[1]王秀峰 陈桂容 林华明 覃武海.中医药治疗慢加急性肝衰竭的研究进展[J].大众科技,2022,24(07):120-124.
 Research Progress in the Treatment of Acute-on-Chronic Liver Failure with Traditional Chinese Medicine[J].Popular Science & Technology,2022,24(07):120-124.
点击复制

中医药治疗慢加急性肝衰竭的研究进展()
分享到:

《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
24
期数:
2022年07
页码:
120-124
栏目:
医药与卫生
出版日期:
2022-07-20

文章信息/Info

Title:
Research Progress in the Treatment of Acute-on-Chronic Liver Failure with Traditional Chinese Medicine
作者:
王秀峰1 陈桂容2 林华明2 覃武海3
(1.广西中医药大学第一附属医院,广西 南宁 530023; 2.广西中医药大学研究生学院,广西 南宁 530001;3.玉林市中医医院,广西 玉林 537000)
关键词:
慢加急性肝衰竭中医药免疫调控肝损伤
Keywords:
acute-on-chronic liver failure traditional Chinese medicine immuno regulation liver injury
文献标志码:
A
摘要:
慢加急性肝衰竭(ACLF)在临床工作中十分常见,文章以慢加急肝衰竭中免疫系统和肝细胞的改变为切入点,全面总结了中药解毒化瘀颗粒、解毒化瘀通腑颗粒、大黄乌梅煎高位保留灌肠结合清热利湿化瘀解毒方、菖蒲郁金汤化裁方、柴芍六君子汤加减、健脾清化方、赤芍解毒汤、解毒凉血方联合西药、解毒化瘀补虚法联合西药、自拟清热祛湿解毒汤、解毒化瘀Ⅱ方、解毒凉血健脾方等中医药对ACLF患者的治疗效果,进而综述中医药对ACLF患者治疗的研究进展,以期为中医药应用于ACLF的临床治疗提供参考。
Abstract:
Acute-on-chronic liver failure (ACLF) is very common in clinical practice. Based on the changes of immune system and hepatocytes in chronic acute liver failure, the article comprehensively summarizes the traditional Chinese medicine Jiedu Huayu granule, Jiedu Huayu Tongfu granule, rhubarb and Wumei decoction high retention enema combined with heat clearing, dampness removing and blood stasis removing formula, Changpu Yujin decoction, chaishaoliujunzi decoction, Jianpi Qinghua formula, Chishao Jiedu decoction, Jiedu Liangxue formula combined with western medicine Jiedu Huayu Buxu method combined with western medicine, self-made Qingre Qushi Jiedu decoction, Jiedu Huayu II recipe, Jiedu Liangxue Jianpi recipe and other traditional Chinese medicine in the treatment of ACLF patients, and then summarize the research progress of traditional Chinese medicine in the treatment of ACLF patients, in order to provide reference for the application of traditional Chinese medicine in the clinical treatment of ACLF.

参考文献/References:

