肝硬化中西医结合治疗的研究进展

蒋式骊; 刘平

doi:10.3969/j.issn.1001-5256.2022.09.001

肝硬化中西医结合治疗的研究进展

DOI: 10.3969/j.issn.1001-5256.2022.09.001

蒋式骊,
刘平^, ,

上海中医药大学附属曙光医院，上海市中医药研究院肝病研究所，上海 201203

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：刘平提供文章思路，并对文章进行修改；蒋式骊参与起草文章，组织语言，整理参考文献等。

详细信息

通信作者:
刘平，liuliver@vip.sina.com

计量
- 文章访问数: 821
- HTML全文浏览量: 130
- PDF下载量: 150
- 被引次数: 0
出版历程
- 收稿日期: 2022-07-25
- 录用日期: 2022-08-25
- 出版日期: 2022-09-20

Research advances in integrated traditional Chinese and Western medicine therapy for liver cirrhosis

Shili JIANG,
Ping LIU^{,
,}

Institute of Liver Disease, Shanghai Academy of Traditional Chinese Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

More Information

Corresponding author: LIU Ping, liuliver@vip.sina.com(ORCID: 0000-0002-6152-4508)

摘要

摘要: 中西药并用是提高肝硬化治疗效果的重要途径，防治慢性乙型肝炎肝硬化长期诊疗实践及临床研究表明，针对病因的抗病毒联合抗肝纤维化中药治疗能够显著提高肝纤维化、肝硬化的逆转率，抗肝纤维化治疗可降低食管胃静脉曲张破裂出血率，减少肝硬化患者肝细胞癌的发生率，提高失代偿期肝硬化患者的5年生存率。深入研究中药复方的主要有效成分作用靶标及相关作用机制，加强药物质控标准的研究，以及获得更多高质量临床疗效证据是有效促进中西医结合治疗肝硬化领域发展亟待解决的主要问题。
- 肝硬化 /
- 治疗学 /
- 中西医结合疗法
Abstract: The combination of traditional Chinese medicine and Western medicine is an important approach to improve the treatment outcome of liver cirrhosis. Long-term diagnosis and treatment practice and clinical studies of the prevention and treatment of chronic hepatitis B cirrhosis have shown that antiviral drugs targeting the cause of the disease combined with anti-liver fibrosis traditional Chinese medicine can significantly improve the reversal rate of liver fibrosis and cirrhosis, and anti-liver fibrosis therapy can reduce the incidence rates of esophagogastric variceal bleeding and hepatocellular carcinoma in cirrhotic patients and improve the 5-year survival rate of patients with decompensated liver cirrhosis. It is necessary to conduct in-depth studies to clarify the target and mechanism of action of the main effective constituents of compound traditional Chinese medicine, strengthen the research on drug quality control standards, and obtain more high-quality evidence for clinical efficacy, so as to effectively promote the development of integrated traditional Chinese and Western medicine therapy for liver cirrhosis.
- Liver Cirrhosis /
- Therapeutics /
- TCM WM Therapy

HTML全文

参考文献(11)

