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| 題 名 | 中醫藥對治療乏效的超級猛爆性溶血性B型肝炎及其續發肝性糖尿與肝腎綜合癥的病例報告及其機轉探討=Case Report and Mechanism Exploration of Traditional Chinese Medicine in Treating Refractory Super-Explosive Hemolytic Hepatitis B and Its Secondary Hepatic Diabetes and Hepatorenal Syndrome |
|---|---|
| 作 者 | 黃詩硯; 曾宣靜; 李政育; | 書刊名 | 中國鍼灸學雜誌 |
| 卷 期 | 13:1 2025.12[民114.12] |
| 頁 次 | 頁83-98 |
| 分類號 | 413.344 |
| 關鍵詞 | 急性肝衰竭; 超級猛爆性B型肝炎; 中醫藥治療超級猛爆性肝炎; 中醫藥治療緩解後的超級猛爆性肝炎續發肝腎綜合癥; 中醫藥治療緩解後的超級猛爆性肝炎續發肝性糖尿病; Acute liver failure; Fulminant hepatitis B; Traditional Chinese medicine treatment for fulminant hepatitis; Traditional Chinese medicine treatment for fulminant hepatitis-induced hepatorenal syndrome after remission; Traditional Chinese medicine treatment for fulminant hepatitis-induced hepatic diabetes after remission; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6528/CAMS.202512_13(1).0008 |
| 中文摘要 | 本病歷報告為51歲男性病患,由於急性肝衰竭(超級猛爆性B型肝炎),在住院中會診中醫治療,病患初診數據已出現溶血性急性肝衰竭,凝血失調,超級猛爆性B型肝炎在目前西方醫學無藥可用,急性發作期併發症極多,如肝衰竭、肝性腦病、凝血障礙、腎衰竭、頑固性腹水等臨床症狀。病患在接受中醫清熱解毒、回陽救逆法治療後轉危為安。但在急性肝衰竭痊癒後,持續追蹤病患,發現肝性糖尿病,中醫利用柔肝養血清熱法,修復肝硬化,促肝細胞新生方式使病患減量西藥,並在持續追蹤後血糖仍穩定,顯示在急性肝衰竭後仍須用中藥修復肝細胞,可避免患者產生終生持續之第二型糖尿病。病患在B肝急性衰竭痊癒後獲得抗體,但之後仍發生肝源性腎臟損傷,這是B型肝炎感染後相關之腎臟病變,使用中藥活血、溫陽、利濁、清利濕熱法治療後,腎功能及時修復。觀察此病例可了解急性肝衰竭後的疾病進程,中藥治療方式能同時抑制病毒不活化且修復肝原性糖尿病與腎功能。中醫使用清熱解毒,回陽救逆法治療完全緩解後,如無續服養肝血、或化痰飲、或養肝腎之陰類藥物,將代謝廢物、損傷肝細胞、肝內微環境重建,易於緩解急性肝炎一段時日後,續發肝性糖尿病、或肝腎綜合癥,即使如此仍可用重鎮潛陽、活血、清熱利濕、化濁、柔肝方劑予以充分緩解。本醫案追蹤至今四年,未復發。 |
| 英文摘要 | This case report documents a 51-year-old male patient hospitalized for acute liver failure (super-acute fulminant hepatitis B) who received traditional Chinese medicine (TCM) treatment during consultation. Initial findings revealed hemolytic acute liver failure, coagulation disorders, Super-acute hepatitis B currently has no Western medical treatment options. Its acute phase carries numerous complications, including liver failure, hepatic encephalopathy, coagulation disorders, renal failure, and refractory ascites. The patient stabilized after receiving TCM treatment employing methods to clear heat and detoxify, restore yang, and reverse critical conditions. However, during follow-up after recovery from acute liver failure, hepatic diabetes was detected. TCM employed methods to nourish the liver, replenish blood, and clear heat to repair liver fibrosis and promote hepatocyte regeneration. This enabled the patient to reduce Western medication dosage. Subsequent monitoring showed stable blood glucose levels, demonstrating that TCM is essential for hepatocyte repair after acute liver failure to prevent lifelong Type 2 diabetes. Following recovery from acute hepatitis B-related liver failure, the patient developed antibodies but subsequently experienced hepatorenal syndrome-a renal complication associated with hepatitis B infection. Treatment with Chinese medicine employing methods to activate blood circulation, warm yang, eliminate turbidity, and clear damp-heat promptly restored renal function. This case illustrates the disease progression following acute liver failure. Traditional Chinese medicine treatment simultaneously suppresses viral inactivation while repairing hepatogenic diabetes and renal function. After complete remission achieved through TCM methods of clearing heat and detoxifying, restoring yang, and reversing collapse, failure to continue medication-such as those nourishing liver blood, resolving phlegm-fluid retention, or replenishing liver-kidney yin-may lead to metabolic waste accumulation, liver cell damage, and disruption of the hepatic microenvironment. potentially triggering secondary hepatic diabetes or hepatorenal syndrome after acute hepatitis remission. Even in such cases, thorough resolution remains achievable through formulas that anchor and subdue yang, activate blood circulation, clear heat and drain dampness, resolve turbidity, and soften the liver. This case has been followed for four years with no recurrence. |
本系統中英文摘要資訊取自各篇刊載內容。