The Feature Research Of Traditional Chinese Medicine Syndrome Of Primary Biliary Cirrhosis

Objective:To probe the feature of Traditional Chinese Medicine (TCM) syndrome of Primary Biliary Cirrhosis (PBC) and raise the recognition to the disease in order to provide a reference for the diagnosis and treatment program.Methods:We collected clinical data diagnosed as PBC in Jiangsu Province Hospital of TCM from Jane,2006to November,2011. Referred to TCM edited by Professor Zhou Zhongying and published by TCM of Chinese medical science, combined with the clinical practice, we summed up the TCM syndrome as6card types which included damp-heat of liver-gall, stagnation of liver Qi and deficiency of spleen, damp-stagnation and blood stasis, damp-stagnation and deficiency of spleen, deficiency of liver-kidney Yin and deficiency of Yin with retained water. According to the clinical stage in "Hepatology" edited by WANG Bao-en, we also divided the disease into three clinical stages. So as to analyze the relationships of among TCM syndrome, clinical stages, symptoms, physical signs, laboratory tests through the method of retrospective study.Results:87patients are diagnosed as PBC which is often associated with cholecystitis. Sjogren’s syndrome in the survey,among52cases of hypochondriac,11cases of jaundice.21cases of distention,9males and78female whose ages are among21to85years old. The more common clinical manifestations include fatigue, yellow urine, anorexia, scleral yellow dye. positive shifting dullness, skin and mucous membrane stained yellow. There are13kinds of tongue and11kinds of pulse. The Laboratory data reveal the increased ALP, GGT and DB which are not obvious at early stage and the increased direct bilirubin and the decreased albumin obviously at the advanced stage. On the basis of statistical results, the differences among ALP, AST and ALT are not obvious in clinical stage. The symptoms and physical signs correlated to AST include a yellow sclera, hepatomegaly, a little pain in flank and distending flank. The bilirubin-related symptoms and physical signs include yellowish skin and mucous membrane, pruritic skin, dryness of mouth, dryness in the nasal cavity. Albumin-related symptoms and physical signs include lower extremity edema, vague pain in flank, and dryness of eyes. Globulin-related symptoms and physical signs include liver palms and joint pain. Early in the disease, the main syndrome is stagnation of liver Qi and deficiency of spleen, so the stagnation of liver Qi and deficiency of spleen and liver kidney yin deficiency in the metaphase and late to permit damp-stagnation and deficiency of spleen and liver kidney yin deficiency. With the development of the disease, the upward trend to the damp-stagnation and deficiency of spleen and liver kidney yin deficiency, the reduced trend to stagnation of liver Qi and deficiency of spleen. The representation correlated to stagnation of liver Qi and deficiency of spleen included dryness in the nasal cavity, agrypnia, distending flank, splenauxe, a red tongue with thin and white coating, a carmoisine tongue with a white coating, a taut, thready pulse or a thready, smooth pulse. In the equal, damp-heat of liver-gall correlated to bitter taste of mouth, shifting dullness. Damp-stagnation and blood stasis correlated to spider angioma, a eclipsed complexion, ecchymosis, a red tongue with white coating and a dark red tongue with a thin coating. Damp-stagnation and deficiency of spleen correlated to chest distress, abdominal distension, edema of the lower limbs, a carmoisine tongue with a white coating, a thready, fast pulse or a thready, smooth pulse. Deficiency of liver-kidney Yin syndrome correlated to dizziness, dryness in the nasal cavity, dry mouth, distending flank, vague pain in flank, belch, a red tongue with a thin coating and a red tongue with thin and white coating. Deficiency of Yin with retained water correlated to shifting dullness, a eclipsed complexion, a red tongue with a thin coating or a carmoisine tongue with a thin coating. The levels of damp-stagnation and deficiency of spleen, deficiency of liver-kidney Yin and deficiency of Yin with retained water are lower than other syndromes. The level of deficiency of liver-kidney Yin syndrome in globulin is higher than damp-heat syndrome. The level of damp-heat of liver-gall, damp-stagnation and deficiency of spleen, and deficiency of Yin with retained water in bilirubin are higher than other syndromes.Conclusion:PBC is a disease of predominantly middle-aged women, which is often related to "hypochondriac","jaundice","distention" according to TCM theories. The feature of syndromes reveal that the stagnation of liver Qi and deficiency of spleen syndrome and deficiency of liver-kidney Yin syndrome are more commonly found and correlated to the stage of disease and the laboratory dates.