Professor Chen Guoliang’s Academic Thoughts And Clinical Experience Summary And Clinical Study Of Clearing Heat,Detoxicating And Cooling Blood Therapy For Early Stage Of Hepatitis B Virus-related Acute-on-chronic Liver Failure

Objective:In theoretic research, to summarize Professor Chen Guoliang’s academic thoughts on treatment of traditional Chinese medicine (TCM) in liver diseases, especially on his clinical experience in liver fibrosis and "acute jaundice " at early stage,, in order to inherit Professor Chen Guoliang’s precious experience in TCM treatment of liver diseases. In clinical research, to observe the efficacy of clearing heat, detoxicating and cooling blood therapy for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) at early stage, to discuss the guidance effects of Professor Chen Guoliang, s academic thoughts, and to provide one of the effective therapies for "acute jaundice " early.Methods:1.Through hands-on practice in outpatient service, by collecting and reading tutor’s medical records, paper and work, Professor Chen Guoliang’s academic thoughts on TCM treatment in liver diseases were summarized. Professor Chen Guoliang’s understanding on the pathogenesis of the cause of liver fibrosis, "acute jaundice ", and clinical commonly used therapeutic principles was theoretically clarified.2. In Clinical research, totally 64 patients with HBV-ACLF at early stage with excessive toxic heat pattern were randomized into the integrative medicine group of 30 cases and western medicine group of 34 cases The western medicine group was treated only with western comprehensive therapies. The integrative medicine group was combined with oral and high retention enema used herb formula of clearing heat, detoxicating and cooling blood. The outcomes were measured when patients have been out of the early stage of HBV-ACLF liver function, including levels of prothrombin activity, HBV DNA, plasma endotoxin, tumor necrosis factor-α and plasma ammonia and compared with baseline as well as between both groups.Results:In theoretic research, the main academic thoughts of Prof. Chen Guoliang in the field of liver diseases were summarized in the following three aspects:1. in the diagnosis and treatment of chronic hepatitis B, he advocates differentiation of both diagnosis and syndrome, more focuses on syndrome differentiation.2. He puts forward Fuzhengquxie treating principle for treatment of liver fibrosis. According to common syndrome of spleen deficiency and blood stasis in clinic, he created a formula named as Qiwei Huaxian Decoction in treatment of hepatic fibrosis.3. He puts forward the treating method of Qingrejiedu and cooling blood for "acute jaundice" at early stage, and advocates to apply oral medicine and enema together, also created the retention enema with Yinyu Mixture. The clinical experience of Professor Chen Guoliang in the field of liver diseases was summarized in the following aspects:1, Qiwei Huaxian Decoction in treating liver fibrosis in chronic hepatitis B; 2, Yinyu mixture retention enema in the treatment of subacute liver failure; 3, clearing heat, detoxicating and cooling blood therapy for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) at early stage. In clinical research, The levels of total bilirubin, prothrombin activity, plasma endotoxin, tumor necrosis factor-a and plasma ammonia, were significantly improved in integrative medicine group compared with those in the western medicine group (P<0.05). And the incidence of complications in the integrative medicine group was obviously less than in the western medicine group (P<0.05). There were no significant differences in HBV DNA between two groups(P>0.05). The overall response rate was 76.7% in the integrative medicine group, compared with 52.9% in the western medicine group (P≈0.048<0.05). The incidences of complications was 20.0%in the integrative medicine group, compared with 44.1% in the western medicine group (P≈0.040<0.05). No obvious adverse event occurred in the two groups during the treatment period.Conclusion:1. Tutor professor Chen Guoliang’s academic thoughts and clinical experience on TCM treatment of liver disease were rich and effective.2.The clearing heat, detoxicating and cooling blood therapy can effectively hold back the progress of HBV-ACLF in early stage, also can reduce the incidence of serious complications. The academic thoughts of Professor Chen Guoliang have important impact on clinical treatment of HBV-ACLF. This integrative therapy could be introduced in clinical practice, and warrants further study.