摘要
瘙痒是胆汁淤积性肝病常见的症状,临床发病率高,发病机制复杂。类固醇类物质、胆汁酸、溶血磷脂酸等潜在瘙痒原在体循环中积累是胆汁淤积性肝病产生瘙痒的主要原因。目前,临床上治疗胆汁淤积性肝病瘙痒的方式主要包括药物治疗、介入治疗和一些试验性方法,但研究仍存在病理机制不明、部分胆汁淤积性肝病瘙痒患者治疗反应欠佳等问题,患者的有效治疗依旧面临挑战。通过大量临床试验对患者血浆(和/或胆汁)样本进行全面筛查来寻找潜在瘙痒原,可以更深入地了解胆汁淤积性肝病中瘙痒原的痒觉信号传导机制,为治疗策略的开发提供基础。中医药在临床治疗方面表现出一定的特色和优势,针对其病因病机,根据辨证论治对患者使用外用、内服及中医特色疗法实施治疗在临床上取得较好的疗效。同样,采用中医药联合西医的中西医结合方式在临床上对胆汁淤积性肝病瘙痒患者也实现了更为有效的治疗。本文将围绕引发胆汁淤积性肝病癌痒症的瘙痒原及中西医治疗胆汁淤积性肝病瘙痒的最新进展进行介绍。
Pruritus is common in cholestatic liver disease,with a high clinical incidence rate and complex pathogenesis.Accumulation of potential pruritus inducers such as steroids,bile acids,and lysophosphatidic acid in the systemic circulation is the main cause of pruritus in cholestatic liver disease.Currently,clinical treatment of cholestatic liver disease-related pruritus mainly includes medication,intervention therapy,and some experimental methods.However,there are still problems,such as unclear pathological mechanisms and unsatisfactory treatment responses in some patients with cholestatic liver disease-related pruritus.Effective treatment for patients still faces challenges.By extensively screening patients’plasma(and/or bile)samples through clinical trials,potential pruritus inducers can be identified comprehensively,which can provide a deeper understanding of the itch signaling pathways in cholestatic liver disease and a basis for the development of treatment strategies.Traditional Chinese medicine(TCM)has shown certain characteristics and advantages in clinical treatment.Based on the etiology and pathogenesis,external application,internal administration,and TCM-specific therapies have achieved good clinical efficacy.Similarly,the combination of Chinese medicine and Western medicine has also achieved more effective treatment for patients with cholestatic liver disease-related pruritus.This article will introduce the latest progress in the study of pruritus inducers in cholestatic liver disease and its treatment in TCM and Western medicine.
作者
代蚊璋
聂红
Wenzhang Dai;Hong Nie(State Key Laboratory of Bioactive Molecules and Druggability Assessment,Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research,International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education(MOE),College of Pharmacy,Jinan University,Guangzhou,Guangdong,China)
基金
the National Natural Science Foundation of China(8181101216)
Outstanding Innovative Talents Cultivation Funded Programs for Doctoral Students of Jinan University(2023CXB027).
关键词
胆汁淤积
瘙痒
中西医
研究进展
cholestasis
pruritus
Chinese medicine
Western medicine
research progress
