攻坚克“黄”——1例多学科中西医协同诊治急黄病例
Overcoming Jaundice:A Case of Acute Jaundice Treated through Multidisciplinary Traditional Chinese and Western Medicine
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1.广西中医药大学第一附属医院肝病科一区,南宁 530023
2.广西中医药大学第一附属医院脾胃病科二区,南宁 530023
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唐秋媛,王萌,张荣臻.攻坚克“黄”——1例多学科中西医协同诊治急黄病例[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867660&Fpath=home&index=0&lang=zh
TANG Qiuyuan,WANG Meng,ZHANG Rongzhen.Overcoming Jaundice:A Case of Acute Jaundice Treated through Multidisciplinary Traditional Chinese and Western Medicine[J].,
唐秋媛,王萌,张荣臻.攻坚克“黄”——1例多学科中西医协同诊治急黄病例[DB/OL].(2023-11-13)[2023-11-13].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43867660&Fpath=home&index=0&lang=zh DOI:
TANG Qiuyuan,WANG Meng,ZHANG Rongzhen.Overcoming Jaundice:A Case of Acute Jaundice Treated through Multidisciplinary Traditional Chinese and Western Medicine[J]., DOI:.
病史摘要,2,本病由华支睾吸虫病诱发亚急性肝衰竭,出现肝性脑病并发症,病情危重。西医方面给予一般支持治疗、对症治疗、病因治疗、并发症治疗、人工肝支持治疗等综合治疗;中医方面根据肝衰竭“毒邪-毒浊致病”理论采用“截断逆转”法,以解毒化瘀方合甘露消毒丹解毒化瘀、利湿开窍;针对肝性脑病采用“通腑开窍”的治则,运用大黄煎剂保留灌肠的中医药特色疗法进行干预。驱虫治疗引发急性胆管炎,及时进行多学科协同诊治,行ERCP减黄治疗,同时明确胆总管占位性质;中医予清热生津,随证治之,标本兼治,共奏多学科、中西医协同之功;预后较好,凸显了多学科、中西医协同治疗急黄的优势。中医诊断 黄疸-急黄(疫毒炽盛证)。西医诊断 1.亚急性肝衰竭(中期),华支睾吸虫病;2.肝性脑病(A型 HE2级)。干预措施 西医方面给予一般支持治疗、对症治疗、病因治疗、并发症治疗、人工肝支持治疗等综合治疗;中医方面根据肝衰竭“毒邪-毒浊致病”理论采用“截断逆转”法,以解毒化瘀方合甘露消毒丹解毒化瘀、利湿开窍;针对肝性脑病采用“通腑开窍”法,运用大黄煎剂保留灌肠的中医药特色疗法。驱虫治疗引发急性胆管炎,及时进行多学科协同诊治,行ERCP减黄治疗,同时明确胆总管占位性质;中医予清热生津,随证治之。疗效转归 患者临床治愈,预后较好。
Summary of case history, This disease was caused by clonorchiasis, resulting in subacute liver failure and complications of hepatic encephalopathy. The condition was critical. In Western medicine, comprehensive treatments such as general supportive treatment, symptomatic treatment, etiology treatment, complication treatment, and artificial liver support treatment were administered. In traditional Chinese medicine, based on the theory of "toxic pathogen-toxic turbidity pathogenesis" of liver failure, the "truncated reversal" method was applied using a combination of JIE DU HUA YU decoction and GAN LU XIAO DU pill for detoxification and removal of blood stasis, along with diuresis and resuscitation promotion. For hepatic encephalopathy, the "purgation and resuscitation" method was adopted, and traditional Chinese medicine characteristic therapy of retention enema with rhubarb decoction was used. Timely multidisciplinary collaborative diagnosis and treatment were executed to address acute cholangitis induced by insect repellent therapy, with ERCP yellow reduction treatment performed while clarifying the nature of the bile duct space-occupying lesion. Traditional Chinese medicine focused on clearing heat and promoting fluid production, tailoring treatments according to syndromes and signs, treating both symptoms and underlying causes. This collaborative approach led to a favorable prognosis, highlighting the advantages of multidisciplinary and coordinated treatment for acute jaundice with traditional Chinese and Western medicine.,TCM diagnosis, Jaundice—Acute Jaundice (Syndrome of excessive epidemic virus).,Western medicine diagnosis, 1. Mid stage of subacute liver failure, Clonorchiasis sinensis; 2. Hepatic Encephalopathy (Type A HE2).,Therapeutic methods, In Western medicine, comprehensive treatments such as general supportive treatment, symptomatic treatment, etiology treatment, complication treatment, and artificial liver support treatment were administered; In traditional Chinese medicine, based on the theory of "toxic pathogen-toxic turbidity pathogenesis" of liver failure, the "truncated reversal" method was was applied using a combination of JIE DU HUA YU decoction and GAN LU XIAO DU pill for detoxification and removal of blood stasis, along with diuresis and resuscitation promotion. For hepatic encephalopathy, the "purgation and resuscitation" method was adopted, and traditional Chinese medicine characteristic therapy of retention enema with rhubarb decoction was used. Timely multidisciplinary collaborative diagnosis and treatment were executed to address acute cholangitis induced by insect repellent therapy, with ERCP yellow reduction treatment performed while clarifying the nature of the bile duct space-occupying lesion. Traditional Chinese medicine provided the function of clearing heat and promoting fluid production, and the treatments followed by syndromes and signs.,Clinical outcomes, The patient achieved clinical cure with a favorable prognosis.
急黄肝衰竭毒邪-毒浊理论多学科中西医
Acute jaundiceLiver failureTheory of toxic pathogen and toxic turbidityMultidisciplinaryTraditional Chinese and western medicine
中华医学会感染病学分会肝衰竭与人工肝学组,肝衰竭诊疗指南(2018年版)[J].中国肝脏病杂志,2019,27(1):18-26.
中华医学会肝病学分会,肝硬化肝性脑病诊疗指南(2018年)[J].中华胃肠内镜电子志,2018, 5(03):97-113.
XU M, JIANG Y Y, YIN J H, et al. Risk factors for clonorchis sinensis infection in residents of Binyang, Guangxi: a cross-sectional and logistic analysis study[J]. Front Public Health, 2021, 9:588325.
陈颖丹,诸廷俊,许隆祺,等.«华支睾吸虫病诊断标准»解毒[J].中国血吸虫病防治杂志,2017, 29(5):538-540.
吉益东洞. 古书医言[M]. 北京:人民卫生出版社,1955:12- 15.
柏文婕,潘佩佩,石清兰等.基于"浊毒致病"学说探讨肝性脑病病因病机[J].中国中医基础医学杂志,2023,29(05):727-730.
王娜,王明刚,毛德文等.大黄煎剂治疗A型肝性脑病的临床疗效观察[J].时珍国医国药,2015, 26 (05):1169-1171.
刑佑美.中西医结合治疗肝性脑病59 例[J].中国中医急症,2009,18(9): 1141-1144.
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