Study On TCM Pathogenesis Of Primary Biliary Cholangitis

Objective: To study the constitution characteristics of patients with primary cholangitis of cholangitis(PBC)in Preclinical and asymptomatic period,and analyze TCM syndrome type in symptomatic and decompensated period.Then,to analyze the evolution rules of each period,and discuss the evolution rules of PBC pathogeny and pathogenesis.Methods: Collecting 200 cases of primary biliary cholangitis(PBC)patients who have treated in the Sixth People's Hospital of Qingdao city and Qingdao Hospital of traditional Chinese Medicine from 2013 to 2017.All of them were confirmed by examination,ultrasound and other related examinations.Then the PBC patients who meet the inclusion criteria were divided into 3 groups according to disease stage,which is group A(the pre clinical and asymptomatic period),group B(the duration of symptoms),and group C(decompensated).Then tstatistical their clinical test indexes and clinical characteristics of each group.Last,A questionnaire survey that was designed in advance was conducted on patients with PBC in A group.However,use the traditional Chinese medicine syndrome information to collect the clinical information of patients with PBC in B and C groups,which combines with four diagnostic methods of TCM,and judge that according to the diagnostic criteria.Results:(1)Group A includes preclinical and asymptomatic periods.The main types of this two phases of patients with PBC are mainly the constitution of Qi stagnation(accounted for 19.01%)and the constitution of Qi deficiency(accounted for 15.91%),next is the constitution of yin deficiency(accounted for 15.49%).(2)Group B is symptomatic period.On the basis of liver and blood deficiency,patients with PBC have syndrome of stagnation of liver qi and spleen deficiency(accounted for 40.82%),syndrome of yin deficiency of liver and kidney(accounted for 25.51%)and syndrome of damp heat(accounted for 19.39%).While,C group is the period of decompensation.Patients with PBC are stll on the basis of liver and blood defiiency,and have syndrome of static blood blocking collaterals(accounted for 41.93%),syndrome of yin deficiency of liver and kidney(accounted for 25.81%),and syndrome of yang deficiency of spleen and kidney(accounted for 16.13%).(3)In addition,statistics showed that the distribution of TCM syndromes was related to clinical stages(P<0.05).Conclusion: The clinical syndrome types of PBC patients are complex,often manifested as deficiency and excess.After analyzing the evolution of the pathogenesis,it can see that PBC belongs to asthenia in origin and asthenia in superficiality.Liver blood deficiency is the basis of the disease,which run through the whole process of disease.Firstly,qi depression transforming into fire,and yin deficiency produces heat,then accumulate heat in dampness and heat pathogen damage the blood and collaterals,and later cause the deficiency of viscera and the imbalance of qi and blood,which is an important internal cause for the development of the disease.The diseased region of it involves liver,spleen and kidney,which is especially liver.In the early and middle stages of PBC disease,the liver is the main and the spleen and kidney are damaged later.This suggests that PBC patients should start with nourishing liver blood and soothing liver qi in preclinical and asymptomatic stage,and early intervention has a clinical effect.Patients with PBC in symptomatic and decompensated phases should be treated with detoxification and remove blood stasis based on the treatment of liver blood.