| 引用本文: |
王石中,苏晓岚,涂雨落,彭憬,孙克伟.孙克伟教授辨治原发性胆汁性胆管炎经验[J].湖南中医药大学学报,2022,42(11):1927-1931[点击复制] |
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| 孙克伟教授辨治原发性胆汁性胆管炎经验 |
| 王石中,苏晓岚,涂雨落,彭憬,孙克伟 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 介绍孙克伟教授治疗原发性胆汁性胆管炎的经验。孙教授认为原发性胆汁性胆管炎病因主要源于患者体虚或七情内伤导致气滞、血瘀、脾虚湿阻，“肝郁脾虚”为关键病机贯穿疾病始终。临诊时分肝郁期、黄疸期、肝肾虚损期3期辨证论治：肝郁期以疏肝理脾、调畅营卫为主；黄疸期首辨阴阳，注重脾胃功能，依循“阳黄-阴阳黄-阴黄”的辨证模式论治。阳黄主于清热凉血、活血化瘀、利胆退黄，阴阳黄主于温阳健脾、解毒化瘀、祛湿退黄，阴黄主于温阳化湿；肝肾虚损期以滋补肝肾、活血利水、缓消瘀滞为主，临床疗效佳。 |
| 关键词: 原发性胆汁性胆管炎 肝郁脾虚 疏肝理脾 清热凉血 解毒化瘀 滋补肝肾 活血利水 孙克伟 |
| DOI：10.3969/j.issn.1674-070X.2022.11.025 |
| 投稿时间：2022-03-30 |
| 基金项目:国家自然科学基金项目（8197152432）。 |
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| Experience of Professor SUN Kewei in treating primary biliary cholangitis |
| WANG Shizhong,SU Xiaolan,TU Yuluo,PENG Jing,SUN Kewei |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| This paper introduces the experience of Professor SUN Kewei in treating primary biliary cholangitis. Professor SUN believes that primary biliary cholangitis is mainly due to body deficiency or seven emotions causing internal damage, which may lead to qi stagnation, blood stasis, spleen deficiency and dampness obstruction, and the key pathogenesis throughout the whole course is "liver qi stagnation and spleen deficiency". The clinical treatment was divided into three stages: liver stagnation stage, jaundice stage and liver-kidney deficiency stage. In the liver stagnation stage, he mainly focuses on soothing the liver, regulating the spleen and adjusting yingwei; in the jaundice stage, he first distinguishes yin and yang, and puts emphasis on the spleen and stomach, then treats according to the pattern differentiation of "yang jaundice, yin-yang jaundice and yin jaundice". Yang jaundice treatment is mainly clearing heat and cooling the blood, activating the blood and transforming stagnation, benefiting gallbladder and removing jaundice. Yin-yang jaundice treatment is mainly warming yang and invigorating spleen, detoxification and transforming stasis, removing dampness and reducing jaundice. Yin jaundice is mainly treated by warming yang and transforming dampness. In the kidney-liver deficiency stage, he mainly focuses on nourishing liver and kidney, activating blood and draining water retention, and resolving stasis, which shows positive clinical effects. |
| Key words: primary biliary cholangitis liver qi stagnation and spleen deficiency sooth liver and regulate spleen clear heat and cool blood detoxification and transform stasis nourish liver and kidney activate blood and drain water retention SUN Kewei |
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