PDF下载 ( 968 KB)
Expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of chronic hepatitis B
-
摘要: 慢性乙型肝炎（CHB）仍是我国重大公共卫生问题，未经有效控制可进一步发展为肝硬化、肝癌，带来巨大社会经济负担。目前西医抗病毒治疗是其主要治疗方式，中西医结合治疗是我国CHB的特色治疗手段，两者优势互补可提高临床疗效。为推广中西医结合协同诊疗理念，促进CHB中西医结合诊疗技术发展，建立规范化、标准化疾病诊断和治疗方案，中国医师协会中西医结合医师分会肝病学专家委员会牵头成立共识专家组，讨论并制定《慢性乙型肝炎中西医结合诊疗专家共识》，从CHB的流行病学、发病机制与病因病机、中西医结合诊断与辨证分型、中西医结合治疗四个方面阐述中西医结合协同诊疗理念并提供推荐意见，期望改善CHB患者预后，提高生活质量。Abstract: Chronic hepatitis B （CHB） is still a major public health issue in China， and without effective control， it can further progress to liver cirrhosis and liver cancer， bringing huge social and economic burdens. At present， antiviral therapy is the main treatment method for CHB， and integrated traditional Chinese and Western medicine therapy is the characteristic treatment method for CHB in China and can improve clinical efficacy by complementing each other’s advantages. In order to promote the concept integrated traditional Chinese and Western medicine collaborative diagnosis and treatment， facilitate the development of integrated traditional Chinese and Western medicine diagnosis and treatment techniques for CHB， and establish standardized disease diagnosis and treatment regimens， Expert Committee on Hepatology in Doctor Society of Integrative Medicine， Chinese Medical Doctor Association， established a consensus expert group to discuss and formulate Expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of chronic hepatitis B， which elaborated on the concept of integrated traditional Chinese and Western medicine collaborative diagnosis and treatment from the four aspects of CHB epidemiology， pathogenesis and etiology， integrated traditional Chinese and Western medicine diagnosis and syndrome differentiation， and integrated traditional Chinese and Western medicine therapy and proposed related recommendations， in order to improve the prognosis and quality of life of CHB patients.
-
表 1 推荐意见的证据等级和推荐强度
Table 1. Evidence grade and strength of recommendation of recommendations
级别 详细说明 证据等级 Ⅰ 大样本（≥100例），随机对照研究，结果清晰，假阳性或假阴性的错误很低 Ⅱ 小样本（<100例），随机对照研究，结果不确定，假阳性和/或假阴性的错误较高 Ⅲ 非随机，同期对照研究和基于古代文献的专家共识 Ⅳ 非随机，历史对照和当代专家共识 Ⅴ 病例报道，非对照研究和专家意见 推荐强度 A 至少有2项Ⅰ级研究结果支持 B 仅有1项Ⅰ级研究结果支持 C 仅有Ⅱ级研究结果支持 D 至少有1项Ⅲ级研究结果支持 E 仅有Ⅳ级或Ⅴ级研究结果支持 
下载: 导出CSV
-
[1] MCNAUGHTON AL, D’ARIENZO V, ANSARI MA, et al. Insights from deep sequencing of the HBV genome-unique, tiny, and misunderstood[J]. Gastroenterology, 2019, 156( 2): 384- 399. DOI: 10.1053/j.gastro.2018.07.058. [2] Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B(2022 version)[J]. Chin J Infect Dis, 2023, 41( 1): 3- 28. DOI: 10.3760/cma.j.cn311365-20230220-00050.