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胆汁淤积性肝病(肝内胆汁淤积)系指多种原因所致细胞分泌胆汁发生障碍,毛细胆管、细胞骨架和高尔基体等细胞器功能异常,使胆汁分泌减少,导致正常数量的胆汁不能下达十二指肠,并使胆汁成分(结合胆红素、胆汁酸、胆固醇和碱性磷酸酶等)反流至血液。临床上是一组有黄疸、瘙痒,伴血清结合胆红素、胆固醇、胆汁酸、碱性磷酸酶、5核苷酸酶及清蛋白增高的症状体征。常见的疾病有病毒性胆汁淤积型肝病、药物性胆汁淤积型肝病和原发性胆汁性肝硬化。本病属于中医学的“黄疸”“胆胀”等范畴。中医学认为,本病病位主要在肝胆、脾胃,病久亦可及肾。湿毒瘀血是基本病机,兼见阳虚、阴虚、气阴两虚表现,初病多实,久则多见虚实夹杂。本文根据中医学的辨证论治、对症用药的理论,从用药原则、用药方案、用药提示等方面,就胆汁淤积性肝病中成药的合理应用进行了阐述与评论。
Cholestatic liver disease (intrahepatic cholestasis) refers to a variety of reasons caused by the secretion of bile cells barriers, capillary bile duct, cytoskeleton and Golgi and other organelles dysfunction, the bile secretion decreased, resulting in the normal number of bile can not be issued twelve The intestine, and bile components (conjugated bilirubin, bile acids, cholesterol and alkaline phosphatase, etc.) back to the bloodstream. Clinically, a group of jaundice, itching, with serum bilirubin, cholesterol, bile acids, alkaline phosphatase, 5-nucleotidase and albumin increased symptoms and signs. Common diseases are viral cholestatic liver disease, drug-induced cholestatic liver disease and primary biliary cirrhosis. The disease belongs to traditional Chinese medicine “jaundice ” “bile bulging ” and other fields. Chinese medicine believes that the disease mainly in the liver and gallbladder disease, spleen and stomach, disease can be long and kidney. Wet poisonous blood stasis is the basic pathogenesis, and see yang, yin deficiency, Qi and Yin Deficiency performance, initial illness and more solid, long time to see the actual situation mixed. Based on the theory of dialectical treatment and symptomatic treatment of traditional Chinese medicine, this article elaborates and comments on the rational application of proprietary Chinese medicines in the treatment of cholestatic liver diseases from the aspects of the principles of medication, medication regimens, medication reminders and so on.