慢性重型肝炎黄疸证候演变规律  

Evolution rule of jaundice syndromes in chronic sever hepatitis

作　　者：李瀚旻[1] 

机构地区：[1]湖北中医学院附属医院肝病研究所,湖北武汉430061

出　　处：《中西医结合肝病杂志》2009年第3期148-150,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(90709041;30672590;30271562;30371787);国家科技重大基础研究项目(2002CCC00300);国家科技支撑计划"中医药标准规范技术体系研究"(2006BAI21B01);国家"十一五"重大专项"慢性重型肝炎证候规律及中西医结合治疗方案研究"(2008ZX10005-007)

摘　　要：目的:探讨慢性重型肝炎(CSH)黄疸证候的演变规律及其生物学基础。方法:在继承黄疸证候中医理论认识的基础上,结合近些年来的实验与临床研究结果,分析总结CSH黄疸证候的演变规律,并探讨其生物学基础。结果:CSH黄疸证候符合阴黄、阳黄和虚实转化的规律,湿、热、瘀、毒是其实邪,脾肾阳虚或肝肾阴虚(肝肾精亏)是其本虚。阳黄多实,阴黄多虚,阴阳间黄多虚实夹杂。其演变规律可从实邪伤正,由实转虚或实中兼虚;亦可因虚致实或虚中夹实。在阴黄脾肾阳虚病机认识的基础上,发现阴黄肝肾阴虚(肝肾精亏)是其新的病机转化规律,阴黄虚证存在肝再生障碍或紊乱的病理机制。结论:CSH黄疸证候具有阳黄、阴黄(脾肾阳虚或肝肾阴虚)、阴阳间黄和虚实证之间存在转化的演变规律,肝再生障碍或紊乱致肝再生不足可能是阴黄虚证的生物学基础。Objective： To discuss evolution rule and biological basis of jaundice syndromes in chronic severe hepatitis. Methods： On the basis of inheriting traditional Chinese medicine theories of jaundice syndromes, combined with recent experimental and clinic researches to analyze and summary evolution rule of jaundice syndromes in chronic sever hepatitis, and to discuss its biological basis. Results： Jaundice syndromes in chronic sever hepatitis measured up to rules of Yin jaundice, Yang jaundice, and asthenia and sthenia transformation. The rules were that damp, heat, stasis and toxin were the excessive pathogenic factors of jaundice syndromes in chronic sever hepatitis, while weakened body resistances of it were spleen-kidney Yang deficiency and liver-kidney Yin deficiency （liver-kidney essence deficiency） . Moreover, Yang jaundice mainly was ex- cess syndrome, Yin jaundice mainly was deficiency syndrome, and Yin-Yang inclusion jaundice mainly was insufficiency and excess syndrome. The evolution rule was that excess syndrome developed to deficiency syndrome or insufficiency and excess syndrome because of excessive pathogenic factors injured healthy Qi, also that deficiency syndrome developed to excess syndrome or insufficiency and excess syndrome. On the basis of understanding about pathogenesis of Yin jaundice of spleen-kidney Yang deficiency syndrome, it was found that liver-kidney Yin deficiency （liver-kidney essence deficiency） of Yin jaundice syndrome was a new pathogenesis transforming rule, and that Yin jaundice deficiency syndrome had a pathological mechanism of liver regeneration disorder. Conclusion： Jaundice syndromes in chronic sever hepatitis have evolution rules of Yang jaundice, Yin jaundice （spleen-kidney Yang deficiency or liver-kidney Yin deficiency）, Yin-Yang inclusion jaundice and asthenia and sthenia transformation. Insufficient liver regeneration caused by liver regeneration disorder may be the bioloical basis of Yin jaundice deficiency syndrome.

关 键 词：肝炎 慢性重型 阳黄 阴黄 肝肾精亏 肝再生 

分 类 号：R259[医药卫生—中西医结合]