Expert consensus on the diagnosis and treatment of acute-on-chronic liver failure with integrated traditional Chinese and Western medicine
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Key words:
- Acute-on-Chronic Liver Failure /
- TCM WM THERAPY /
- Consensus
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表 1 证据评价分级和推荐等级分级标准
级别 详细说明 证据级别 Ⅰ 大样本(≥100例),随机研究,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1) Ⅳ 非随机,历史对照和当代专家共识2) Ⅴ 病例报道,非对照研究和专家意见3) 推荐等级 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 注:1)基于古代文献的专家共识指古代医籍记载,历代沿用至今,当代专家调查意见达成共识者;2)当代专家共识指当代专家调查意见达成共识;3)专家意见仅指个别专家意见。 -
[1] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2012)[J]. Chin J Hepatol, 2019, 35(1): 38-44. DOI: 10.3760/cma.j.issn.1007-3418.2013.03.006.中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2012年版)[J]. 中华肝脏病杂志, 2013, 21(3): 177-183. DOI: 10.3760/cma.j.issn.1007-3418.2013.03.006. [2] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35(1): 38-44. DOI: 10.3969/j.issn.1001-5256.2019.01.007. [3] SARIN SK, KUMAR A, ALMEIDA JA, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)[J]. Hepatol Int, 2009, 3(1): 269-282. DOI: 10.1007/s12072-008-9106-x. [4] MOREAU R, JALAN R, GINES P, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis[J]. Gastroenterology, 2013, 144(7): 1426-1437. e1-e9. DOI: 10.1053/j.gastro.2013.02.042. [5] SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific association for the study of the liver (APASL): An update[J]. Hepatol Int, 2019, 13(4): 353-390. DOI: 10.1007/s12072-019-09946-3. [6] MVCKE MM, RUMYANTSEVA T, MVCKE VT, et al. Bacterial infection-triggered acute-on-chronic liver failure is associated with increased mortality[J]. Liver Int, 2018, 38(4): 645-653. DOI: 10.1111/liv.13568. [7] SZABO G. Pathogenesis of acute-on-chronic liver failure in patients with infection[J]. Clin Liver Dis (Hoboken), 2019, 14(3): 103-106. DOI: 10.1002/cld.826. [8] CASULLERAS M, ZHANG IW, LÓPEZ-VICARIO C, et al. Leukocytes, systemic inflammation and immunopathology in acute-on-chronic liver failure[J]. Cells, 2020, 9(12): 2632. DOI: 10.3390/cells9122632. [9] CLÀRIA J, STAUBER RE, COENRAAD MJ, et al. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure[J]. Hepatology, 2016, 64(4): 1249-1264. DOI: 10.1002/hep.28740. [10] TRIANTAFYLLOU E, POP OT, POSSAMAI LA, et al. MerTK expressing hepatic macrophages promote the resolution of inflammation in acute liver failure[J]. Gut, 2018, 67(2): 333-347. DOI: 10.1136/gutjnl-2016-313615. [11] WANG Y, ZHANG H, CHEN Q, et al. TNF-α/HMGB1 inflammation signalling pathway regulates pyroptosis during liver failure and acute kidney injury[J]. Cell Prolif, 2020, 53(6): e12829. DOI: 10.1111/cpr.12829. [12] SUN KW, CHEN B, HUANG YH, et al. Clinical observation on chronic severe hepatitis B treated by principles of Cooling-Blood and Detoxicating Combined with Clearing-Heat and Resolving-Damp or Combined with Strengthening-Pi and Warming-Yang[J]. Chin J Integr Trad West Med, 2006, 26(11): 981-983. DOI: 10.3321/j.issn:1003-5370.2006.11.005.