慢性HBV携带状态的治疗难点及中医治疗实践  

Difficulties in treatment of chronic HBV Carrying state patients and TCM treatment practice

作　　者：童光东[1,2] 周大桥[1,2] TONG Guang-dong;ZHOU Da-qiao(The Fourth Clinical Medical College of Guangzhou University of traditional Chinese medicine(Guangdong,Shenzhen,518033),China;Department of Hepatology,Shenzhen Hospital of traditional Chinese medicine(Guangdong,Shenzhen,518033),China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院肝病科

出　　处：《中西医结合肝病杂志》2021年第7期577-581,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：深圳市医疗卫生“三名工程”(No.SZSM2016120740);2020年广东省名中医传承工作室建设项目;2018年艾滋病、病毒性肝炎等重大传染病项目(No.2018zx10725-505-002)。

摘　　要：慢性HBV携带状态处于乙型肝炎病毒慢性感染的早期,目前临床治疗仍面临许多挑战。本文回顾了中国各版本指南对携带状态临床定义的演变历程,对免疫状态机制不明、疾病进展风险、抗病毒治疗失败等热点话题进行讨论,认为如何改善肝脏免疫微环境是目前治疗的难点。通过中医理论创新与临床实践,提出“肾虚疫毒之邪伏于肝血”为HBV慢性携带状态的主要病机,并将补肾法运用于临床实践,以期为中医治疗慢性HBV携带状态提供新思路。Chronic HBV Carrying state is in the early stage of chronic hepatitis B virus infection.At present,clinical treatment still faces many challenges.This manuscript reviews the evolution of the nomenclature and definition of clinical diagnosis of"carrier status"in Chinese different edition guidelines,discusses hot topics such as the unknown mechanism of immune status and the risk of disease progression,and the failure of antiviral therapy.It is believed that how to improve the liver immune microenvironment is the difficulty of current treatment.Through theoretical innovation and clinical practice of traditional Chinese medicine,it is suggested that the main pathogenesis of chronic carrying-state is"kidney deficiency and epidemic toxin in liver blood",and the treatment practice of"tonifying the kidney"is adopted,in order to provide new ideas for clinical treatment of traditional Chinese medicine.

关 键 词：慢性HBV携带状态 免疫机制 治疗难点 补肾法 

分 类 号：R575.1[医药卫生—消化系统]