中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 中华传染病杂志, 2023, 41( 1): 3- 28. DOI: 10.3760/cma.j.cn311365-20230220-00050. [3] World Health Organization. Progress report on HIV, viral hepatitis and sexually transmitted infections 2021: accountability for the global health sector strategies, 2016-2021[R]. Geneva: World Health Organization, 2019. [4] CUI FQ, SHEN LP, LI L, et al. Prevention of chronic hepatitis B after 3 decades of escalating vaccination policy, China[J]. Emerg Infect Dis, 2017, 23( 5): 765- 772. DOI: 10.3201/eid2305.161477. [5] Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: A modelling study[J]. Lancet Gastroenterol Hepatol, 2018, 3( 6): 383- 403. DOI: 10.1016/S2468-1253(18)30056-6. [6] XU YY, LIU HH, WANG Y, et al. The next step in controlling HBV in China[J]. BMJ, 2013, 347: f4503. DOI: 10.1136/bmj.f4503. [7] KAYESH MEH, KOHARA M, TSUKIYAMA-KOHARA K. Toll-like receptor response to hepatitis B virus infection and potential of TLR agonists as immunomodulators for treating chronic hepatitis B: An overview[J]. Int J Mol Sci, 2021, 22( 19): 10462. DOI: 10.3390/ijms221910462. [8] BERTOLETTI A, FERRARI C. Innate and adaptive immune responses in chronic hepatitis B virus infections: Towards restoration of immune control of viral infection[J]. Gut, 2012, 61( 12): 1754- 1764. DOI: 10.1136/gutjnl-2011-301073. [9] CORNBERG M, WONG VWS, LOCARNINI S, et al. The role of quantitative hepatitis B surface antigen revisited[J]. J Hepatol, 2017, 66( 2): 398- 411. DOI: 10.1016/j.jhep.2016.08.009. [10] Hepatobiliary Specialized Committee of China Association of Chinese Medicine, Liver Diseases Specialized Committee of China Medical Association of Minorities. The clinical guidelines of diagnosis and treatment of chronic hepatitis B with traditional Chinese medicine(2018)[J]. J Clin Hepatol, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.中华中医药学会肝胆病专业委员会, 中国民族医药学会肝病专业委员会. 慢性乙型肝炎中医诊疗指南(2018年版)[J]. 临床肝胆病杂志, 2018, 34( 12): 2520- 2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007. [11] LIU Y, XU HC, WANG L. Immunomodulatory effects of traditional Chinese medicine on chronic hepatitis B[J]. Shanghai J Tradit Chin Med, 2022, 56( 5): 93- 97. DOI: 10.16305/j.1007-1334.2022.2107123.刘影, 徐汉辰, 王磊. 中医药对慢性乙型肝炎免疫调节作用概述[J]. 上海中医药杂志, 2022, 56( 5): 93- 97. DOI: 10.16305/j.1007-1334.2022.2107123. [12] LI XK, ZHOU DQ, CHI XL, et al. Entecavir combining Chinese herbal medicine for HBeAg-positive chronic hepatitis B patients: A randomized, controlled trial[J]. Hepatol Int, 2020, 14( 6): 985- 996. DOI: 10.1007/s12072-020-10097-z. [13] ZHANG JH, ZHANG X, ZHOU ZH, et al. Bushen Jianpi formula combined with entecavir for the treatment of HBeAg-negative chronic hepatitis B: A multicenter, randomized, double-blind, placebo-controlled trial[J]. Evid Based Complement Alternat Med, 2022, 2022: 6097221. DOI: 10.1155/2022/6097221. [14] RONG GH, CHEN YP, YU ZJ, 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. [15] JI D, CHEN Y, BI JF, et al. Entecavir plus Biejia-Ruangan compound reduces the risk of hepatocellular carcinoma in Chinese patients with chronic hepatitis B[J]. J Hepatol, 2022, 77( 6): 1515- 1524. DOI: 