[1]	Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007. 中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648- 2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
[2]	Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006. 中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
[3]	SHI K, ZHANG Q, HUANG YY, et al. Effects of anti-liver fibrosis treatment on the occurrence of liver cancer in patients with hepatitis B-related liver cirrhosis[J]. Chin J Hepatol, 2021, 29(7): 685-689. DOI: 10.3760/cma.j.cn501113-20200227-00072. 时克, 张群, 黄云义, 等. 抗肝纤维化治疗对乙型肝炎肝硬化患者发生肝癌的影响[J]. 中华肝脏病杂志, 2021, 29(7): 685-689. DOI: 10.3760/cma.j.cn501113-20200227-00072.
[4]	RONG G, CHEN Y, YU Z, et al. Synergistic effect of Biejia-Ruangan on fibrosis regression in patients with chronic hepatitis B treated with entecavir: A multicenter, randomized, double-blind, placebo-controlled trial[J]. J Infect Dis, 2022, 225(6): 1091-1099. DOI: 10.1093/infdis/jiaa266.
[5]	MIAO L, YANG WN, DONG XQ, et al. Combined anluohuaxianwan and entecavir treatment significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection[J]. Chin J Hepatol, 2019, 27(7): 521-526. DOI: 10.3760/cma.j.issn.1007-3418.2019.07.009. 苗亮, 杨婉娜, 董晓琴, 等. 安络化纤丸联合恩替卡韦治疗可显著提高慢性乙型肝炎病毒感染者肝纤维化的改善率[J]. 中华肝脏病杂志, 2019, 27(7): 521-526. DOI: 10.3760/cma.j.issn.1007-3418.2019.07.009.
[6]	GUI HL, ZHAO CQ, WANG Y, et al. Histological outcome of Fuzheng Huayu plus entecavir combination therapy in chronic hepatitis B patients with significant liver fibrosis[J]. J Clin Transl Hepatol, 2020, 8(3): 277-284. DOI: 10.14218/JCTH.2020.00004.
[7]	Chinese Society of Hepatology, Chinese Medical Association. Consensus on the secondary prevention for primary liver cancer (2021 edition)[J]. J Clin Hepatol, 2021, 37(3): 532-542. DOI: 10.3969/j.issn.1001-5256.2021.03.008. 中华医学会肝病学分会. 原发性肝癌二级预防共识(2021年版)[J]. 临床肝胆病杂志, 2021, 37(3): 532-542. DOI: 10.3969/j.issn.1001-5256.2021.03.008.
[8]	SHI K, LIU Y, WANG X, et al. Adjuvant Fuzheng Huayu Capsule reduces the incidence of hepatocellular carcinoma in patients with hepatitis B-caused cirrhosis[J]. Evid Based Complement Alternat Med, 2020, 2020: 8826091. DOI: 10.1155/2020/8826091.
[9]	GE XJ, ZHAO CQ, XU LM. Effect of Fuzheng Huayu capsules on survival rate of patients with liver cirrhosis[J]. Chin J Hepatol, 2017, 25(11): 834-840. DOI: 10.3760/cma.j.issn.1007-3418.2017.11.007. 戈雪婧, 赵长青, 徐列明. 扶正化瘀胶囊对肝硬化患者生存率的影响[J]. 中华肝脏病杂志, 2017, 25(11): 834-840. DOI: 10.3760/cma.j.issn.1007-3418.2017.11.007.
[10]	XIAO DH, GU J, CAI H, et al. A randomized placebo-controlled multicentre study of Fuzhenghuayu capsule for prevention of oesophageal variceal bleeding in patients with liver cirrhosis[J]. Chin J Hepatol, 2014, 22(8): 594-599. DOI: 10.3760/cma.j.issn.1007-3418.2014.08.009. 肖定洪, 顾杰, 蔡虹, 等. 扶正化瘀胶囊预防肝硬化患者食管静脉曲张破裂出血的随机对照多中心临床研究[J]. 中华肝脏病杂志, 2014, 22(8): 594-599. DOI: 10.3760/cma.j.issn.1007-3418.2014.08.009.
[11]	NIU SS, ZHANG Q, HOU YX, et al. Primary preventive effect of anti-fibrosis treatment on esophageal and gastric varices bleeding in patients with cirrhosis: a real-world study[J]. Chin J Integr Tradit West Med Liver Dis, 2019, 29(4): 305-309. DOI: 10.3969/j.issn.1005-0264.2019.04.006. 牛帅帅, 张群, 侯艺鑫, 等. 抗肝纤维化治疗对肝硬化食管胃静脉曲张出血的一级预防作用[J]. 中西医结合肝病杂志, 2019, 29(4): 305-309. DOI: 10.3969/j.issn.1005-0264.2019.04.006.