Multidisciplinary expert consensus on bicyclol in prevention and treatment of inflammatory liver injury
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摘要: 肝脏炎性损伤是许多慢性肝病的始动因素。肝脏炎性损伤可累及全身,反之,全身疾病也会导致肝损伤。肝病的诊治既要考虑肝脏病变本身,又需了解全身各系统疾病与肝脏炎性损伤之间相互影响及其病理生理发生机制。因此,针对肝损伤的诊治,常需多学科讨论,共同决策。肝病治疗的重要环节之一是保护和维持肝功能的稳定,其中如何进行抗炎护肝是制定治疗策略的重要考量因素之一。双环醇是由我国自主研发、用于治疗肝脏炎性损伤的一类化学药物,对各种原因所致的肝脏炎性损伤均具有较好的防治作用,已于“一带一路”沿线九国注册并上市。为此,本学组组织了国内相关学科专家,根据肝病诊疗相关指南/共识/临床路径和循证医学证据,结合我国临床实践,总结双环醇在防治肝脏炎性损伤多学科临床应用方面的进展,旨在形成共识,提高双环醇临床使用的科学性和规范性,提升各学科对肝脏炎性损伤的防治水平。Abstract: Inflammatory liver injury is the initiating factor for various chronic liver diseases. It can involve the whole body, and on the contrary, systemic diseases may also lead to liver injury. The diagnosis and treatment of liver disease should not only consider the liver disease itself, but also understand the interaction between various systemic diseases and inflammatory liver injury and related pathophysiological mechanisms. Therefore, the diagnosis and treatment of liver injury often require multidisciplinary discussions and joint decision-making. One of the important links in the treatment of liver disease is to protect and maintain the stability of liver function, and how to carry out anti-inflammatory and liver-protecting treatment should be considered during the development of treatment strategies. Bicyclol is a chemical agent independently developed by China and is used for the treatment of inflammatory liver injury. Bicyclol has a good clinical effect in the prevention and treatment of inflammatory liver injury due to various causes and has been registered and listed in nine countries along the Belt and Road. Therefore, we have organized domestic experts from relevant disciplines all over the country to summarize the advances in the multidisciplinary clinical application of bicyclol in the prevention and treatment of inflammatory liver injury based on related guidelines/consensus statements/clinical pathways and evidence-based medicine and with reference to the clinical practice in China, in order to improve the scientific and standard use of bicyclol in clinical practice and the prevention and treatment of inflammatory liver injury in each discipline.
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Key words:
- Inflammatory Liver Injury /
- Bicyclol /
- Consensus
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表 1 证据质量分级和推荐强度分级标准
Table 1. Evidence quality and recommendation strength classification
项目 描述 证据质量分级 高(A) 非常确信估计的效应值接近真实效应值:进一步研究也不可能改变该估计效应值的可信度(多中心随机临床试验;多项随机研究;多项荟萃分析) 中(B) 对效应估计值确信中等程度信心,估计值有可能接近真实值,但仍存在二者不同的可能性,进一步研究有可能改变该估计效应值的可信度(单项随机研究或多项非随机研究) 低或极低(C) 效应估计值的确信程度有限,真实值可能与估计值大不相同,进一步研究极有可能改变该估计效应值的可信度;对效应估计值几乎没有信心,真实值很可能与估计值完全不同;对效应值的任何估计都很不确定(专家共识观点,病例报道或诊疗规范性文件) 推荐强度分级 强(1级) 明确显示干预措施利大于弊或弊大于利 弱(2级) 利弊不确定或无论质量高低的证据均显示利弊相当,可能利大于弊 -
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