10.1016/j.jhep.2022.07.018. [16] TSAI TY, LIVNEH H, HUNG TH, et al. Associations between prescribed Chinese herbal medicine and risk of hepatocellular carcinoma in patients with chronic hepatitis B: A nationwide population-based cohort study[J]. BMJ Open, 2017, 7( 1): e014571. DOI: 10.1136/bmjopen-2016-014571. [17] CHENG YA, WANG SD, DANG SS, et al. Clinical study of phyllanthus pill on treating chronic hepatitis B[J]. Chin J Integr Tradit West Med Liver Dis, 2009, 19( 4): 195- 197. DOI: 10.3969/j.issn.1005-0264.2009.04.002.程延安, 王顺达, 党双锁, 等. 叶下珠抗病毒治疗慢性乙型肝炎140例疗效分析[J]. 中西医结合肝病杂志, 2009, 19( 4): 195- 197. DOI: 10.3969/j.issn.1005-0264.2009.04.002. [18] YU YY, WANG QH, ZHU LM, et al. A clinical research on oxymatrine for the treatment of chronic hepatitis B[J]. Chin J Hepatol, 2002, 10( 4): 280- 282. DOI: 10.3760/j.issn: 1007-3418.2002.04.010.于岩岩, 王勤环, 朱理珉, 等. 苦参素治疗慢性乙型肝炎的临床研究[J]. 中华肝脏病杂志, 2002, 10( 4): 280- 282. DOI: 10.3760/j.issn:1007-3418.2002.04.010. [19] SHEN Y. Application and research of Hugan Tablet in acute and chronic hepatitis B[J]. Guangming J Chin Med, 2017, 32( 4): 525- 526. DOI: 10.3969/j.issn.1003-8914.2017.04.029.沈勇. 护肝片在急慢性乙型病毒性肝炎中的应用和研究[J]. 光明中医, 2017, 32( 4): 525- 526. DOI: 10.3969/j.issn.1003-8914.2017.04.029. [20] PIAO MS, LI X. Effect observation of entecavir combined with liver protecting tablets in treatment of chronic hepatitis B[J]. Chin Community Dr, 2018, 34( 22): 42- 43. DOI: 10.3969/j.issn.1007-614x.2018.22.023.朴美善, 李宪. 恩替卡韦联合护肝片对慢性乙型肝炎治疗效果观察[J]. 中国社区医师, 2018, 34( 22): 42- 43. DOI: 10.3969/j.issn.1007-614x.2018.22.023. [21] DONG YY, XIANG Y. Clinical observation of Hugan Tablet combined with entecavir on elderly patients with chronic hepatitis B and its influence on endothelial function and liver fibrosis[J]. Chin J Gerontol, 2019, 39( 20): 4990- 4992. DOI: 10.3969/j.issn.1005-9202.2019.20.035.董亚云, 向阳. 护肝片联合恩替卡韦对老年慢性乙型肝炎患者疗效观察及对内皮功能和肝纤维化的影响[J]. 中国老年学杂志, 2019, 39( 20): 4990- 4992. DOI: 10.3969/j.issn.1005-9202.2019.20.035. [22] Branch of Hepatobiliary Diseases, China Association of Chinese Medicine. Expert consensus on clinical application of Jianganle Granule in treating abnormal liver function[J]. Chin J Integr Tradit West Med Liver Dis, 2022, 32( 11): 1057- 1058.中华中医药学会肝胆病学分会. 健肝乐颗粒治疗肝功能异常临床应用专家共识[J]. 中西医结合肝病杂志, 2022, 32( 11): 1057- 1058. [23] TIAN LY, WU Z, ZHAN K. 68 cases of chronic hepatitis B treated by jianganle granule[J]. Chin J Integr Tradit West Med Liver Dis, 2022, 32( 4): 371- 372, 374. DOI: 10.3969/j.issn.1005-0264.2022.04.023.田凌云, 吴哲, 占凯. 健肝乐颗粒治疗慢性乙型肝炎68例[J]. 中西医结合肝病杂志, 2022, 32( 4): 371- 372, 374. DOI: 10.3969/j.issn.1005-0264.2022.04.023. [24] Hepatobiliary Disease Branch of Chinese Academy of Traditional Chinese medicine, Chinese Patent Medicine Branch of Chinese Academy of traditional Chinese Medicine, Clinical Pharmacy Professional Committee of Chinese Pharmaceutical Association. Expert consensus on the clinical application of Liuwei Wuling tablets in the treatment of chronic hepatitis B[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30( 5): 482- 485. DOI: 10.3969/j.issn.1005-0264.2020.05.034.