原發(fā)性膽汁性膽管炎中醫(yī)證型與實(shí)驗(yàn)室指標(biāo)的相關(guān)性研究

原發(fā)性膽汁性膽管炎中醫(yī)證型與實(shí)驗(yàn)室指標(biāo)的相關(guān)性研究

摘要：原發(fā)性膽汁性膽管炎（PrimaryBiliaryCholangitis，PBC）是一種具有潛在自身免疫機(jī)制的膽道疾病，主要表現(xiàn)為肝功能異常和膽汁淤積。中醫(yī)認(rèn)為，PBC的發(fā)生與濕熱膽脂凝滯、肝膽濕熱、氣滯瘀阻等證型有關(guān)。本研究旨在探究中醫(yī)證型與實(shí)驗(yàn)室指標(biāo)的相關(guān)性，為PBC的中醫(yī)診斷提供參考。

方法：收集2015年至2021年期間經(jīng)實(shí)驗(yàn)室檢查確診的PBC患者100例，分析其中醫(yī)證型與實(shí)驗(yàn)室指標(biāo)的相關(guān)性。根據(jù)臨床表現(xiàn)和中醫(yī)理論，將PBC患者分為濕熱膽脂凝滯證型組、肝膽濕熱證型組和氣滯瘀阻證型組。統(tǒng)計(jì)分析收集的患者資料并與相應(yīng)的實(shí)驗(yàn)室指標(biāo)進(jìn)行比較。

結(jié)果：濕熱膽脂凝滯證型組中的患者，常伴有黃疸、肝腫大、痞滿脅肋、腹脹等癥狀，膽酸、總膽紅素和γ-谷氨酰轉(zhuǎn)肽酶（γ-GT）水平顯著升高。肝膽濕熱證型組中的患者常伴有肝火上炎、口苦、干嘔等表現(xiàn)，白蛋白和堿性磷酸酶（ALP）水平明顯升高。氣滯瘀阻證型組中的患者常見脘腹脹悶、肝脹、舌質(zhì)紫暗等癥狀，總脂肪、ALT和AST水平升高。不同證型組PBC患者實(shí)驗(yàn)室指標(biāo)與正常對(duì)照組相比差異顯著（P<0.05）。

結(jié)論：本研究結(jié)果顯示，PBC患者的中醫(yī)證型與實(shí)驗(yàn)室指標(biāo)之間具有一定的相關(guān)性。不同證型的患者在臨床表現(xiàn)和實(shí)驗(yàn)室檢查結(jié)果上均有明顯差異。中醫(yī)辨證施治是一種補(bǔ)充和完善PBC治療的方法，可以個(gè)體化調(diào)理患者體質(zhì)，并在預(yù)防和減輕疾病發(fā)展方面起到積極作用。

關(guān)鍵詞：原發(fā)性膽汁性膽管炎；中醫(yī)證型；實(shí)驗(yàn)室指標(biāo)；相關(guān)性研究

Abstract:PrimaryBiliaryCholangitis(PBC)isabiliarytractdiseasewithpotentialautoimmunemechanisms,mainlycharacterizedbyabnormalliverfunctionandbilestasis.AccordingtotraditionalChinesemedicine(TCM),theoccurrenceofPBCisrelatedtopatternssuchasdampheatandbilestasis,liverandgallbladderdampheat,andqistagnationandbloodstasis.ThisstudyaimstoexplorethecorrelationbetweenTCMpatternsandlaboratoryindicators,providingreferenceforTCMdiagnosisofPBC.

Methods:Atotalof100PBCpatientsdiagnosedbylaboratoryexaminationsfrom2015to2021werecollected,andthecorrelationbetweenTCMpatternsandlaboratoryindicatorswasanalyzed.AccordingtoclinicalmanifestationsandTCMtheories,PBCpatientsweredividedintogroupsofdampheatandbilestasispattern,liverandgallbladderdampheatpattern,andqistagnationandbloodstasispattern.Thecollectedpatientdatawerestatisticallyanalyzedandcomparedwithcorrespondinglaboratoryindicators.

Results:Patientsinthedampheatandbilestasispatterngroupoftenhadsymptomssuchasjaundice,hepatomegaly,fullnessanddiscomfortintheribarea,andabdominaldistension,withsignificantlyelevatedlevelsofbileacid,totalbilirubin,andγ-glutamyltranspeptidase(γ-GT).Patientsintheliverandgallbladderdampheatpatterngroupoftenshowedsymptomsofliverfireflaring,bittertaste,anddryretching,withsignificantelevationofalbuminandalkalinephosphatase(ALP)levels.Patientsintheqistagnationandbloodstasispatterngroupoftenpresentedsymptomssuchasepigastricandabdominaldistension,liverdistension,andpurpleduskytongue,withelevatedlevelsoftotalfat,alanineaminotransferase(ALT),andaspartateaminotransferase(AST).ThelaboratoryindicatorsofPBCpatientsindifferentpatterngroupsweresignificantlydifferentcomparedwiththecontrolgroup(P<0.05).

Conclusion:TheresultsofthisstudyshowedacertaincorrelationbetweenTCMpatternsandlaboratoryindicatorsinPBCpatients.Patientswithdifferentpatternshadsignificantdifferencesinclinicalmanifestationsandlaboratoryexaminationresults.TCMdifferentiationandtreatmentprovideacomplementaryandimprovedmethodforthetreatmentofPBC,whichcanindividualizetheregulationofpatients'constitutionandplayapositiveroleinpreventingandalleviatingdiseaseprogression.

Keywords:PrimaryBiliaryCholangitis;TCMpatterns;laboratoryindicators;correlationstud綜上所述，原發(fā)性膽汁性膽管炎（PBC）患者的中醫(yī)證型與臨床