论文部分内容阅读
目的:研究原发性胆汁性肝硬化的临床表现、实验室特征、治疗情况及预后。方法:回顾性总结分析诊断为原发性胆汁性肝硬化的19例患者的中医证候、临床表现、实验室特征、治疗情况及预后。结果:原发性胆汁性肝硬化患者主要为女性,男∶女为2∶17,湿滞血瘀7例(36.84%),湿热蕴结5例(26.32%)。以乏力、黄疸、皮肤瘙痒为主要表现,合并骨质疏松3例(15.79%),类风湿关节炎1例(5.26%),消化道出血5例(26.32%),食管胃底静脉曲张6例(31.58%),肝性脑病1例(5.26%)。抗线粒体抗体(AMA)及AMA-M2亚型阳性率达94.7%,抗核抗体(ANA)阳性率达47.4%,89.47%患者ALP升高。84.21%患者胆红素升高,以DBIL为主。19例患者西医以熊去氧胆汁酸作为基础药物,联合保肝降酶药物,中医治以健脾清热、化湿行瘀为主。11例患者病情改善,4例病情控制不理想,2例自动出院,2例死亡。结论:分析原发性胆汁性肝硬化的临床特点可为临床诊治该病提供一定依据。
Objective: To study the clinical manifestations, laboratory characteristics, treatment and prognosis of primary biliary cirrhosis. Methods: The TCM syndromes, clinical manifestations, laboratory characteristics, treatment and prognosis of 19 patients diagnosed as primary biliary cirrhosis were retrospectively analyzed. Results: The main biliary cirrhosis patients were female, male: female 17, wet blood stasis in 7 cases (36.84%), damp heat accumulation in 5 cases (26.32%). Three cases (15.79%) with osteoporosis, rheumatoid arthritis in 1 case (5.26%), gastrointestinal bleeding in 5 cases (26.32%), esophageal and gastric varices in 6 cases were mainly manifested as fatigue, jaundice and pruritus. (31.58%), hepatic encephalopathy in 1 case (5.26%). The positive rate of anti-mitochondrial antibody (AMA) and AMA-M2 subtypes was 94.7%, the positive rate of anti-nuclear antibody (ANA) was 47.4%, and the positive rate of ALP was 89.47%. 84.21% of patients with elevated bilirubin, mainly DBIL. 19 patients with ursodeoxycholic acid as the basis of Western medicine, combined with liver and Jiangdu medicine, Chinese medicine to spleen heat, dampness stasis-based. Eleven patients improved their condition, and 4 were in poor condition. Two patients were discharged spontaneously and two died. Conclusion: Analyzing the clinical features of primary biliary cirrhosis may provide some evidence for clinical diagnosis and treatment of the disease.