热态.治疗上根据疾病的自身规律分态势进行态靶论治,使用相应的症靶药、标靶药,以提高治疗的针对性.
A new diagnosis and treatment system for gallstones based on state target combina-tion
A new system of differentiation and treatment of cholelithiasis"disease-type-state-syndrome"was constructed under the guidance of the theory of differentiation and treatment of state and target combination.Cholelithiasis can be divided into two categories:the excess state and the deficiency state.The excess state can contain three basic states:depression,heat,and stasis,while the deficiency state can contain one basic state:deficiency state.The syndrome of depression is the syndrome of liver-qi stagnation.The syndrome of heat state is dampness-heat syndrome of the liver and gallbladder and incandescent syndrome of heat toxicity.The syndrome of stasis state is the syndrome of blood stasis block,deficiency syndrome of liver Yin,deficiency of liver depression,and spleen deficiency syndrome.According to the clinical manifestations of the disease,the targets of cholelithiasis can be summarized as gallstones,elevated white blood cells,bile reflux,elevated aminotransferase,and elevated bilirubin.The targets are hypochondriac pain,fever,jaundice,and bitter mouth.In Western medicine theory,cholelithiasis combined with chronic cholecystitis and chronic cholangitis is mostly a depressive state,stasis state,and depression state.Cholelithiasis combined with acute cholecystitis and acute suppurative cholangitis is usually heat state.Treatment according to the law of the disease by state and target treatment,using the corresponding target drugs,target drugs,to improve the pertinence of treatment.

chololithiasisstate-target differentiation and treatmentTONG Xiaolin

王嘉伟、张京轩、梁枫荻、周滔、仝小林

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北京中医药大学临床医学院(北京,100029)

首都医科大学附属北京中医医院

北京中医药大学东方医院

中国中医科学院广安门医院

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胆石症 态靶辨治 仝小林

2024

中西医结合肝病杂志
中国中西医结合学会,湖北中医学院

中西医结合肝病杂志

CSTPCD
影响因子:0.908
ISSN:1005-0264
年,卷(期):2024.34(5)