孙克伟, 陈斌, 黄裕红, 等. 凉血解毒、清热化湿和凉血解毒、健脾温阳法治疗慢性重型肝炎的临床观察[J]. 中国中西医结合杂志, 2006, 26(11): 981-983. DOI: 10.3321/j.issn:1003-5370.2006.11.005. [13] WANG XB, LI B, LIU HM. Experience in the detoxicating, blood-cooling, spleen-strengthening, and dampness-removing therapy for treatment of acute-on-chronic hepatitis B liver failure[J]. J Tradit Chin Med, 2012, 53(20): 1772-1776. DOI: 10.13288/j.11-2166/r.2012.20.017.王宪波, 李斌, 刘慧敏. 解毒凉血、健脾化湿法治疗乙型肝炎慢加急性肝功能衰竭体会[J]. 中医杂志, 2012, 53(20): 1772-1776. DOI: 10.13288/j.11-2166/r.2012.20.017. [14] Infectious Disease Committee, China Society of Integrated Traditional Chinese and Western Medicine, Liver Disease Committee, China Society of Integrated Traditional Chinese and Western Medicine, Branch of Hepatobiliary Diseases, China Association of Chinese Medicine. Recommendations for integrated traditional Chinese and Western medicine diagnosis and treatment of HBV-related acute-on-chronic liver failure[J]. J Clin Hepatol, 2019, 35(6): 1215-1221. DOI: 10.3969/j.issn.1001-5256.2019.06.009.中国中西医结合学会传染病专业委员会, 中国中西医结合学会肝病专业委员会, 中华中医药学会肝胆病分会. HBV相关慢加急性肝衰竭中西医结合诊疗推荐意见[J]. 临床肝胆病杂志, 2019, 35(6): 1215-1221. DOI: 10.3969/j.issn.1001-5256.2019.06.009 [15] YANG Y, LI XH. Correlation analysis between biochemical indicators and TCM attributes in HBV-related acute-on-chronic liver failure[J]. Beijing J Tradit Chin Med, 2019, 38(3): 207-211. DOI: 10.16025/j.1674-1307.2019.03.003.杨洋, 李秀惠. HBV相关慢加急性肝衰竭患者生化指标与中医虚实属性的相关性分析[J]. 北京中医药, 2019, 38(3): 207-211. DOI: 10.16025/j.1674-1307.2019.03.003. [16] QIN LX, ZHOU XL, TANG N, et al. Exploration on pathogenesis and therapeutic methods of acute-on-chronic liver failure based on Strengthening Yang Thought[J]. Shandong J Tradit Chin Med, 2019, 38(11): 1010-1013. DOI: 10.16295/j.cnki.0257-358x.2019.11.004.覃绿星, 周晓玲, 唐农, 等. 基于扶阳思想探讨慢加急性肝衰竭病机及治法[J]. 山东中医杂志, 2019, 38(11): 1010-1013. DOI: 10.16295/j.cnki.0257-358x.2019.11.004. [17] YIN GH, WEN T. Clinical study on Liangxue Jiedu Huayu Tang for hepatitis B virus-associated acuteon-chronic liver failure[J]. J New Chin Med, 2020, 52(17): 81-83. DOI: 10.13457/j.cnki.jncm.2020.17.024.殷光辉, 闻涛. 凉血解毒化瘀汤治疗乙肝相关性慢加急性肝衰竭临床研究[J]. 新中医, 2020, 52(17): 81-83. DOI: 10.13457/j.cnki.jncm.2020.17.024. [18] WANG XF, ZHONG YQ, ZHANG RZ, et al. Effect of Wenyang Huazhuo Tuihuang decoction on hepatitis B-related acute-on-chronic liver failure[J]. J Emerg Tradit Chin Med, 2019, 28(9): 1540-1542. DOI: 10.3969/j.issn.1004-745X.2019.09.010.王秀峰, 钟云青, 张荣臻, 等. 温阳化浊退黄汤治疗乙肝相关慢加急性肝衰竭的临床研究[J]. 中国中医急症, 2019, 28(9): 1540-1542. DOI: 10.3969/j.issn.1004-745X.2019.09.010. [19] ZHANG QY, LIU XH, WANG RB, et al. Distribution and combination of traditional Chinese medicine syndromes of chronic severe hepatitis B[J]. Beijing J Tradit Chin Med, 2008, 27(2): 87-90. https://www.cnki.com.cn/Article/CJFDTOTAL-BJZO200802004.htm张秋云, 李秀惠, 王融冰, 等. 慢性病毒性乙型重型肝炎中医证候分布及组合规律研究[J]. 