中华中医药学会肝胆病分会, 中华中医药学会中成药分会, 中国药学会临床药学专业委员会. 六味五灵片治疗慢性乙型肝炎临床应用专家共识[J]. 中西医结合肝病杂志, 2020, 30( 5): 482- 485. DOI: 10.3969/j.issn.1005-0264.2020.05.034. [25] WANG F, CHEN JF. Clinical analysis of Wuzhi capsule combined with tenofovir disoproxil fumarate in the treatment of chronic hepatitis B[J]. J N Pharm, 2020, 17( 9): 48- 49. DOI: 10.3969/j.issn.1672-8351.2020.09.017.王菲, 陈敬峰. 五酯胶囊联合替诺福韦酯治疗慢性乙型肝炎的临床疗效分析[J]. 北方药学, 2020, 17( 9): 48- 49. DOI: 10.3969/j.issn.1672-8351.2020.09.017. [26] HUI RWH, SETO WK, CHEUNG KS, et al. Inverse relationship between hepatic steatosis and hepatitis B viremia: Results of a large case-control study[J]. J Viral Hepat, 2018, 25( 1): 97- 104. DOI: 10.1111/jvh.12766. [27] KIM D, KONYN P, SANDHU KK, et al. Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States[J]. J Hepatol, 2021, 75( 6): 1284- 1291. DOI: 10.1016/j.jhep.2021.07.035. [28] YANG SS, GUO Y, LI T, et al. Huazhi Rougan Granule in treating damp-heat accumulation type non-alcoholic fatty liver disease[J]. Chin J Exp Tradit Med Formulae, 2015, 21( 24): 157- 160. DOI: 10.13422/j.cnki.syfjx.2015240157.杨书山, 郭洋, 李彤, 等. 化滞柔肝颗粒治疗湿热蕴结型非酒精性脂肪肝[J]. 中国实验方剂学杂志, 2015, 21( 24): 157- 160. DOI: 10.13422/j.cnki.syfjx.2015240157. [29] ZHANG E, LI L, LIN T, et al. Systematic evaluation and Meta-analysis of the efficacy of Huazhi Rougan Granule in the treatment of non-alcoholic fatty liver disease[J]. Clin J Chin Med, 2022, 14( 3): 99- 105. DOI: 10.3969/j.issn.1674-7860.2022.03.032.张娥, 李丽, 林彤, 等. 化滞柔肝颗粒治疗非酒精性脂肪性肝病疗效的系统评价和Meta分析[J]. 中医临床研究, 2022, 14( 3): 99- 105. DOI: 10.3969/j.issn.1674-7860.2022.03.032. [30] GUO ZH, ZANG YJ, ZHANG LJ. The efficacy of Polyporus Umbellatus polysaccharide in treating hepatitis B in China[J]. Prog Mol Biol Transl Sci, 2019, 163: 329- 360. DOI: 10.1016/bs.pmbts.2019.03.012. [31] LIU JP, MCINTOSH H, LIN H. Chinese medicinal herbs for chronic hepatitis B[J]. Cochrane Database Syst Rev, 2001, 2000( 1): CD001940. DOI: 10.1002/14651858.CD001940. [32] FENG HD, ZHENG ZW, CHEN N. Application progress of immunomodulators in the treatment of chronic hepatitis B[J]. Shandong Med J, 2022, 62( 2): 108- 112. DOI: 10.3969/j.issn.1002-266X.2022.02.026.奉慧东, 郑智武, 陈宁. 免疫调节剂在慢性乙型肝炎治疗中的应用进展[J]. 山东医药, 2022, 62( 2): 108- 112. DOI: 10.3969/j.issn.1002-266X.2022.02.026. [33] FU XY, PENG YZ, NIE G, et al. Oral polyporus polysaccharide combined with entecavir in the treatment of 60 cases of chronic hepatitis B[J]. Chin J Integr Tradit West Med Liver Dis, 2008, 18( 1): 51- 52. DOI: 10.3969/j.issn.1005-0264.2008.01.019.付小义, 彭雁忠, 聂广, 等. 口服猪苓多糖联合恩替卡韦治疗慢性乙型肝炎60例[J]. 