“肝臭”作为肝衰竭阶段特征性临床症候，是由于机体代谢紊乱而出现呼出气的变化所致，目前已发现肝臭与肝衰竭进展存在关联。肝臭是肝衰竭中医嗅诊辨证的基本内容，但诊察过程主观性强，未与中医辨证分型明确对应，现有的肝衰竭中医辨证标准中，未纳入肝臭中医嗅诊辨证的内容，其对辨证分型、预后判断的价值未能体现。课题组前期发现肝衰竭阳黄证、阴黄证肝臭存在差异，本项目基于气相色谱-质谱(GC-MS)联用的代谢组学方法，以慢性乙型病毒性肝炎慢加急性肝衰竭患者呼出气样本为研究对象，与正常呼出气样本对照，通过表征呼出气代谢物差异，筛选阳黄证、阴黄证呼出气代谢标志物，建立肝衰竭肝臭中医嗅诊辨证分型的明确对应，并与临床生化指标建立关联，最后对回顾性、前瞻性临床样本进行基于呼出气代谢标志物的阳黄证、阴黄证分型预判，确证肝臭中医嗅诊辨证的物质基础，实现肝衰竭肝臭中医嗅诊辨证的客观化，为肝衰竭预后判定及疗效评估提供依据。

Hepaticus fetor, as one of hepatic failure characteristic clinical symptoms, is due to the changes of metabolic disorder and appear breath gas.which has been found relevance to the progress of hepatic failure.Nowadays, olfactory examination on hepaticus fetor, as the basic elements of TCM diagnosis,in hepatic failure patients often have a basis on doctor’s subjective sense, which is lack of objective standard and hard to closely correspond with the syndrome differentiation.Existing hepatic failure in TCM syndrome differentiation standard, did not include the content of hepaticus fetor and the evaluation value for syndrome differentiation failed to reflect..In our previous study, there were differences existed in the feature of the hepaticus fetor between Yang huang and Yin huang.Therefore, in this project, with the breath samples from as the research object and the normal breath samples as the negative control, GC-MS-based breath metabonomics technology would be adopted to present the metabolite differentiation for screening biomarkers from different syndrome types (Yang huang and Yin huang). And a corresponding relationship would be established within different syndrome types in Chronic hepatitis B with acute hepatic failure samples. Finally, the conclusion would be tested with actual situation by the retrospective and prospective clinical samples examination based on the established metabonomics analysis methods. Aim to explain the connotation of olfactory examination, to objectify the olfactory examination on hepaticus fetor in hepatic failure patients, and to provide the reference for the prognosis judgement and curative effect evaluation of hepatic failure.