肝硬化的病机及临床治疗探讨

本文通过对64例肝硬化住院患者的观察,认为肝硬化病中医可诊断为癥积。癥积之主要病机乃在于气结血瘀,而癥积之形成,一般又均有正气不足之因素参与,尤其以脾虚为多见,形成虚实夹杂之证。肝内病变活动时,则多兼见湿热内蕴的表现。故活血袪瘀、软坚消积的治则宜贯彻本病治疗的始终,使肝脏变软,脾脏回缩。运用此治法的患者组,其病情好转的有效率可达86.1％。虚实夹杂者的扶正则宜以健脾益气为主,以促进肝细胞的再生与纤维组织的吸收,并有助于腹水的消除。而肝内病变活动时,可配合使用清利湿热药,以促进肝功能的恢复和黄疸的消退。

Pathogenesis and Treatment of Hepatocirrhosis

By studying 64 cases of hepatocirrhosis, the auther believes that hepatocirrhosis may be diagnosed as zheng ji ("abdominal mass") in traditional Chinese medicine. Zheng ji is a disorder mainly due to qi-stagnation and blood stasis and is also related to deficiency of healthy qi, especially deficiency of spleen-qi. In its active stage, zheng ji may show signs of retention of damp-heat. Therefore the principles of activating blood circulation to dissipate blood stasis, and resolving the hard mass should be applied through the whole course of treatment, so as to soften the liver and reduce the enlargement of spleen. The total effective rate is 86.1 fo. For those who are diagnosed, according to TCM zheng-differentiation, as sthenia-syndrome accompanied with asthenia-syndrome, supporting healthy qi to eliminate evils and invigorating the spleen are regarded as the chief method to promote hepatocellular regeneration, absorption of fibrous tissue and elimination of ascitic fluid. In the active stage of this case, medicines for clearing away heat and dampness should be used as supporting drugs to promote recovery of liver function and resolution of jaundice.