中西医结合肝病杂志, 2008, 18( 1): 51- 52. DOI: 10.3969/j.issn.1005-0264.2008.01.019. [34] ZHANG HT, ZHANG XY, YAO ZY, et al. Clinical efficacy of entecavir combined with thymosin α1 in the treatment of HBeAg positive chronic hepatitis B[J]. Chin J Gerontol, 2015, 35( 5): 1266- 1267. DOI: 10.3969/j.issn.1005-9202.2015.05.053.张海涛, 张晓艳, 么作义, 等. 恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎的临床疗效[J]. 中国老年学杂志, 2015, 35( 5): 1266- 1267. DOI: 10.3969/j.issn.1005-9202.2015.05.053. [35] DU F, LU D. Clinical efficacy of adefovir dipivoxil combined with thymosin α1 in the treatment of hepatitis B patients[J]. Med Forum, 2017, 21( 13): 1657- 1659. DOI: 10.19435/j.1672-1721.2017.13.047.杜风, 卢东. 阿德福韦酯联合胸腺肽α1治疗乙肝患者临床有效性探析[J]. 基层医学论坛, 2017, 21( 13): 1657- 1659. DOI: 10.19435/j.1672-1721.2017.13.047. [36] YANG Y, ZHAO YH, ZHUANG H, et al. Effect and mechanism of Fufang Biejia Ruangan Tablet in prevention and treatment of rat hepatic fibrosis[J]. J Guizhou Med Univ, 2018, 43( 12): 1380- 1385. DOI: 10.19367/j.cnki.1000-2707.2018.12.004.杨宇, 赵月涵, 庄海, 等. 复方鳖甲软肝片防治大鼠肝纤维化作用及机制[J]. 贵州医科大学学报, 2018, 43( 12): 1380- 1385. DOI: 10.19367/j.cnki.1000-2707.2018.12.004. [37] YANG RH, LI Q, CHEN W. Efficacy and safety of Fuzhenghuayu capsule for treating liver fibrosis in patients with chronic hepatitis B: A meta-analysis[J]. Chin J Hepatol, 2015, 23( 4): 295- 296. DOI: 10.3760/cma.j.issn.1007-3418.2015.04.013.杨瑞华, 李芹, 陈玮. 扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化疗效的Meta分析[J]. 中华肝脏病杂志, 2015, 23( 4): 295- 296. DOI: 10.3760/cma.j.issn.1007-3418.2015.04.013. [38] 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. [39] LIU YQ, ZHANG C, LI JW, et al. An-Luo-Hua-Xian pill improves the regression of liver fibrosis in chronic hepatitis B patients treated with entecavir[J]. J Clin Transl Hepatol, 2023, 11( 2): 304- 313. DOI: 10.14218/JCTH.2022.00091. [40] Branch of Hepatobiliary Diseases, Chinese Association of Chinese Medicine. Expert consensus on clinical application of Biejiajian pill in treating hepatic fibrosis[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30( 6): 577- 578, 584.中华中医药学会肝胆病学分会. 鳖甲煎丸治疗肝纤维化临床应用专家共识[J]. 中西医结合肝病杂志, 2020, 30( 6): 577- 578, 584. [41] ZHANG HX, LIU XD, WANG CY. The clinical observation of treatment of Dahuang Zhechong pill combined with entecavir in chronic hepatitis B patient with liver cirrhosis[J]. Chin J Integr Tradit West Med Dig, 2016, 24( 8): 575- 577. DOI: 10.3969/j.issn.1671-038X.2016.08.02.张红星, 刘旭东, 王朝阳. 大黄蛰虫丸联合恩替卡韦治疗慢性乙型肝炎肝硬化疗效观察[J]. 中国中西医结合消化杂志, 2016, 24( 8): 575- 577. DOI: 10.3969/j.issn.1671-038X.2016.08.02. [42] Liver Disease Committee, Chinese Association of Integrative Medicine. Guidelines for the diagnosis and treatment of liver fibrosis in integrative medicine practice(2019)[J]. J Clin Hepatol, 2019, 35( 7): 1444- 1449. DOI: 10.3969/j.issn.1001-5256.2019.07.007.中国中西医结合学会肝病专业委员会. 