北京中医药, 2008, 27(2): 87-90. https://www.cnki.com.cn/Article/CJFDTOTAL-BJZO200802004.htm [20] HU JH, QIAN Y, YAO NL, et al. Treatment of chronic severe hepatitis B by Jieduan Niwan method[J]. Chin J Integr Tradit West Med Liver Dis, 2010, 20(4): 200-203. DOI: 10.3969/j.issn.1005-0264.2010.04.003.胡建华, 钱英, 姚乃礼, 等. "截断逆挽法"治疗慢性乙型重型肝炎临床疗效观察[J]. 中西医结合肝病杂志, 2010, 20(4): 200-203. DOI: 10.3969/j.issn.1005-0264.2010.04.003. [21] CHEN B, ZHANG L, PENG J, et al. Retrospective study of clinical features and traditional Chinese medicine syndrome characteristics on HBV-ACLF Patients with Bacterial Infection[J]. Chin J Exp Med Formul, 2020, 26(2): 39-44. DOI: 10.13422/j.cnki.syfjx.20200224.陈斌, 张丽, 彭杰, 等. 乙型肝炎相关性慢加急性肝衰竭细菌感染临床特点及中医证候回顾性分析[J]. 中国实验方剂学杂志, 2020, 26(2): 39-44. DOI: 10.13422/j.cnki.syfjx.20200224. [22] ZHOU XZ, HAUNG QG, SUN XF, et al. Study on the principle of TCM syndrome distribution in patients with liver failure[J]. J Tradit Chin Med Univ Hunan, 2013, 33(1): 64-66. DOI: 10.3969/j.issn.1674-070X.2013.01.018.064.03.周小舟, 黄俏光, 孙新锋, 等. 肝衰竭中医证候分布规律研究[J]. 湖南中医药大学学报, 2013, 33(1): 64-66. DOI: 10.3969/j.issn.1674-070X.2013.01.018.064.03. [23] CHEN H, LI SH. Professor Li Xiu-hui's"Truncated Reversal Method"in the treatment of chronic liver failure[J]. Chin J Integr Tradit West Med Liver Dis, 2021, 31(1): 21-22. DOI: 10.3969/j.issn.1005-0264.2021.01.005.陈欢, 李秀惠. 李秀惠教授运用截断逆挽法治疗慢性肝衰竭验案[J]. 中西医结合肝病杂志, 2021, 31(1): 21-22. DOI: 10.3969/j.issn.1005-0264.2021.01.005. [24] Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007. [25] KEAYS R, HARRISON PM, WENDON JA, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: A prospective controlled trial[J]. BMJ, 1991, 303(6809): 1026-1029. DOI: 10.1136/bmj.303.6809.1026. [26] ZHU WF, SUN KE, CHEN B, et al. Effect of Wenyang Jiedu Huayu prescription on intestinal bacteria in patients with HBV related liver failure[J]. Chin J Integr Tradit West Med Liver Dis, 2014, 24(4): 214-216. DOI: 10.3969/j.issn.1005-0264.2014.04.007.朱文芳, 孙克伟, 陈斌, 等. 温阳解毒化瘀方对HBV相关肝衰竭患者肠道菌群的影响[J]. 中西医结合肝病杂志, 2014, 24(4): 214-216. DOI: 10.3969/j.issn.1005-0264.2014.04.007. [27] WANG RB, LIU JM, WU YZ, et al. Clinical study of compound formula Qingdutang on intestinal endotoxemia in patients with liver disease[J]. Chin J Integr Tradit West Med Liver Dis, 2004, 14(3): 135-137. DOI: 10.3969/j.issn.1005-0264.2004.03.003.王融冰, 刘军民, 吴云忠, 等. 清毒汤治疗肝病肠源性内毒素症临床观察[J]. 中西医结合肝病杂志, 2004, 14(3): 135-137. DOI: 10.3969/j.issn.1005-0264.2004.03.003. [28] LUO HY, SHEN Z, FAN H, et al. Clinical effect of retention enema with traditional Chinese medicine combined with artificial liver in treatment of acute-on-chronic liver failure[J]. Lishizhen Med Mater Med Res, 2020, 31(4): 907-909. DOI: 10.3969/j.issn.1008-0805.2020.04.042.罗海燕, 沈震, 范恒, 等. 中药保留灌肠联合人工肝治疗慢加急性肝衰竭的临床疗效观察[J]. 