摘要
近年来对自身免疫性肝病的认识与临床诊治取得了长足进展,但其病理机制复杂,尚存在部分患者标准治疗应答不佳、或缺乏有效治疗方法等,需要中西医结合以满足临床需求。首先,应该明确自身免疫性肝病的疾病类型与病情程度,积极采用免疫抑制剂与熊去氧胆酸等药物控制疾病进展。其次,病下分证,根据疾病分期分辨患者不同阶段的主要证候,并注意不同自身免疫性肝病的共性中医证候——脾肾亏虚。而后,针对西医疾病与中医证候,中药西药合理联合应用,以提高疗效、减少激素等副作用。并需进一步加强规范临床研究,促进中西医结合诊治自身免疫性肝病的研究发展。
Recent years have witnessed the remarkable progresses in the understanding of autoimmune liver disease(ALD)and related diagnosis and treatment.However,ALD has a very complicated pathological mechanism,and there are still unmet needs for the patients with ALD,including non response to the standard of care in part of patients,and lacking the specific treatment in some types of ALD.It’s necessary to apply the integrative medicine,i.e.the combination of traditional Chinese and Western medicine,to satisfy the clinical needs.At first,we should clarify the disease type and degrees of different ALDs,and inhibit disease progression with drugs such as immunosuppressant and ursodeoxycholic acid(UDCA).Secondly,we should differentiate the syndrome pattern of traditional Chinese medicine(TCM)mainly according to the disease stages,after the disease diagnosis was completed,with the attention to the common TCM syndrome of ALDs-both deficiency in spleen and kidney.Thirdly,in order to improve the efficacy,reduce side effects of glucocorticoid,we can combine the western drugs and Chinese medicines according the above the western disease and TCM syndrome.Moreover,the rigorous clinic trials are needed in order to improve the diagnosis and treatment of ALDs with the integrative medicine.
作者
幸鹭
刘成海
XING Lu;LIU Cheng-hai(Institute of Liver Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中西医结合肝病杂志》
CAS
2021年第4期299-302,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
上海市进一步加快中医药事业发展三年行动计划[ZY-(2018-2020)-CCCX-5001]
上海市临床重点专科建设项目(shslczdzk01201)。
关键词
自身免疫性肝病
中西医结合
证候
病下分证
诊治
autoimmune liver disease
integrative medicine
TCM syndrome pattern
syndrome differentiation under disease
diagnosis
treatment