[1] Gao F, Zhang Q, Liu Y, et al. Nomogram prediction of individual prognosis of patients with acute-on-chronic hepatitis B liver failure[J]. Digestive and Liver Disease, 2019, 51(3): 425-33. [2] Arroyo V, Moreau R, Jalan R. Acute-on-chronic liver failure [J]. The New England Journal of Medicine,, 2020, 382(22): 2137-2145. [3] Nielsen M C, Hvidbjerg G R, Claria J, et al. Macrophage activation markers, CD163 and CD206, in acute-on- chronic liver failure[J]. Cells, 2020, 9(5): 1175. [4] Stravitz R T, Lee W M. Acute liver failure [J]. Lancet, 2019, 394(10201): 869-881. [5] Sole C, Sola E. Update on acute-on-chronic liver failure[J]. Journal of Gastroenterology and Hepatology, 2018, 41(1): 43-53. [6] Moreau R, Gao B, Papp M, et al. Acute-on-chronic liver failure: a distinct clinical syndrome[J]. Journal of Hepatology, 2021, 75(Suppl 1): S27-S35. [7] Wu D, Zhang S, Xie Z, et al. Plasminogen as a prognostic biomarker for HBV-related acute-on-chronic liver failure [J].Journal of Clinical Investigation, 2020, 130(4): 2069-2080. [8] Ferstl P, Trebicka J. Acute Decompensation and acute-on-chronic liver failure[J]. Clinical Liver Disease, 2021, 25(2): 419-430. [9] Kabbani A R, Tergast T L, Manns M P, et al. Treatment strategies for acute-on-chronic liver failure[J]. Medizinische Klinik-Intensivmedizin und Notfallmedizin, 2021, 116(1): 3-16. [10] Bajaj J S, Oleary J G, Lai J C, et al. Acute-on-chronic liver failure clinical guidelines[J]. American Journal of Gastroenterology, 2022, 117(2): 225-252. [11] Blernai W, Karvellas C, Saliba F, et al. Intensive care management of acute-on-chronic liver failure[J]. Journal of Hepatology, 2021, 75(Suppl 1): S163-S177. [12] Tan E X, Wang M X, Pang J, et al. Plasma exchange in patients with acute and acute-on-chronic liver failure: A systematic review[J]. World Journal of Gastroenterology, 2020, 26(2): 219-45. [13] Karvellas C J, Francoz C, Weiss E. Liver transplantation in acute-on-chronic liver failure[J]. Transplantation, 2021, 105(7): 1471-1481. [14] Tomescu D, Popescu M, Biancofiore G. Liver transplantation for acute-on-chronic liver failure[J]. Best Practice and Research in Clinical Anaesthesiology, 2020, 34(1): 25-33. [15] Trebicka J, Sundaram V, Moreau R, et al. Liver transplantation for acute-on-chronic liver failure: science or fiction[J]. Liver Transplantation, 2020, 26(7): 906-915. [16] Tang L, Wang F, Xiao L, et al. Yi-Qi-Jian-Pi formula modulates the PI3K/AKT signaling pathway to attenuate acute-on-chronic liver failure by suppressing hypoxic injury and apoptosis in vivo and in vitro[J]. Journal of Ethnopharmacology, 2021, 280: 114411. [17] Xiang X, Feng D, Hwang S, et al. Interleukin-22 ameliorates acute-on-chronic liver failure by reprogramming impaired regeneration pathways in mice [J]. Journal of Hepatology, 2020, 72(4): 736-745. [18] Triantafyllou E, Woollard K J, Mcphail M J W, et al. The role of monocytes and macrophages in acute and acute-on-chronic liver failure[J]. Frontiers in Immunology, 2018, 9: 2948. [19] Chen P, Wang Y Y, Chen C, et al. The immunological roles in acute-on-chronic liver failure: an update[J]. International Journal of Hepatobiliary and Pancreatic Diseases, 2019, 18(5): 403-411. [20] Chen