时珍国医国药, 2020, 31(4): 907-909. DOI: 10.3969/j.issn.1008-0805.2020.04.042. [29] TAN ZR, XU YJ, ZHANG Q, et al. Clinical effect of enema with Qudu Huchang decoction combined with Western medicine in treatment of intestinal endotoxemia in patients with HBV-related acute-on-chronic liver failure[J]. J Emerg Tradit Chin Med, 2018, 27(12): 2217-2219. DOI: 10.3969/j.issn.1004-745X.2018.12.047.谭峥嵘, 徐勇军, 张清, 等. 祛毒护肠汤灌肠辅助西药治疗HBV相关慢加急性肝衰竭肠源性内毒素血症疗效观察[J]. 中国中医急症, 2018, 27(12): 2217-2219. DOI: 10.3969/j.issn.1004-745X.2018.12.047. [30] WAHLSTRÖM A. Outside the liver box: The gut microbiota as pivotal modulator of liver diseases[J]. Biochim Biophys Acta Mol Basis Dis, 2019, 1865(5): 912-919. DOI: 10.1016/j.bbadis.2018.07.004. [31] YANG X, LU D, ZHUO J, et al. The gut-liver axis in immune remodeling: New insight into liver diseases[J]. Int J Biol Sci, 2020, 16(13): 2357-2366. DOI: 10.7150/ijbs.46405. [32] GAO R, LI Y, CAO Y, et al. Glucocorticoid versus traditional therapy for hepatitis B virus-related acute-on-chronic liver failure: A systematic review and meta-analysis[J]. Medicine (Baltimore), 2020, 99(25): e20604. DOI: 10.1097/MD.0000000000020604. [33] Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis(2018, Beijing)[J/CD]. Chin J Gastrointestinal Endosc(Electronic Edition), 2018, 5(3): 97-113. DOI: 10.3877/cma.j.issn.2095-7157.2018.03.001.中华医学会肝病学分会. 肝硬化肝性脑病诊疗指南(2018年, 北京)[J/CD]. 中华胃肠内镜电子杂志, 2018, 5(3): 97-113. DOI: 10.3877/cma.j.issn.2095-7157.2018.03.001. [34] LIU LM, WANG LT, CHEN JJ, et al. Effect of Qingkai Granule on patients with subclinical hepatic encephalopathy of intelligence test and evoked potential[J]. Chin Tradit Patent Med, 2006, 28(3): 372-375. DOI: 10.3969/j.issn.1001-1528.2006.03.018.刘龙民, 王灵台, 陈建杰, 等. 清开颗粒对亚临床肝性脑病患者智力测试与诱发电位的影响[J]. 中成药, 2006, 28(3): 372-375. DOI: 10.3969/j.issn.1001-1528.2006.03.018. [35] GONG M, ZHOU C, ZHANG N, et al. Clinical effect of integrated traditional Chinese and Western medicine therapy in patients with hepatitis B virus-related acute-on-chronic liver failure complicated by hepatic encephalopathy[J]. J Clin Hepatol, 2018, 34(4): 795-800. DOI: 10.3969/j.issn.1001-5256.2018.04.020.宫嫚, 周超, 张宁, 等. 中西医结合治疗HBV相关慢加急性肝衰竭合并肝性脑病的效果分析[J]. 临床肝胆病杂志, 2018, 34(4): 795-800. DOI: 10.3969/j.issn.1001-5256.2018.04.020. [36] ZHOU ZE, LU P, HAN L, et al. A multi-center randomized parallel-controlled clinical study on efficiency of Rhubarb Decoction Retention Enema Combined with Western Medicine in Treating Hepatic Encephalopathy[J]. Liaoning J Tradit Chin Med, 2014, 41(9): 1918-1921. DOI: 10.13192/j.issn.1000-1719.2014.09.053.周智恩, 卢萍, 韩丽, 等. 大黄煎剂保留灌肠联合西药治疗肝性脑病多中心随机平行对照研究[J]. 辽宁中医杂志, 2014, 41(9): 1918-1921. DOI: 10.13192/j.issn.1000-1719.2014.09.053. [37] MOSSAD SB. Management of infections in solid organ transplant recipients[J]. Infect Dis Clin North Am, 2018, 32(3): xiii-xvii. DOI: 10.1016/j.idc.2018.06.001. [38] UOJIMA H, KINBARA T, HIDAKA H, et al. Close correlation between urinary sodium excretion and response to tolvaptan in liver cirrhosis patients with ascites[J]. Hepatol Res, 2017, 47(3): e14-e21. DOI: 10.1111/hepr.12716. [39] Branch of Gastrointestinal Diseases, China Association of Chinese Medicine. Expert consensus on TCM diagnosis and treatment of ascites due to cirrhosis (2017)[J]. J Clin Hepatol, 2017, 33(9): 1621-1626. DOI: 10.3969/j.issn.1001-5256.2017.09.002.