慢加急性肝衰竭中西医结合诊疗指南
DOI: 10.3969/j.issn.1001-5256.2023.07.006
利益冲突声明:本指南由中国中西医结合学会立项,参与指南制定的所有成员均已签署利益冲突声明,申明无和本指南主题相关的任何商业的、专业的或其他方面的利益,和所有可能被本指南成果影响的利益。本指南将在临床应用中进一步完善并及时更新。
Guidelines for the integrated traditional Chinese and Western medicine diagnosis and treatment of acute-on-chronic liver failure
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摘要: 慢加急性肝衰竭(ACLF)是在慢性肝病基础上,由各种诱因引起的以黄疸急性加深、凝血功能障碍等肝衰竭表现的临床症候群,短期内出现多脏器功能衰竭及高病死率是其主要特征。慢加急性肝衰竭中医学属于“急黄”“瘟黄”“肝瘟”等范畴,目前临床上尚缺乏特效的内科治疗手段。本指南以解决“中西医临床关键问题”为导向,工作组参考PICO(Participants、Interventions、Comparisons、Outcomes)原则构建ACLF相关临床问题,遵循循证医学原则,在对近10年ACLF中西医结合疗效临床证据进行系统梳理和客观评价的基础上,参考最新发表的国际、国内相关诊疗指南、专家共识等,并广泛征求多学科专家的意见,最终形成本指南, 旨在为临床医师诊断和治疗ACLF提供指导和参考意见,进一步提高我国ACLF诊治水平。Abstract: Acute-on-chronic liver failure (ACLF) is a clinical syndrome with the manifestations of liver failure such as acute deepening of jaundice and coagulation disorder due to various predisposing factors, characterized by multiple organ failure and high mortality rate within a short period of time. In terms of traditional Chinese medicine, ACLF belongs to the categories of "acute jaundice", "scourge jaundice", and "liver failure", and now there is still a lack of specific medical treatment methods in clinical practice. With the orientation of "key clinical problems of traditional Chinese and Western medicine" in the guidelines, the working group constructed the clinical problems associated with ACLF based on the principles of Participants, Interventions, Comparisons, and Outcomes and followed the principles of evidence-based medicine. Through systematic review and objective evaluation of the clinical evidence concerning the efficacy of integrated traditional Chinese and Western medicine therapy for ACLF in the past 10 years, the guidelines were developed with reference to the latest diagnosis and treatment guidelines and expert consensus in China and globally and the comments from multidisciplinary experts, in order to provide guidance and reference for the diagnosis and treatment of ACLF among clinicians and further improve the diagnosis and treatment level of ACLF in China.
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表 1 GRADE证据等级分级表
证据质量 详细说明 高(A) 进一步研究不可能改变对该疗效评估结果的可信度 中(B) 进一步研究有可能影响该疗效评估结果的可信度,且可能改变该评估结果 低(C) 进一步研究很有可能影响该疗效评估结果的可信度,且很可能改变该评估结果 -
慢加急性肝衰竭中西医结合诊疗指南.pdf