慢加急性肝衰竭的证候演变及证治思路
Syndrome evolution of acute-on-chronic liver failure and ideas for diagnosis and treatment
摘要
Abstract
Acute-on-chronic liver failure(ACLF)is an acute and critical illness with a high short-term mortality rate,and current therapies mainly focus on elimination of causes,organ support,and prevention of complications.Although liver transplantation is the most effective treatment modality,its clinical application is limited,and traditional Chinese medicine has shown significant advantages and characteristics in the treatment of ACLF.In traditional Chinese medicine,ACLF is classified into the same category as diseases such as"jaundice",and unlike traditional jaundice which is mostly characterized by excess and heat syndromes,the syndrome of ACLF has gradually transformed from Yang jaundice to Yin jaundice due to the changing disease spectrum of ACLF.With reference to the pathogenesis of ACLF in Western medicine and traditional Chinese medicine theories,this article discusses the essential pathogenesis of ACLF in traditional Chinese medicine,explores the evolution of ACLF syndromes,and reviews the research advances in the clinical efficacy and mechanisms of traditional Chinese medicine based on the three-factor differentiation-based treatment of damp-heat,blood stasis-heat,and spleen deficiency,as well as the safety of spleen-strengthening and Yang-warming drugs in the clinical treatment of ACLF,in order to provide ideas,methods,and evidence for the application of traditional Chinese medicine in ACLF.关键词
慢加急性肝功能衰竭/证候/湿热/瘀热/脾虚Key words
Acute-On-Chronic Liver Failure/Symptom Complex/Dampness Heat/Stagnant Heat/Spleen Deficiency引用本文复制引用
张茜茜,黄玉,孙克伟..慢加急性肝衰竭的证候演变及证治思路[J].临床肝胆病杂志,2025,41(6):1008-1015,8.基金项目
国家科技重大专项(2008ZX10005-007) （2008ZX10005-007）
国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023146) （zyyzdxk-2023146）
国家中医临床研究基地业务建设科研专项(JDZX2012061) （JDZX2012061）
国家自然科学基金面上项目(81973833,81673959) （81973833,81673959）
国家中医药管理局科研基金(JDZX2012061) （JDZX2012061）
湖南省自然科学基金面上项目(2025JJ50697,2020JJ4475) National Science and Technology Major Project(2008ZX10005-007) （2025JJ50697,2020JJ4475）
High Level Key Discipline Construction Project of Traditional Chinese Medicine by the State Administration of Traditional Chinese Medicine(zyyzdxk-2023146) （zyyzdxk-2023146）
National Traditional Chinese Medicine Clinical Research Base Business Contruction Research Special Project(JDZX2012061) （JDZX2012061）
General Project of National Natural Science Foundation of China(81973833,81673959) （81973833,81673959）
Scientific Research Fund of State Administration of Traditional Chinese Medicine(JDZX2012061) （JDZX2012061）
General Project of Natural Science Foundation of Hunan Province(2025JJ50697,2020JJ4475) （2025JJ50697,2020JJ4475）
