轻微肝性脑病的中西医研究进展

Research Progress on Traditional Chinese and Western Medicine of Minimal Hepatic Encephalopathy

综述了轻微肝性脑病(minimal hepatic encephalopathy,MHE)在发病机制及诊疗方面的中西医研究进展。轻微肝性脑病是肝硬化常见的并发症,为肝性脑病(HE)发病过程中最早的表现形式,其特点是患者无可察觉的临床症状及体征。神经心理测试发现患者存在轻度神经认知功能异常。目前我国已经确立了统一的诊断标准,但MHE发病机制尚未能完全阐释,临床治疗仍缺乏规范化及统一的标准。中医药在MHE治疗中具有独特作用,但中医辨证论治尚未形成统一、规范的标准,多从实证、热证对MHE进行辨证论治,常见中医证型为热毒炽盛证和痰浊蒙窍证。

This article summarizes the research results of(minimal hepatic encephalopathy, MHE) in pathogenesis and diagnosis. Mild hepatic encephalopathy is a common complication of cirrhosis. It is the earliest manifestation of hepatic encephalopathy(HE), which is characterized by unobservable clinical symptoms and signs, but mild neurocognitive dysfunction can be found in patients by neuropsychological tests. At present, a unified diagnostic standard has been established in China, but the pathogenesis of MHE has not been fully explained, and the clinical treatment still lacks standardized and unified standards. Chinese Medicine plays a unique role in the treatment of MHE, but the syndrome differentiation and treatment of TCM has not yet formed a unified and standardized standard. The syndrome differentiation and treatment of MHE are mainly based on the excess syndrome and heat syndrome, and the common TCM syndrome types are the syndrome of excessive heat toxin and orifices obstruction by turbid phlegm.