肝纤维化中西医结合诊疗指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35( 7): 1444- 1449. DOI: 10.3969/j.issn.1001-5256.2019.07.007. [43] WANG WE, ZHANG Q, WANG YL, et al. Curative effect of Modified Xiaoyao Powder combined with tenofovir on chronic hepatitis B liver fibrosis[J]. J Hubei Univ Chin Med, 2022, 24( 5): 28- 31. DOI: 10.3969/j.issn.1008-987x.2022.05.06.王万娥, 张青, 王雨露, 等. 逍遥散加减联合替诺福韦治疗慢性乙肝肝纤维化(肝郁脾虚证)临床观察[J]. 湖北中医药大学学报, 2022, 24( 5): 28- 31. DOI: 10.3969/j.issn.1008-987x.2022.05.06. [44] WANG Y, LU BJ. Clinical observation on Xiaoyao Powder combined with entecavir dispersible tablets in the treatment of chronic hepatitis B with liver depression and spleen deficiency[J]. Hebei J Tradit Chin Med, 2019, 41( 10): 1529- 1531, 1544. DOI: 10.3969/j.issn.1002-2619.2019.10.019.王叶, 卢秉久. 逍遥散加减联合恩替卡韦分散片治疗肝郁脾虚型慢性乙型病毒性肝炎临床观察[J]. 河北中医, 2019, 41( 10): 1529- 1531, 1544. DOI: 10.3969/j.issn.1002-2619.2019.10.019. [45] GAO XG, RUAN LG. Clinical observation and evaluation of quality of life of chaihushugan powder combined with entecavir in treatment of chronic hepatitis B[J]. Hubei J Tradit Chin Med, 2014, 36( 4): 12- 13.高雪岗, 阮连国. 柴胡疏肝散加减联合恩替卡韦治疗慢性乙型肝炎患者的临床疗效及其生存质量评价[J]. 湖北中医杂志, 2014, 36( 4): 12- 13. [46] LIU L, YANG J, LI ZY, et al. Ganshuang granule alleviates early liver fibrosis(S1 and S2)in chronic hepatitis B with liver depression spleen deficiency and blood stasis syndrome[J]. Chin J Exp Tradit Med Formulae, 2022, 28( 11): 132- 138. DOI: 10.13422/j.cnki.syfjx.20221192.刘莉, 杨静, 李宗云, 等. 肝爽颗粒对慢性乙型肝炎肝纤维化(S1和S2期)肝郁脾虚兼血瘀证的早期防治疗效[J]. 中国实验方剂学杂志, 2022, 28( 11): 132- 138. DOI: 10.13422/j.cnki.syfjx.20221192. [47] BAI Y, LOU FR, ZHANG M, et al. Efficacy of entecavir plus the Ganshuang Granules on HBeAg negative chronic hepatitis B[J]. Clin J Chin Med, 2022, 14( 20): 45- 48. DOI: 10.3969/j.issn.1674-7860.2022.20.014.白宇, 刘繁荣, 张敏, 等. 恩替卡韦联合肝爽颗粒治疗HBeAg阴性慢性乙型病毒性肝炎患者疗效研究[J]. 中医临床研究, 2022, 14( 20): 45- 48. DOI: 10.3969/j.issn.1674-7860.2022.20.014. [48] Branch of Hepatobiliary Diseases, Chinese Association of Chinese Medicine. Expert consensus on the clinical application of Ganshuang granules in the treatment of liver fibrosis[J]. Chin J Integr Tradit West Med Liver Dis, 2020, 30( 5): 481- 482. DOI: 10.3969/j.issn.1005-0264.2020.05.033.中华中医药学会肝胆病分会. 肝爽颗粒治疗肝纤维化临床应用专家共识[J]. 中西医结合肝病杂志, 2020, 30( 5): 481- 482. DOI: 10.3969/j.issn.1005-0264.2020.05.033. [49] XIA XF. Effect of gankangning tablets combined with lamivudine tablets on T cell subsets of chronic hepatitis B[J]. J N Chin Med, 2016, 48( 4): 61- 63. DOI: 10.13457/j.cnki.jncm.2016.04.022.夏小芳. 肝康宁片联合拉米夫定对慢性乙型肝炎T细胞亚群的影响[J]. 新中医, 2016, 48( 4): 61- 63. DOI: 10.13457/j.cnki.jncm.2016.04.022. [50] LIU YW, LIAO CJ, HUANG SD. Clinical study on Gankangning Tablets combined with tenofovir in treatment of viral hepatitis[J]. Drugs Clin, 2019, 34( 5): 1398- 1401. DOI: 10.7501/j.issn.1674-5515.2019.05.028.刘义文, 廖春娇, 黄顺东. 肝康宁片联合替诺福韦治疗病毒性肝炎的临床研究[J]. 