五灵胶囊(丸)治疗慢性乙型肝炎临床应用专家共识

中华中医药学会肝胆病分会

doi:10.3969/j.issn.1001-5256.2022.09.007

五灵胶囊(丸)治疗慢性乙型肝炎临床应用专家共识

DOI: 10.3969/j.issn.1001-5256.2022.09.007

中华中医药学会肝胆病分会

利益冲突声明：在共识制定过程中共收集32份利益声明表，所有相关参与者均与企业无利益冲突，企业人员主要负责组织、服务等事务性工作，不参与任何共识决策工作。

通信作者：李秀惠，lixiuhui2020@ccmu.edu.cn

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出版历程
- 收稿日期: 2022-08-12
- 录用日期: 2022-08-15
- 出版日期: 2022-09-20

Expert consensus for clinical application of Wuling capsule(pill) in the treatment of chronic hepatitis B

Branch of Hepatobiliary Diseases, Chinese Association of Chinese Medicine

摘要

- 慢性乙型肝炎 /
- 中药疗法 /
- 共识
- Chronic Hepatits B /
- Drug Therapy (TCD) /
- Consensus

HTML全文

表 1 达成的推荐意见

序号	推荐条目	证据级别	推荐强度
1	五灵胶囊(丸)用于慢性乙型肝炎的治疗	Ⅱ级	强推荐
2	五灵胶囊(丸)用于慢性乙型肝炎治疗，具有保肝降酶作用	Ⅰ级	强推荐
3	五灵胶囊(丸)可显著降低慢性乙型肝炎患者ALT、AST水平，停药后不易反跳	Ⅱ级	强推荐
4-1	五灵胶囊(丸)能改善慢性乙型肝炎患者肝区疼痛	Ⅰ级	强推荐
4-2	五灵胶囊(丸)能改善慢性乙型肝炎患者脘腹胀满	Ⅰ级	强推荐
4-3	五灵胶囊(丸)能改善慢性乙型肝炎患者疲倦乏力	Ⅰ级	强推荐
4-4	五灵胶囊(丸)能改善慢性乙型肝炎患者食少纳呆	Ⅰ级	强推荐
5	五灵胶囊(丸)能改善慢性乙型肝炎患者情志抑郁	Ⅲ级	弱推荐
6	五灵胶囊(丸)用于慢性乙型肝炎治疗，具有退黄作用	Ⅰ级	强推荐
7	五灵胶囊(丸)联合抗病毒药物能显著降低慢性乙型肝炎患者肝生化指标(ALT、AST、TBil)水平, 有助于降低血清Ⅲ型前胶原、层粘连蛋白、透明质酸水平	Ⅱ级	强推荐
8	用法用量五灵胶囊：5粒/次，3次/d，饭后30 min服用五灵丸：9 g/次，3次/d，饭后30 min服用疗程：用于慢性乙型肝炎患者保肝降酶服药时间3个月，可根据病情需要延长用药时间	Ⅱ级	强推荐

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表 2 达成的共识建议

序号	共识条目	证据级别	建议强度
1	五灵胶囊(丸)可用于慢性乙型肝炎合并药物性肝损伤、代谢相关脂肪性肝病、自身免疫性肝病、酒精性肝病引起的ALT、AST、TBil异常以及纳呆、腹胀、嗳气、胁肋胀痛、疲乏无力等临床症状的治疗	无	建议
2	五灵胶囊(丸)治疗慢性乙型肝炎时，肝生化指标恢复正常后需要继续巩固治疗	无	建议
3	孕妇慎用五灵胶囊(丸)	无	建议

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表 3 临床问题清单

序号	临床问题
1	五灵胶囊(丸)治疗哪些西医疾病
2	五灵胶囊(丸)是否对慢性乙型肝炎患者具有保肝降酶作用
3	五灵胶囊(丸)用于慢性乙型肝炎患者降低ALT、AST，停药后是否不易反跳
4	五灵胶囊(丸)是否能改善慢性乙型肝炎患者肝区疼痛
5	五灵胶囊(丸)是否能改善慢性乙型肝炎患者脘腹胀满
6	五灵胶囊(丸)是否能改善慢性乙型肝炎患者疲倦乏力
7	五灵胶囊(丸)是否能改善慢性乙型肝炎患者食少纳呆
8	五灵胶囊(丸)是否能改善慢性乙型肝炎患者情志抑郁
9	五灵胶囊(丸)用于慢性乙型肝炎治疗，是否具有退黄作用
10	有抗病毒治疗指征的慢性乙型肝炎患者，在接受抗病毒治疗时，联合五灵胶囊(丸)，是否有助于改善患者的实验室指标(ALT、AST、TBil)
11	有抗病毒治疗指征的慢性乙型肝炎患者，在接受抗病毒治疗时，联合五灵胶囊(丸)，是否有助于延缓或逆转肝纤维化程度
12	五灵胶囊(丸)治疗慢性乙型肝炎时，肝生化指标恢复正常后是否有必要巩固治疗
13	五灵胶囊(丸)治疗慢性乙型肝炎代偿期肝硬化是否能够改善患者肝功能指标和肝纤维化指标
14	对于慢性乙型肝炎代偿期肝硬化患者，五灵胶囊(丸)是否有助于防止并发症的发生
15	五灵胶囊(丸)治疗慢性乙型肝炎用法用量和疗程
16	五灵胶囊(丸)治疗慢性乙型肝炎肝纤维化用法用量和疗程
17	五灵胶囊(丸)适用人群有哪些(除消化道溃疡病史者)

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