Professor Dong Zhenhua Experience Treating Primary Biliary Cirrhosis

[Background]Primary biliary cirrhosis(PBC) is a kind of chronic and progressive liver disease relate to autoimmunity.The early pathologic features of PBC is nonsuppurative and destructive inflammation in intrahepatic bile duct. Cirrhosis is the result.Now UDCA is the only Western medicine treatment for early PBC patient,and the patients in the advanced stage have to do liver transplant to saved their lives.In recent years,more and more Traditional Chinese medicine for the PBC has been reported. Clinical symptom and quality of life of the patients is improved by combined of Western and Chinese medicine.My mentor Professor Dong Zhenhua has work on rheumatoid immune disease TCM by treatment with TCM and treatment combined traditional Chinese medicine and Western medicine. He has accumulated rich experience in long-term clinical practice and research.[Objective]This study sums up the experience of Professor Dong Zhenhua by his96PBC cases, then looks into his way of thinking the pathological mechanism,the law of syndrome differentiation and finds out his unique feature.That will lay the foundations for raising the curative effect,giving full play to traditional Chinese medicine(TCM) advantages and further creative study on the action mechanism of TCM in treating PBC.[Methods]Collected96cases of PBC from medical records dept and outpatient clinic of Peking Union Medical College Hospital,These cases from June1999to January2012.Then review all cases, analyze distribution of syndrome types and its characteristic,combine with my mentor’s inspiration in the teaching and learning process and his articles published on this study recent period. Finally,sum up the experience of Professor Dong Zhenhua treating PBC,including the essence of etiology and pathogenesis of PBC,he law of syndrome differentiation,his unique Treatment characteristics.[Results]1.Distribution of the main symptom:①Liver stagnation and spleen deficiency syndrome,32cases,33%②Qi deficiency of the spleen and stomach syndrome22cases,23%③Qi-Yin deficiency syndrome,9cases,9%④Yin deficiency of the liver and kidney syndrome,14cases,15%⑤Stagnation of dampness and heat syndromel4cases,15%⑥Blood stasis obstructing the collaterals syndrome5cases,5%.2.Distribution of accompanied symptoms of each main symptom:①The most common accompanied symptoms of Liver stagnation and spleen deficiency syndrome,are damp-heat syndrome13cases(41%), damp-heat and blood stasis syndrome6cases (19%)②The most common accompanied symptoms of Qi deficiency of the spleen and stomach syndrome are damp-heat syndrome and dampness retention damage the body fluid syndrome both are3cases(14)③There are4accompanied symptoms of Qi-Yin deficiency syndrome each have1case,takes up11%④The most common accompanied symptoms of Yin deficiency of the liver and kidney syndrome are damp-heat syndrome and Liver stagnation-spleen deficiency syndrome,both are3cases(21%)⑤The most common accompanied symptoms of Stagnation of dampness and heat syndrome are Yin deficiency4cases(29%) and damp-heat syndrome2cases(14%)⑥Total number of blood stasis obstructing the collaterals syndrome is5.Damp-heat,deficiency of the spleen with abundance of hot-dampness, Qi stagnancy and hot-dampness damage the body fluid all lcases(20%).[Conclusions]1.The essence of etiology and pathogenesis:Centered on the spleen and stomach,spleen deficiency throughout the disease process.2.The feature of syndrome differentiation:①"the weakness of vital-qi" is the main type of of the main symptom,especially spleen and stomach qi,which in accordance with the essence of etiology and pathogenesis.②Accompanied symptoms of each main symptom are indeed many kinds and always accompanied one or two or three different symptoms at the same time. Thus it can be seen TCM syndrome type of PBC is really complicated③The patterns of TCM syndrome of PBC were related to the seriousness of the condition to the patients.With the progress of the disease,part of the TCM syndrome transform from mild to severe condition.But that can be reverse by treatment.3.The feature of prescription and drug usages:Based on syndrome differentiation,there are four feature as fellows:No limitations,absorption by learning from others;Professor Dong Zhenhua paying high attention to the compatibility and making the best use of pairs of herbs.He integrate Chinese and western medicine;Reduce the side effects of glucocorticoid and enhance efficacy by using Chinese medicine.His treatment is effective.