现代药物与临床, 2019, 34( 5): 1398- 1401. DOI: 10.7501/j.issn.1674-5515.2019.05.028. [51] Branch of Hepatobiliary Diseases, Chinese Association of Chinese Medicine. Expert consensus for clinical application of Wuling capsule(pill)in the treatment of chronic hepatitis B[J]. J Clin Hepatol, 2022, 38( 9): 1986- 1989. DOI: 10.3969/j.issn.1001-5256.2022.09.007.中华中医药学会肝胆病分会. 五灵胶囊(丸)治疗慢性乙型肝炎临床应用专家共识[J]. 临床肝胆病杂志, 2022, 38( 9): 1986- 1989. DOI: 10.3969/j.issn.1001-5256.2022.09.007. [52] LI GA, QIN GA, HUANG YN. Yinchenhao Tang damp heat resistance combined with western medicine treatment of moderate to severe chronic hepatitis type parallel randomized controlled study[J]. J Pract Tradit Chin Intern Med, 2015, 29( 5): 144- 146. DOI: 10.13729/j.issn.1671-7813.2015.05.70.李格爱, 覃贵岸, 黄岳宁. 茵陈蒿汤联合西药治疗湿热中阻型重度慢乙肝随机平行对照研究[J]. 实用中医内科杂志, 2015, 29( 5): 144- 146. DOI: 10.13729/j.issn.1671-7813.2015.05.70. [53] LI JH, JIANG YP. 30 cases of chronic hepatitis B with damp-heat syndrome of liver and gallbladder treated by modified Ganlu Xiaodu Dan[J]. Jiangxi J Tradit Chin Med, 2014, 45( 4): 37- 38.黎嘉辉, 江一平. 甘露消毒丹加减治疗慢性乙型肝炎肝胆湿热证30例[J]. 江西中医药, 2014, 45( 4): 37- 38. [54] LIU DL, WEN WQ, HE QJ, et al. Clinical observation on treating chronic hepatitis B with the Yinzhi Huang oral liquid[J]. Clin J Chin Med, 2015, 7( 28): 88- 90. DOI: 10.3969/j.issn.1674-7860.2015.28.048.刘定立, 文维群, 何钦俊, 等. 茵栀黄口服液治疗慢性乙型肝炎的临床研究[J]. 中医临床研究, 2015, 7( 28): 88- 90. DOI: 10.3969/j.issn.1674-7860.2015.28.048. [55] YU YS, CHU JG, ZHANG L, et al. Efficacy of Yinzhihuang oral liquid on hepatitis patients and its mechanism[J]. Chin Arch Tradit Chin Med, 2022, 40( 2): 241- 244. DOI: 10.13193/j.issn.1673-7717.2022.02.057.俞玉珊, 褚金国, 张璐, 等. 茵栀黄口服液对慢性乙型肝炎患者的疗效及退黄作用机制[J]. 中华中医药学刊, 2022, 40( 2): 241- 244. DOI: 10.13193/j.issn.1673-7717.2022.02.057. [56] MA ZR, SONG B, CHEN XY. Curative effect observation of lamivudine combined with Kuhuang injection on 18 cases of chronic hepatitis B[J]. Yunnan J Tradit Chin Med Mater Med, 2012, 33( 7): 30- 31. DOI: 10.16254/j.cnki.53-1120/r.2012.07.048.马真荣, 宋波, 陈弦玉. 拉米呋啶配合苦黄注射液治疗慢性乙肝18例疗效观察[J]. 云南中医中药杂志, 2012, 33( 7): 30- 31. DOI: 10.16254/j.cnki.53-1120/r.2012.07.048. [57] LIAN H, ZHOU T, HU L, et al. Clinical efficacy of Kuhuang injection, compound glycyrrhizic acid glycoside, and adefovir ester triple therapy in the treatment of HBeAg positive chronic hepatitis B and its impact on patient immune function[J]. Mod J Integr Tradit Chin West Med, 2017, 3( 12): 1314- 1316. DOI: 10.3969/j.issn.1008-8849.2017.12.020.廉华, 周涛, 胡莲, 等. 苦黄注射液、复方甘草酸苷、阿德福韦酯三联疗法治疗HBeAg阳性慢性乙型肝炎的临床疗效及对患者免疫功能的影响[J]. 现代中西医结合杂志, 2017, 3( 12): 1314- 1316. DOI: 10.3969/j.issn.1008-8849.2017.12.020. [58] GUO W, CHEN DY. Clinical observation of Kelong capsule in the treatment of 43 cases of moderate chronic hepatitis B[J]. Chin Tradit Pat Med, 1997( 2): 28- 29.郭文, 陈德勇. 克癀胶囊治疗中度慢性乙型肝炎43例疗效观察[J]. 中成药, 1997( 2): 28- 29. [59] PENG JC. 120 cases of hepatitis B liver fibrosis treated with Kelong capsule[J]. J World Latest Med Inf, 2021, 21( 89): 223- 224. DOI: 10.3969/j.issn.1671-3141.2021.89.108.