摘要
综述肝硬化门静脉高压症(CPHT)的中西医结合诊断和治疗研究进展。CPHT是肝硬化失代偿期以门静脉系统压力升高为主要病理特征,并继发包括食管-胃底静脉曲张、难治性腹水、肝性脑病等一系列症状的临床证候群。目前CPHT主要基于肝静脉压力梯度进行诊断和分级,但该法临床常规开展难度较大,因此各种无创诊断方法成为研究热点。该病的治疗目的为降低门静脉压力,预防和治疗各种严重并发症,治疗方案有解除病因、对症治疗、抗肝纤维化、减少门静脉血流、降低肝内阻力等,涉及药物、内镜、介入、外科等多种治疗手段。中医治疗CPHT的主要模式为病证结合,中西医结合疗法治疗本病具有一定的疗效优势,未来需进一步明确中西医结合的优势环节和作用机制,并形成规范化的中西医结合诊疗指南,以更好地指导临床实践。
This paper reviews the advances in the diagnosis and treatment of cirrhotic portal hypertension(CPHT)with integrated traditional Chinese and Western medicine(ITCWM).CPHT is a series of clinical syndromes in decompensated cirrhosis characterized by elevated pressure in the portal venous system,with secondary disorders such as esophagogastric varices,refractory ascites,and hepatic encephalopathy.Currently,CPHT is mainly diagnosed and graded based on the hepatic venous pressure gradient measurement,but it is difficult to be carried out routinely in clinical practice.Therefore,various non-invasive diagnostic methods have become a hot research topic.The aim of CPHT treatment is to reduce portal vein pressure,prevent and treat various serious complications.The treatment options include etiological treatment,symptomatic treatment,antihepatic fibrosis,reducing portal venous blood flow,and lowering intrahepatic resistance,etc.,involving a variety of treatment methods such as drugs,endoscopy,intervention and surgery.The combined differentiation of disease and syndrome is the main pattern for the TCM treatment of CPHT,and the ITCWM has certain advantages in terms of efficacy.In the future,in order to better guide clinical practice,it is necessary to further clarify the competitive aspects and mechanism of action of the ITCWM,and to form standardized ITCWM treatment guidelines.
作者
战俊邑
刘成海
慕永平
ZHAN Junyi;LIU Chenghai;MU Yongping(Cell Biology Laboratory,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai201203,China;Institute of Liver Diseases,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China;Key Laboratory of Liver and Kidney Diseases,Ministry of Education,Shanghai 201203,China;ShanghaiClinical Key Laboratory of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《上海中医药杂志》
CSCD
2023年第8期11-15,共5页
Shanghai Journal of Traditional Chinese Medicine
基金
国家自然科学基金项目(81874390)
上海市自然科学基金项目(21ZR1464100)
上海市科委“科技创新行动计划”生物医药科技支撑专项(22S11901700)
上海市临床重点专科建设项目(shslczdzk01201)。
关键词
肝硬化
门静脉高压症
中西医结合
临床诊疗
病证结合
liver cirrhosis
portal hypertension
integrated traditional Chinese and Western medicine
clinical diagnosis and treatment
disease-syndrome combined differentiation
