PDF下载 ( 637 KB)
Guidelines for TCM diagnosis and treatment of autoimmune hepatitis
-
摘要: 自身免疫性肝炎是一种由免疫介导的针对肝细胞的肝实质炎症损伤。近年来自身免疫性肝炎的发病率呈逐年上升趋势，为进一步统一和完善自身免疫性肝炎的中医药诊疗路径及规范，提高中医药治疗自身免疫性肝炎的临床疗效，依据循证医学证据，根据中医标准化和相关技术指导文件要求，起草组编写本指南，供临床医师参考。本指南经由中华中医药学会批准发布，标准编号：T/CACM 1630-2024。Abstract: Autoimmune hepatitis （AIH） is an immune-mediated inflammatory injury of the hepatic parenchyma targeting hepatocytes. In recent years， the incidence rate of AIH has tended to increase year by year. To further unify and refine the traditional Chinese medicine （TCM） diagnostic and therapeutic pathways and standards for AIH and to improve the clinical efficacy of TCM in the treatment of AIH， this guideline was developed by the drafting group based on evidence-based medicine in accordance with the requirements of TCM standardization and relevant technical guidance documents for the reference of clinicians. This guideline was approved and issued by China Association of Chinese Medicine， with the standard number of T/CACM 1630-2024.
-
表 1 GRADE系统证据质量等级
Table 1. Quality of evidence based on the GRADE system
质量等级 具体描述 高（A） 非常确信真实的效应值接近效应估计值 中（B） 对效应估计值有中等程度的信心：真实值有可能接近估计值，但仍存在二者大不相同的可能性 低（C） 对效应估计值确信程度有限：真实值可能与估计值大不相同 极低（D） 对效应估计值几乎没有信心：真实值很可能与估计值大不相同 注：GRADE，推荐意见分级评价、制定与评估。
下载: 导出CSV
表 2 GRADE系统推荐强度等级
Table 2. Strengthen of recommendation based on the GRADE system
推荐强度 具体描述 强推荐 明确显示干预措施利大于弊或者弊大于利 弱推荐 利弊不确定或无论质量高低的证据均显示利弊相当 注：GRADE，推荐意见分级评价、制定与评估。
下载: 导出CSV
-
[1] Wang G Q, Tanaka A, Zhao H, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidance: The diagnosis and management of patients with autoimmune hepatitis[J]. Hepatol Int, 2021, 15( 2): 223- 257. DOI: 10.1007/s12072-021-10170-1. [2] Mack C L, Adams D, Assis D N, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases[J]. Hepatology, 2020, 72( 2): 671- 722. DOI: 10.1002/hep.31065. [3] European Association for the Study of the Liver. EASL clinical practice guidelines: Autoimmune hepatitis[J]. J Hepatol, 2015, 63( 4): 971- 1004. DOI: 10.1016/j.jhep.2015.06.030. [4] Tanaka A. Autoimmune hepatitis: 2019 update[J]. Gut Liver, 2020, 14( 4): 430- 438. DOI: 10.5009/gnl19261. [5] Floreani A, Restrepo-Jiménez P, Secchi M F, et al. Etiopathogenesis of autoimmune hepatitis[J]. J Autoimmun, 2018, 95: 133- 143. DOI: 10.1016/j.jaut.2018.10.020. [6] Pape S, Schramm C, Gevers T J. Clinical management of autoimmune hepatitis[J]. U Eur Gastroenterol J, 2019, 7( 9): 1156- 1163. DOI: 10.1177/2050640619872408. [7] Czaja A J. Natural history, clinical features, and treatment of autoimmune hepatitis[J]. Semin Liver Dis, 1984, 4( 1): 1- 12. DOI: 10.1055/s-2008-1040641. [8] Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of autoimmune hepatitis(2021)[J]. J Clin Hepatol, 2022, 38( 1): 42- 49. DOI: 10.3760/cma.j.cn112138-20211112-00796.中华医学会肝病学分会. 自身免疫性肝炎诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38( 1): 42- 49. DOI: 10.3760/cma.j.cn112138-20211112-00796. [9] Doycheva I, Watt K D, Gulamhusein A F. Autoimmune hepatitis: Current and future therapeutic options[J]. Liver Int, 2019, 39( 6): 1002- 1013. DOI: 10.1111/liv.14062. [10] Braga A, Vasconcelos C, Braga J. Autoimmune hepatitis and pregnancy[J]. Best Pract Res Clin Obstet Gynaecol, 2020, 68: 23- 31. DOI: 10.1016/j.bpobgyn.2020.03.007. [11] Rizvi S, Gawrieh S. Autoimmune hepatitis in the elderly: Diagnosis and pharmacologic management[J]. Drugs Aging, 2018, 35( 7): 589- 602. DOI: 10.1007/s40266-018-0556-0. [12] Jin Chao, Pan Jielu, Yu Xiao, et al. Advances in the clinical treatment of autoimmune hepatitis[J]. J Clin Hepatol, 2019, 35( 10): 2331- 2334. DOI: 10.3969/j.issn.1001-5256.2019.10.044.金超, 潘洁露, 喻晓, 等. 自身免疫性肝炎临床治疗进展[J]. 