Division of Gastroenterology and Hepatology, Michigan Medicine, 1500 East Medical Center Drive, SPC 5334, Ann Arbor, MI 48109, USA.
Department of Psychiatry, Michigan Medicine, 1500 East Medical Center Drive, SPC 5118, Ann Arbor, MI 48109, USA.
Clin Liver Dis. 2019 Feb;23(1):55-69. doi: 10.1016/j.cld.2018.09.004.
Alcohol use disorder (AUD) is common in alcoholic liver disease (ALD) and intrinsic to its pathophysiology. Optimal treatment requires a multidisciplinary team approach and a working alliance between patients and providers. Diagnosing AUD involves a combination of thorough history taking, physical examination, screening questionnaires, and alcohol biomarkers. Alcohol biomarkers have advantages and limitations of use of which clinicians should be aware. AUD treatment is effective, multifaceted, and can be tailored to each individual. Available treatment modalities are myriad: motivational enhancement therapy, cognitive behavior therapy, 12-step facilitation, group therapies, intensive outpatient programs, inpatient and residential treatment, and relapse prevention medications.
酒精使用障碍（AUD）在酒精性肝病（ALD）中很常见，是其病理生理学的内在特征。最佳治疗需要多学科团队方法和患者与提供者之间的工作联盟。AUD 的诊断涉及详细的病史采集、体格检查、筛查问卷和酒精生物标志物的组合。酒精生物标志物的使用具有优势和局限性，临床医生应该了解这些优势和局限性。AUD 的治疗是有效的、多方面的，可以针对每个人进行调整。可用的治疗方式多种多样：动机增强疗法、认知行为疗法、12 步促进、团体治疗、强化门诊计划、住院和住院治疗以及预防复发的药物。