中华中医药学会脾胃病分会. 肝硬化腹水中医诊疗专家共识意见(2017)[J]. 临床肝胆病杂志, 2017, 33(9): 1621-1626. DOI: 10.3969/j.issn.1001-5256.2017.09.002. [40] Special Committee of Kidney Diseases, Chinese Association of Integrative Medicine. Guidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of chronic renal failure[J]. Hebei J TCM, 2016, 38(2): 313-317. DOI: 10.3969/j.issn.1002-2619.2016.02.049.中国中西医结合学会肾脏疾病专业委员会. 慢性肾衰竭中西医结合诊疗指南[J]. 河北中医, 2016, 38(2): 313-317. DOI: 10.3969/j.issn.1002-2619.2016.02.049. [41] LIU HM, WANG XB, HOU YX, et al. Clinical effect of Jiedu Liangxue prescription combined with Western medicine in treatment of hepatitis B virus-associated acute-on-chronic liver failure: An analysis of 64 cases[J]. J Tradit Chin Med, 2013, 54(21): 1829-1833. DOI: 10.13288/j.11-2166/r.2013.21.027.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. DOI: 10.13288/j.11-2166/r.2013.21.027. [42] LIU HM, WANG XB, HOU YX, et al. Clinical effect of modified Jiedu Liangxue prescription in treatment of acute-on-chronic hepatitis B liver failure: A randomized controlled clinical study[J]. Chin J Integr Trad West Med, 2014, 34(4): 412-417. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201404006.htm刘慧敏, 王宪波, 侯艺鑫, 等. 解毒凉血方加减治疗乙型肝炎慢加急性肝衰竭的随机对照临床研究[J]. 中国中西医结合杂志, 2014, 34(4): 412-417. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201404006.htm [43] ZHOU C, GONG M, ZHANG N, et al. Study on the intervention of integrated traditional Chinese and Western medicine therapy in patients with hepatitis B virus-related acute-on-chronic liver failure[J]. Chin J Integr Tradit West Med Liver Dis, 2019, 29(3): 203-207. DOI: 10.3969/j.issn.1005-0264.2019.03.004.周超, 宫嫚, 张宁, 等. 中西医结合治疗方案干预乙型肝炎病毒相关慢加急性肝衰竭的疗效分析[J]. 中西医结合肝病杂志, 2019, 29(3): 203-207. DOI: 10.3969/j.issn.1005-0264.2019.03.004. [44] WANG LF, LI Y, LI FN, et al. Analysis the curative efficacy of combination of Chinese and Western medicine treatment the hepatitis B virus associated hepatic failure[J]. Chin J Integr Tradit West Med Liver Dis, 2018, 28(2): 70-74. DOI: 10.3969/j.issn.1005-0264.2018.02.002.王立福, 李筠, 李丰衣, 等. 中西医结合治疗乙型肝炎病毒相关肝衰竭的疗效分析[J]. 中西医结合肝病杂志, 2018, 28(2): 70-74. DOI: 10.3969/j.issn.1005-0264.2018.02.002. [45] SANG PM, GIMLAI D, WANG LS, et al. Survival analysis of "Yang Jaundice-Yin-Yang Jaundices-Yin Jaundice" syndrome differentiation combined with western medicine in the treatment of patients with hbv-related acute-on-chronic liver failure[J]. J Tradit Chin Med, 2019, 60(7): 582-586. DOI: 10.13288/j.11-2166/r.2019.07.010.桑培敏, 达呼巴雅尔, 王乐三, 等. 阳黄-阴阳黄-阴黄辨证论治联合西药治疗乙型肝炎相关慢加急性肝衰竭患者生存分析[J]. 