中医和中西医结合治疗自身免疫性肝炎的优势与挑战

Advantages and Challenges of Treatment on Autoimmune Hepatitis by Traditional Chinese Medicine and Integrative Medicine

自身免疫性肝炎(AIH)是一种病因和发病机制尚未明确,由异常自身免疫反应介导的严重进行性疾病。流行病学调查显示,AIH病情反复发作,迁延不愈,发病率逐年升高。患者可迅速进展为肝硬化和肝衰竭,或发生暴发性或亚暴发性肝病。西医学已将免疫抑制剂作为AIH的首选治疗药物,波尼松(龙)单一治疗或加用硫唑嘌呤联合治疗,被公认为是AIH的基础治疗,并被临床广泛运用。多数AIH患者对激素及免疫抑制剂反应较好,但长期应用副作用明显,且停药后复发率较高,所以探寻新的AIH治疗措施仍是临床研究的重要课题。在临床实践中,中医、中西医结合疗法在AIH的治疗中取得了较好的疗效。因此,本文就AIH的中医、中西医结合治疗情况进行综述和分析,以期为AIH的治疗提供新的视野。

Autoimmune hepatitis（ AIH） is a severe progressive disease mediated by abnormal autoimmune reactions. Its etiology and pathogenesis are not yet clear. Epidemiological survey shows that AIH is a recurrent disease and the incidence rate is increasing year by year. Patients can quickly progress to cirrhosis and liver failure,or fulminant or sub-fulminant liver disease. In western medicine,the immunosuppressive agents have been used as the first choice for AIH. Prednisone（ and/or prednisolone） monotherapy or combined with azathioprine therapy is recognized as the basic treatment for AIH,and widely used in clinical application. The majority of patients with AIH have a good response to hormones and immunosuppressive agents,but the side effects are obvious in long-term application,and the risk of recurrence is higher after stopping treatment. Therefore,it is still an important research topic to explore new AIH therapy. In clinical practice,the traditional Chinese medicine（ TCM） and integrative Chinese and western medicine have achieved a better efficacy in the treatment of AIH,so the treatment conditions for AIH with TCM and integrative Chinese and western medicine would be reviewed and analyzed in this paper,hoping to provide a new perspective for the treatment of AIH.