肝硬化中西医结合诊疗指南
DOI: 10.3969/j.issn.1001-5256.2023.11.005
Guidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of liver cirrhosis
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摘要: 肝硬化是各种慢性肝病进展至以肝脏慢性炎症、弥漫性纤维化、假小叶形成及门-体侧支循环形成等为特征的终末病理阶段,属于中医学“黄疸”“胁痛”“鼓胀”等的范畴。目前尚缺乏特效的临床治疗手段,中西医结合治疗可以有效延缓肝硬化的病情进展。本指南工作组在遵循循证医学原则的基础上,结合近年的临床实践总结,参考国内外最新发表的相关指南与专家共识,客观评价肝硬化中西医结合诊治证据,广泛征求中医学、临床医学、临床流行病学等多学科专家的意见,最终形成本指南,旨在为中西医结合诊治肝硬化的临床实践提供参考。Abstract: Liver cirrhosis (LC) is the terminal pathological stage of various chronic liver diseases and is characterized by chronic inflammation, diffuse fibrosis, pseudolobular formation, and portal-systemic collateral circulation, which belongs to the category of jaundice, hypochondriac pain, and abdominal distension in traditional Chinese medicine. At present, there is still a lack of specific clinical treatment methods, and integrated traditional Chinese and Western medicine therapy can effectively delay the progression of LC. Based on the principle of evidence-based medicine and with reference to the summary of recent clinical practice and the latest guidelines and expert consensus published in China and globally, the guidelines in this article are formed by objectively evaluating the evidence of integrated traditional Chinese and Western medicine diagnosis and treatment of LC and extensively soliciting the opinions of experts in the fields of traditional Chinese medicine, clinical medicine, and clinical epidemiology, so as to provide a reference for integrated traditional Chinese and Western medicine diagnosis and treatment of LC in clinical practice.
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表 1 GRADE证据等级分级表
Table 1. Recommended levels of GRADE evidence
证据等级 描述 高级证据(A) 非常确信真实的效应值接近效用估计值 中级证据(B) 对效应估计值有中等程度信心:真实值有可能接近估计值,但仍存在二者大不相同的可能性 低级证据(C) 对效应估计值的确信程度有限:真实值与估计值可能有很大差别 极低级证据(D) 对效应估计值几乎没有信心:真实值与估计值可能有很大差别
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