原发性胆汁性胆管炎中医证型与实验室指标的相关性研究

原发性胆汁性胆管炎中医证型与实验室指标的相关性研究

摘要：原发性胆汁性胆管炎（PrimaryBiliaryCholangitis，PBC）是一种具有潜在自身免疫机制的胆道疾病，主要表现为肝功能异常和胆汁淤积。中医认为，PBC的发生与湿热胆脂凝滞、肝胆湿热、气滞瘀阻等证型有关。本研究旨在探究中医证型与实验室指标的相关性，为PBC的中医诊断提供参考。

方法：收集2015年至2021年期间经实验室检查确诊的PBC患者100例，分析其中医证型与实验室指标的相关性。根据临床表现和中医理论，将PBC患者分为湿热胆脂凝滞证型组、肝胆湿热证型组和气滞瘀阻证型组。统计分析收集的患者资料并与相应的实验室指标进行比较。

结果：湿热胆脂凝滞证型组中的患者，常伴有黄疸、肝肿大、痞满胁肋、腹胀等症状，胆酸、总胆红素和γ-谷氨酰转肽酶（γ-GT）水平显著升高。肝胆湿热证型组中的患者常伴有肝火上炎、口苦、干呕等表现，白蛋白和碱性磷酸酶（ALP）水平明显升高。气滞瘀阻证型组中的患者常见脘腹胀闷、肝胀、舌质紫暗等症状，总脂肪、ALT和AST水平升高。不同证型组PBC患者实验室指标与正常对照组相比差异显著（P<0.05）。

结论：本研究结果显示，PBC患者的中医证型与实验室指标之间具有一定的相关性。不同证型的患者在临床表现和实验室检查结果上均有明显差异。中医辨证施治是一种补充和完善PBC治疗的方法，可以个体化调理患者体质，并在预防和减轻疾病发展方面起到积极作用。

关键词：原发性胆汁性胆管炎；中医证型；实验室指标；相关性研究

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综上所述，原发性胆汁性胆管炎（PBC）患者的中医证型与临床