胆汁淤积性肝病继发皮肤瘙痒中西医诊疗研究进展

摘要

Itching is common in patients with chronic cholestatic liver disease, almost accompanying all liver disease. The incentives of itching are bile salts, histamine, progesterone metabolites, endogenous opioid substances accumulation or lysophosphatidic acid. Chinese medicine believes that the itching is mainly caused by blood heat and blood stasis. However, the exact pathogenesis of cholestatic pruritus remains unclear and the current treatment can only alleviate the symptoms of part of the patients. This article focuses on the recent studies of Chinese and western medicine pathogenesis, pathology and treatment status of cholestatic pruritus.%瘙痒常见于慢性胆汁淤积性肝胆疾病,也可伴发于几乎所有其他种类肝病.既往研究的胆汁淤积所致瘙痒的潜在致痒源有胆盐、组胺、孕酮代谢产物、内源性阿片类物质和溶血磷脂酸.中医认为血热血淤是引起胆汁淤积性瘙痒的主要原因.然而,胆汁淤积性瘙痒的确切发病机制尚不明确,现有的止痒治疗方法仅可使部分患者症状得以缓解.本文旨在回顾最近相关研究,对胆汁淤积性瘙痒的中西医病机、病理和治疗现状予以概述.