彭金城. 克癀胶囊治疗乙肝肝纤维化病例120例[J]. 世界最新医学信息文摘, 2021, 21( 89): 223- 224. DOI: 10.3969/j.issn.1671-3141.2021.89.108. [60] YI SH, SONG JM, ZHANG H. 100 cases of chronic hepatitis B with liver-kidney Yin deficiency treated by Yiguan Decoction[J]. J Beijing Univ Tradit Chin Med Clin Med, 2004, 11( 2): 17- 18. DOI: 10.3969/j.issn.1672-2205.2004.02.007伊书红, 宋菊梅, 张辉. 一贯煎加味治疗肝肾阴虚型慢性乙型肝炎100例[J]. 北京中医药大学学报(中医临床版), 2004, 11( 2): 17- 18. DOI: 10.3969/j.issn.1672-2205.2004.02.007. [61] HU T, LYU ZP. Clinical study of Qijudihuang pill combined with entecavir in the treatment of chronic hepatitis B with Yin deficiency of liver and kidney[J]. Zhejiang J Tradit Chin Med, 2009, 44( 1): 48- 49. DOI: 10.3969/j.issn.0411-8421.2009.01.043.胡涛, 吕志平. 杞菊地黄丸联合恩替卡韦治疗肝肾阴虚型慢性乙型肝炎的临床研究[J]. 浙江中医杂志, 2009, 44( 1): 48- 49. DOI: 10.3969/j.issn.0411-8421.2009.01.043. [62] YANG WH. Effect analysis of modified Gexia Zhuyu Decoction in the treatment of chronic hepatitis B with blood stasis heat obstructing collaterals[J/CD]. Cardiov Dis J Integr Tradit Chin Western Med, 2019, 7( 15): 158.杨卫宏. 加减膈下逐瘀汤治疗瘀热阻络型慢性乙型肝炎肝炎维化的效果分析[J/CD]. 中西医结合心血管病电子杂志, 2019, 7( 15): 158. [63] HE XQ, HU GX. Meta-analysis of clinical effect of Gexia Zhuyu Decoction on hepatitis B cirrhosis[J]. Shaanxi J Tradit Chin Med, 2021, 42( 3): 398- 401, 408. DOI: 10.3969/j.issn.1000-7369.2021.03.034.何湘琴, 胡国信. 膈下逐瘀汤治疗乙型肝炎肝硬化临床疗效Meta分析[J]. 陕西中医, 2021, 42( 3): 398- 401, 408. DOI: 10.3969/j.issn.1000-7369.2021.03.034. [64] SHEN DY. Effect of acupoint application nursing on clinical symptoms and liver function of patients with hepatitis B[J]. Shanxi Med J, 2020, 49( 17): 2382- 2385.沈丹阳. 穴位敷贴护理对乙型肝炎患者临床症状及肝功能的影响[J]. 山西医药杂志, 2020, 49( 17): 2382- 2385. [65] ZHOU J, YOU J, LAN Q, et al. Clinical analysis of entecavir combined with acupuncture in the treatment of chronic hepatitis B[J]. China Pract Med, 2021, 16( 12): 170- 172. DOI: 10.14163/j.cnki.11-5547/r.2021.12.063.周菊, 游晶, 兰青, 等. 恩替卡韦联合针灸治疗慢性乙型肝炎的疗效分析[J]. 中国实用医药, 2021, 16( 12): 170- 172. DOI: 10.14163/j.cnki.11-5547/r.2021.12.063. [66] NIE L, ZHANG JL, KONG XH. Clinical study of warm needling moxibustion combined with entecavir in the treatment of compensated cirrhosis due to chronic hepatitis B[J]. J Acupunct Tuina Sci, 2022, 20( 3): 199- 205.聂璐, 张娟丽, 孔谐和. 温针灸联合恩替卡韦治疗慢性乙肝肝硬化代偿期临床研究[J]. 针灸推拿医学(英文版), 2022, 20( 3): 199- 205. [67] FU YP, ZHOU MF, ZHANG HY. Effect of auricular point bean pressing combined with feeding nursing on symptoms and quality of life of patients with liver cirrhosis and abdominal distension after chronic hepatitis B[J]. Mod J Integr Tradit Chin West Med, 2019, 28( 6): 673- 676. DOI: 10.3969/j.issn.1008-8849.2019.06.030.傅亚萍, 周美芳, 章红燕. 耳穴压豆联合纳食护理对慢性乙肝后肝硬化腹胀患者症状及生活质量的影响[J]. 现代中西医结合杂志, 2019, 28( 6): 673- 676. DOI: 10.3969/j.issn.1008-8849.2019.06.030. -
本文二维码
表(1)
计量
- 文章访问数: 853
- HTML全文浏览量: 229
- PDF下载量: 306
- 被引次数: 0