中医杂志, 2019, 60(7): 582-586. DOI: 10.13288/j.11-2166/r.2019.07.010. [46] DANG ZB, DANG ZQ, WANG YL, et al. Clinical study on combination of chinese and western medicine treatment of hepatitis B virus-acute on chronic liver failure[J]. China J Chin Med, 2017, 32(8): 1491-1494. DOI: 10.16368/j.issn.1674-8999.2017.08.393.党志博, 党中勤, 王宇亮, 等. 中西医结合治疗乙型肝炎慢加急性肝功能衰竭临床研究[J]. 中医学报, 2017, 32(8): 1491-1494. DOI: 10.16368/j.issn.1674-8999.2017.08.393. [47] GUO YM, LI FY, GONG M, et al. Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial[J]. Chin J Integr Med, 2016, 22(8): 573-580. DOI: 10.1007/s11655-016-2582-2. [48] ZHU J, ZHANG XM. The clinical study on treatment of late-stage HBV-related acute-on-chronic liver failure with Chinese Medicine Compound of Wenyang Tongluo combined with Western Medicine Comprehensive Therapy[J]. Med Frontier, 2018, 8(26): 340-343. DOI: 10.3969/j.issn.2095-1752.2018.26.289.朱静, 张雪梅. 温阳通络中药复方联合西医综合疗法治疗HBV相关性慢加急性肝衰竭晚期的临床研究[J]. 医药前沿, 2018, 8(26): 340-343. DOI: 10.3969/j.issn.2095-1752.2018.26.289. [49] LI HM, YE ZH, ZHANG J, et al. Clinical trial with traditional Chinese medicine intervention "'tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"' for chronic hepatitis B-associated liver failure[J]. World J Gastroenterol, 2014, 20(48): 18458-18465. DOI: 10.3748/wjg.v20.i48.18458. [50] ZENG YX, TAN LX, MA XW, et al. Clinical effect of colon lavage and dialysis combined with traditional Chinese medicine enema in treatment of acute-on-chronic hepatitis B liver failure: An analysis of 40 cases[J]. Hunan J Tradit Chin Med, 2021, 37(1): 41-43. DOI: 10.16808/j.cnki.issn1003-7705.2021.01.014.曾岳祥, 谭兰香, 马新文, 等. 结肠灌洗透析联合中药灌肠治疗乙型肝炎相关慢加急性肝衰竭40例[J]. 湖南中医杂志, 2021, 37(1): 41-43. DOI: 10.16808/j.cnki.issn1003-7705.2021.01.014. [51] TANG BZ, YANG ZG, YE C, et al. Clinical observation on oral administration and enema of traditional Chinese medicine combined with conventional therapy in treatment of hepatitis B virus associated acute-on-chronic liver failure at early and middle stages[J]. Shanghai J Tradit Chin Med, 2019, 53(8): 60-64. DOI: 10.16305/j.1007-1334.2019.08.015.汤伯宗, 杨宗国, 叶晨, 等. 中药内服、灌肠联合常规疗法治疗早中期乙型肝炎病毒相关慢加急性肝衰竭的临床观察[J]. 上海中医药杂志, 2019, 53(8): 60-64. DOI: 10.16305/j.1007-1334.2019.08.015. [52] ZHANG LY, ZHANG XR. Clinical study of chishao jiedu decoction retention enema combined with routine comprehensive therapy for chronic and acute liver failure[J]. Systems Med, 2019, 4(13): 138-140. DOI: 10.19368/j.cnki.2096-1782.2019.13.138.张龙跃, 张序瑞. 赤芍解毒汤保留灌肠治疗慢加急性肝衰竭临床研究[J]. 系统医学, 2019, 4(13): 138-140. DOI: 10.19368/j.cnki.2096-1782.2019.13.138. [53] BI QC, LIN MR. The observation on the curative effect of the holistic nursing care following Traditional Chinese Medicine theory on patients with edema of acute-on-chronic liver failure[J]. Chin Med Modern Distance Educ of China, 2017, 15(23): 125-127. DOI: 10.3969/j.issn.1672-2779.2017.23.055.毕启超, 林敏如. 慢加急性肝衰竭水肿患者的中医整体护理疗效观察[J]. 中国中医药现代远程教育, 2017, 15(23): 125-127. DOI: 10.3969/j.issn.1672-2779.2017.23.055.
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