中医阴黄本质探讨

目的:从现代医学角度研究阴黄的机理。方法:观察黄疸患者的症状与体征,分析T淋巴细胞亚群转化率,检测胆酸(CG)、透明质酸(HA)、层粘蛋白(LN)等指标。结果:阳黄湿热证病毒复制活跃,体液免疫功能亢进,肝细胞炎症反应明显,血清总胆红素、谷丙转氨酶显著上升,表现出正邪抗争剧烈的态势;而阴黄证谷丙转氨酶轻度增高或不增高,胆红素残留不退,病毒复制减弱,外周血细胞数降低,血清C_3处于低水平,T淋巴细胞CD_8接近正常,血清LN、HA显著上升。表明阴黄患者肝细胞损伤坏死反应趋于减弱或停止,有向肝纤维化方向发展的趋势。结论:阴黄是肝细胞处理胆红素能力不足、肝脏纤维化、肝脏微循环障碍等多种因素造成的复合证候。

Study on the Mechanism of Yin Jaundice

Aims: Study on the Mechanism of Yin jaundice from the asrect of modern medicine. Methods: The jaundice patients were observed for the corresponding symptoms and signs. The T lymphocyte subsets were analysed and different biochemical items were tested such as CG, HA and LN. Results: In the patients with damp-heat of Yang jaundice, there is active replication of virus, increased activity of humoral immunity,significantly inflammatory response in hepatic tissue and high levels of serum total bilirubin and glutaminic-pyruvic transminase (GPT). The results suggested statues of strong conflict of positive versus negative forces. There is , however, slight or no increase of GPT, retarded decrease of bilirubin, lower degree of virus replication, decreased number of peripheral blood cells, lower level of C3 in serum as well as normal level of CD8 T lymphocytes and higher level of HA and LN. The data show that in Yin type of jaundice necros-tic reaction in hepacytes tends to decrease or terminate while there is an evidenced interstitial reaction. Conclusions: Yin jaundice differs from Yang jaundice in many aspects such as levels of GPT, cellular and humoral immunity and blood adherence.