中医药研究论丛

202.17 从中西医整合角度推演肝硬化腹水之治疗模式

 

从中西医整合角度推演肝硬化腹水之治疗模式
The Treatment Mode of Liver Cirrhosis with Ascites from the Perspective of Integrated
Chinese and Western Medicine
邱媛贞1 杨舒渝1 洪晨昕1 王人澍1*
1 台中慈济医院中医部,台中,台湾
【摘要】
肝硬化的形成机理目前已知是由各种不同可能造成肝损伤的原因,造成肝脏慢性持续发炎,使肝脏细胞不断坏死,而再生速度赶不上坏死速度,坏死细胞遍布疤痕组织,导致肝脏纤维化,久而久之形成肝硬化,而肝硬化後续衍伸的并发症,除了威胁了生命,对於生活品质的影响更是让患者苦不堪言,近几年在慢性肝病进一步演化为肝纤微化或肝硬化的致病路径上有越来越多突破的研究发现,尤其是在分子生物学的层次上,发现许多致肝纤微化的发炎介质,而中医药在治疗肝病的研究上,除了临床辨证施治外,也致力於药物作用於抗肝纤微化的机转研究,使得肝硬化的治疗面向更加全面。本案例为大肠癌後合并肝硬化引起腹水并发症,透过整合中医传统辨证与纳入「微观证型」的辨证论治思维,在腹水与其他相关并发症上皆获得稳定改善。藉此个案分享进行分析与讨论,期许让更多同道在治疗肝硬化腹水上有更全
面的思考方向。
【关键词】
肝硬化、腹水、肝纤维化、微观辨证、中西医整合
 
Yuan-Chen Chiu1 Su-Yu Yang1 Chen-Shin Hung1 Ren-Shu Wang1*
1Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical
Foundation, Taiwan
【Summary】
The mechanism of liver cirrhosis is currently known to be caused by a variety of different causes of liver injury. Due to chronic inflammation of liver, so the liver cells continue to necrosis, and regeneration rate can not keep up with necrosis rate, necrotic cells throughout the scar tissue, leading to liver fibrosis, over time the formation of cirrhosis. Many complications are caused by liver cirrhosis not only threaten to life, but also the quality of life. In recent years, research has further evolved into more and more breakthrough discoveries on liver fibrosis or cirrhosis of pathogenic micro-pathway in chronic liver disease, especially at the molecular biology level, finding out many inflammatory medium factors of liver fibrosis. Nowadays liver disease research of Chinese medicine not only using clinical syndrome differentiation, but also committed to the role of drugs in the anti-liver fibrosis of the machine research, making cirrhosis treatment more comprehensive. In this case, patient has colorectal history and liver cirrhosis complicated ascites, the thinking process of treatment is integration of Chinese medicine pattern identification for determining treatment and concept of micro-syndrome. Patient got improvement on many ways after treatment, so we discuss and analyze how we think and treat on this case, and wish offering more comprehensive thinking process on treatment of liver cirrhosis and ascites.
Keywords: liver cirrhosis, ascites, liver fibrosis, micro-syndrome, Integrative Medicine