临床肝胆病杂志, 2019, 35( 10): 2331- 2334. DOI: 10.3969/j.issn.1001-5256.2019.10.044. [13] Wang Ying, Zheng Wei, Ma Junfu, et al. Literature metrology research for the treatment of autoimmune hepatitis by traditional Chinese medicine[J]. Chin Arch Tradit Chin Med, 2016, 34( 12): 2861- 2864. DOI: 10.13193/j.issn.1673-7717.2016.12.012.王颖, 郑炜, 马俊福, 等. 中医药治疗自身免疫性肝炎的文献计量研究[J]. 中华中医药学刊, 2016, 34( 12): 2861- 2864. DOI: 10.13193/j.issn.1673-7717.2016.12.012. [14] Pu Shibiao, Wang Jiabo, Wang Ruilin, et al. Advantages and challenges of treatment on autoimmune hepatitis by traditional Chinese medicine and integrative medicine[J]. Chin J Exp Tradit Med Formulae, 2016, 22( 23): 197- 202. DOI: 10.13422/j.cnki.syfjx.2016230197.浦仕彪, 王伽伯, 王睿林, 等. 中医和中西医结合治疗自身免疫性肝炎的优势与挑战[J]. 中国实验方剂学杂志, 2016, 22( 23): 197- 202. DOI: 10.13422/j.cnki.syfjx.2016230197. [15] Zhang Hongxia, Zhou Lu, Wang Bangmao. Advances in the application of anti-inflammatory and liver-protecting drugs in treatment of autoimmune hepatitis[J]. J Clin Hepatol, 2017, 33( 3): 588- 592. DOI: 10.3969/j.issn.1001-5256.2017.03.042.张红霞, 周璐, 王邦茂. 抗炎保肝药在自身免疫性肝炎治疗中的应用进展[J]. 临床肝胆病杂志, 2017, 33( 3): 588- 592. DOI: 10.3969/j.issn.1001-5256.2017.03.042. [16] Tian Qiuhong, Liu Wei. Progress in clinical research of Chinese and western medicine for autoimmune hepatitis[J]. J Liaoning Univ Tradit Chin Med, 2019, 21( 9): 104- 108. DOI: 10.13194/j.issn.1673-842x.2019.09.026.田秋红, 刘维. 自身免疫性肝炎中西医临床研究进展[J]. 辽宁中医药大学学报, 2019, 21( 9): 104- 108. DOI: 10.13194/j.issn.1673-842x.2019.09.026. [17] Li Sheng, Shi Meijie, Xiao Huanming, et al. Data mining for diagnosis and treatment law of autoimmune hepatitis based on Chinese medical records[J]. J Tradit Chin Med, 2017, 58( 14): 1237- 1240. DOI: 10.13288/j.11-2166/r.2017.14.017.黎胜, 施梅姐, 萧焕明, 等. 自身免疫性肝炎中医医案诊治规律数据挖掘[J]. 中医杂志, 2017, 58( 14): 1237- 1240. DOI: 10.13288/j.11-2166/r.2017.14.017. [18] Wang Siying, Zhao Wenxia. Understanding of autoimmune hepatitis in traditional Chinese medicine[J]. Chin Med Mod Distance Educ China, 2020, 18( 1): 137- 140. DOI: 10.3969/j.issn.1672-2779.2020.01.056.王思颖, 赵文霞. 中医学对自身免疫性肝炎的认识[J]. 中国中医药现代远程教育, 2020, 18( 1): 137- 140. DOI: 10.3969/j.issn.1672-2779.2020.01.056. [19] Wang Encang. Clinical study on Xiaoyao powder combined with Taohong Siwu decoction in the treatment of autoimmune hepatitis with qi stagnation and blood stasis[J]. Renowned Doctor, 2023( 10): 165- 167.王恩仓. 逍遥散合桃红四物汤加味治疗气滞血瘀型自身免疫性肝炎的临床研究[J]. 名医, 2023( 10): 165- 167. [20] Fu Hongwei, Jin Yuli, Zhang Lei, et al. Clinical observation on 34 cases of autoimmune hepatitis treated by the method of soothing liver, tonifying kidney and removing stasis[J]. Hebei J Tradit Chin Med, 2012, 34( 2): 198- 199. DOI: 10.3969/j.issn.1002-2619.2012.02.018.傅红卫, 金毓莉, 张蕾, 等. 疏肝补肾化瘀法治疗自身免疫性肝炎34例临床观察[J]. 河北中医, 2012, 34( 2): 198- 199. DOI: 10.3969/j.issn.1002-2619.2012.02.018. [21] Li Shuangquan, Li Bianhua. 13 cases of autoimmune hepatitis treated by Zishui Qinggan decoction[J]. Chin J Integr Med Cardio Cerebrovascular Dis, 1999( 6): 21- 22.李双全, 李变华. 滋水清肝饮为主治疗自身免疫性肝炎13例[J]. 中医药研究, 1999( 6): 21- 22. [22] Wang Yi, Zhang Wei. 46 cases of autoimmune hepatitis treated by fuzheng Quyu decoction[J]. Shaanxi J Tradit Chin Med, 2009, 30( 9): 1126.王奕, 张玮. 扶正祛瘀汤治疗自身免疫性肝炎46例[J]. 陕西中医, 2009, 30( 9): 1126. [23] Shijie Jie, Zhang Zhenxian. Clinical observation on Xiaoyao Powder in treating autoimmune hepatitis[J]. Guangming J Chin Med, 2008, 23( 5): 640- 641.介世杰, 张珍先. 逍遥散加减治疗自身免疫性肝炎临床观察[J]. 光明中医, 2008, 23( 5): 640- 641. [24] Chen Jing. Clinical investigation on six-ingredient rehmanuia decoction for autoimmune hepatitis[J]. Chin Tradit Pat Med, 2001, 23( 3): 188- 190. DOI: 10.3969/j.issn.1001-1528.2001.03.013.陈静. 六味地黄汤治疗自身免疫性肝炎的临床观察[J]. 中成药, 2001, 23( 3): 188- 190. DOI: 10.3969/j.issn.1001-1528.2001.03.013. -
本文二维码
表(2)
计量
- 文章访问数: 18
- HTML全文浏览量: 9
- PDF下载量: 2
- 被引次数: 0