Y, Luo Y, Wu F, et al. Traditional Chinese medicine enema for acute chronic liver failure: a protocol of systematic review and meta-analysis of randomized clinical trials[J]. Medicine, 2020, 99(41): e22585. [21] Zhang N, Zhou C, Wang L, et al. Effectiveness and safety of Chinese herbal medicines for hepatitis B virus-related acute-on-chronic liver failure: study protocol for a multicenter randomized controlled trial[J]. Journal of Traditional Chinese Medicine, 2020, 40(6): 1052-1058. [22] Guo Y, Zhu Z, Wu W, et al. Liver transplantation in a patient with acute-on-chronic liver failure due to traditional Chinese medicine intoxication using donation after circulatory death from a renal transplant recipient: a case report[J]. Transplantation proceedings, 2020, 52(9): 2813-2816. [23] Hou W, Hao Y, Yang W, et al. The Jieduan-Niwan (JDNW) formula ameliorates hepatocyte apoptosis: a study of the inhibition of E2F1-mediated apoptosis signaling pathways in acute-on-chronic liver failure (ACLF) using rats[J]. Drug Design Development and Therapy, 2021, 15: 3845-3862. [24] 龙富立,毛德文,陈小明,等. 基于IL-17在CD4+T细胞表达比例观察解毒化瘀颗粒对慢加急性肝衰竭预后干预的研究[J]. 2017,28(4): 796-798. [25] Bunte K, Beikler T. Th17 cells and the IL-23/IL-17 axis in the pathogenesis of periodontitis and immune-mediated inflammatory diseases[J]. International Journal of Molecular Sciences, 2019, 20(14): 3394 [26] Yasuda K, Takeuchi Y, Hirota K. The pathogenicity of Th17 cells in autoimmune diseases[J]. Seminars in Immunopathology, 2019, 41(3): 283-97. [27] Ang Q Y, Alexander M, Newman J C, et al. Ketogenic diets alter the gut microbiome resulting in decreased intestinal Th17 cells[J]. Cell, 2020, 181(6): 1263-1275. [28] 刘巧红. 解毒化瘀通腑方对SALF及ACLF患者内毒素及TLR4/NF-κB通路的影响[D]. 郑州: 河南中医药大学,2017. [29] 廖陆雷,卓蕴慧. 大黄乌梅煎高位保留灌肠结合中药口服治疗瘀黄型慢加急性肝衰竭40例临床研究[J]. 时珍国医国药,2016,27(5): 1138-1140. [30] 刘子情,谭年花,郝若冰,等. 温阳解毒化瘀方对慢加急性肝衰竭大鼠肝组织白细胞介素-10/信号转导因子和转录激活因子3及相关因子表达的影响[J]. 中医临床研究,2017(15): 1-5. [31] 郝若冰,谭年花,刘子情,等. 温阳解毒化瘀方对慢加急性肝衰竭大鼠肝组织M1/M2型巨噬细胞免疫失衡的调控研究[J]. 中国医学创新,2022,19(11): 23-28. [32] 田甜,张秋云,魏晓艺,等. 菖蒲郁金汤化裁方对慢加急性肝衰竭大鼠血氨水平及脑组织神经胶质纤维酸性蛋白,水通道蛋白4表达的影响[J]. 北京中医药,2020,39(4): 321-325,F0003. [33] 李静,李翻红,田淑菊,等. 中医辨证论治治疗96例慢加急性肝衰竭前期乙肝肝郁脾虚证患者的疗效评价[J]. 中国中西医结合消化杂志,2020,28(4): 272-275,279. [34] 刘光伟,赵文霞,李明明,等. 健脾清化方药物血清对慢加急性肝衰竭患者体外T淋巴细胞及其细胞因子的影响[J]. 辽宁中医杂志,2017,44(4): 748-750. [35] 龚艳桥,黄丽,姜锦林. 赤芍解毒汤保留灌肠联合常规综合治疗慢加急性肝衰竭34例[J]. 中医研究,2018,31(3): 17-19. [36] 刘慧敏,王宪波,侯艺鑫,等. 解毒凉血方联合西药治疗乙型肝炎慢加急性肝衰竭患者64例临床观察[J]. 中医杂志,2013,54(21): 1829-1833. [37] Wu T, Li J, Shao L, et al. Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure[J]. Gut, 2018, 67(12): 2181-2191. [38] Zhao R H, Shi Y, Zhao H, et al. Acute-on-chronic liver failure in chronic hepatitis B: an update[J]. Expert Review of Gastroenterology and Hepatology, 2018, 12(4): 341-350. [39] 阮连国,张妍,朱清静,等. 解毒化瘀补虚法联合西药治疗乙型肝炎慢加急性肝衰竭临床研究[J]. 时珍国医国药,2016,27(10): 2460-2461. [40] 任文君,刘晓兰,黄珊,等. 自拟清热祛湿解毒汤辅助西医治疗乙型肝炎慢加急性肝衰竭前期患者疗效观察[J]. 中国中医急症,2020,29(1): 130-133. [41] 石清兰,袁果,毛德文,等. 解毒化瘀颗粒对慢性重型肝炎患者外周血单个核细胞Toll样受体4表达调控的研究[J]. 中西医结合肝病杂志,2013,23(2): 76-78. [42] 侯艺鑫,王宪波,杨志云,等. 解毒凉血健脾方治疗乙型肝炎病毒相关慢加急性肝衰竭高风险患者的随机对照临床研究[J]. 中国中西医结合杂志,2019,39(11): 1314-1319. [43] 朱冰冰,陈宇,高方媛,等. 凉血解毒法治疗乙肝慢加急性肝衰竭疗效的Meta分析[J]. 世界中医药,2022,17(8): 1086-1994.

