Exploration of integrative Chinese and western medicine diagnosis and treatment on autoimmune hepatitis combined with metabolism-related steatohepatopathy
The morbidity of metabolic dysfunction-associated steatotic liver disease (MASLD) is the highest among liver diseases,and the combination of autoimmune hepatitis (AIH) and MASLD is commonly seen clinically. Although the clinical manifestations of these two liver diseases are similar,there are significant differences in pathologic mechanism and diagnosis and treatment,and there is a lack of consensus on the research and diagnosis and treatment of these two liver diseases because of the complexity of the condition and the difficulty of the treatment after the concurrency. This paper firstly analyzes the existing difficulties in diagnosis and treatment of AIH combined with MASLD,summarizes the main identification points of the two,and initially put forward the clinical diagnosis and treatment flowchart;then,it points out that AIH combined with MASLD belongs to the category of combined diseases in Chinese medicine,and the main pathogenesis is depression of liver,deficiency of spleen and kidney,obstruction of dampness,heat,phlegm,stasis and blood stagnation,and the basic treatment principles are to dredge liver,strengthen the spleen and benefit the kidney,and to clear away heat and resolve phlegm and activate blood circulation. Codonopsis,Poria,Atractylodes macrocephala,Ligustri lucidi fructus,Lycii fructus,Chuanxiong rhizome,Paeoniae radix rubra,Scutellariae radix,Coicis semen,Citri reticulatae pericarpium,Pinelliae rhizome,Fritillariae thunbergii bulbus are used as the basic formula,and it is tailored to the characteristics of the individual's physique and the course of the disease,and can be flexibly combined with the formula to improve the clinical symptoms and the patient's prognosis. Finally,it is suggested that in the clinical diagnosis and treatment,AIH combined with MASLD should be emphasized,and the clinical research on diagnosis and treatment on AIH combined with MASLD should be actively carried out so as to improve patients' prognosis.
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