相似文献/References:

[1]李瑞祥 陈斯宁.中医药对 COPD 大鼠模型作用机理的研究进展[J].大众科技,2014,16(05):95.
[2]廖咸硕.慢性乙型肝炎中医药治疗进展[J].大众科技,2014,16(10):124.
 Progress in the treatment of chronic hepatitis B with traditional Chinese medicine[J].Popular Science & Technology,2014,16(07):124.
[3]李鹏程 韦艾凌 张永琴 唐秋媛.中医药调控肝癌血管生成的研究近况[J].大众科技,2014,16(11):136.
 Research status on traditional Chinese medicine of angiogenesis inhepatocellular carcinoma[J].Popular Science & Technology,2014,16(07):136.
[4]万 媛.中医药协同治疗卒中后抑郁症的研究近况[J].大众科技,2014,16(12):98.
 The recent clinical research of Chinese-western therapy on post-stroke depression[J].Popular Science & Technology,2014,16(07):98.
[5]杨 赟 梁爱武.中医药对慢性阻塞性肺疾病MMP-9、TIMP-1 影响的研究进展[J].大众科技,2015,15(02):78.
 慢性阻塞性肺疾病;基质金属蛋白酶-9;金属蛋白酶组织抑制-1;气道重塑;中医药[J].Popular Science & Technology,2015,15(07):78.
[6]张艳娟,吴 光.中医药院校助力精准扶贫工作研究——以广西中医药大学定点扶贫为例[J].大众科技,2019,21(09):129.
 Research on Targeted Poverty Alleviation Work in Colleges and Universities of Traditional Chinese Medicine ——Take Guangxi University of Traditional Chinese Medicine as an Example[J].Popular Science & Technology,2019,21(07):129.
[7]陈曹华 李沛桢 周华亮 马潍珩 刘汝专.中医药治疗腰椎间盘突出症术后残留症状的研究进展[J].大众科技,2022,24(06):112.
 Research Status of Postoperative Residual Symptoms of Lumbar Intervertebral Disc Herniation Treated with Traditional Chinese Medicine[J].Popular Science & Technology,2022,24(07):112.
[8]桂雄斌 伏广虎.中医药治疗变应性鼻炎研究进展[J].大众科技,2018,20(06):61.
[9]韦卓 伍燕宏 郑景辉.血府逐瘀汤治疗心血管病的研究进展[J].大众科技,2018,20(06):63.
[10]兰鹏潘凤仙苏锦勋.脑卒中后肩手综合征的中医药外治法研究进展[J].大众科技,2018,20(06):71.

备注/Memo

备注/Memo:
【收稿日期】2022-04-28 【基金项目】广西自然科学基金资助项目(2018GXNSFBA281031);广西自然科学基金创新研究团队项目(2018GXNSF GA281002)。 【作者简介】王秀峰(1983-),女,广西中医药大学第一附属医院副主任医师,硕士,从事中西结合肝病临床与科研工作。 【通信作者】覃武海(1979-),男,玉林市中医医院副主任医师,从事中西结合防治肝病工作。
更新日期/Last Update: 2022-09-08