从乙型肝炎病毒病原学探讨慢性乙型肝炎病毒相关性肝病的中医病因病机  

Discussion on the etiology and pathogenesis of chronic hepatitis B from the perspective of its etiology in traditional Chinese medicine

作　　者：武庆娟 吕文良[1] WU Qingjuan;LV Wenliang(Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《吉林中医药》2024年第4期396-398,共3页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2018YFC1705700);北京市自然科学基金项目(7222295);中国中医科学院科技创新工程项目(C12021A00801,C12021A00802)。

摘　　要：慢性乙型肝炎病毒相关性肝病是由乙型肝炎病毒持续感染引起的肝脏慢性炎症性疾病,包括从肝炎向肝纤维化/肝硬化甚至肝癌发展的一系列疾病,属于中医“胁痛”“黄疸”“积聚”“鼓胀”等疾病范畴,病因病机与“虚”“湿”“疫”“毒”“瘀”有关。正气本虚是本病发生的根本原因,外感疫毒是疾病发展的始动因素,湿毒邪恋贯穿疾病始终;随着疾病的进展,还会表现出气滞血瘀、脾虚痰浊、癥瘕积聚、气阴两虚等病机特点。在治疗上应将扶正祛邪的思想贯穿始终,抗病毒治疗的基础上,灵活采用益气活血、清热解毒、补脾化痰、利湿通络等方法,达到既病防变、截断病势的治疗目的。Chronic hepatitis B refers to chronic inflammatory diseases of the liver caused by persistent infection of the hepatitis B virus,including a series of diseases from hepatitis to liver fibrosis/cirrhosis and even liver cancer.Yet the above varying diseases belong to the categories of"hypochondriac pain","jaundice","amassment and accumulation",and"tympanites"in traditional Chinese medicine(TCM),whose etiology and pathogenesis are always related to"deficiency","dampness","epidemic","toxin",and"blood stasis",etc.The internal inducement of chronic hepatitis B is the deficiency of vital qi,while the external infection of epidemic toxin is the initiating factor for its further development,and the lingering pathogens of dampness and toxin run throughout its entire course.With the progress of the disease,it may also show the pathogenesis characteristics of qi and blood stasis stagnation,spleen deficiency and phlegm turbidity,accumulation of abdominal masses,deficiency of both qi and yin in its different stages.In the treatment of chronic hepatitis B,the thought of strengthening vital qi to eliminate pathogenic factors should be carried out.On the basis of an antiviral therapy targeting its etiology,it is advisable to flexibly adopt the methods of benefiting qi for activating blood circulation,clearing heat and removing toxicity,invigorating the spleen and resolving phlegm,promoting diuresis and dredging channels,to achieve the therapeutic goal of preventing its progression.

关 键 词：乙型肝炎病毒 病原学 慢乙肝 病因 病机 

分 类 号：R228[医药卫生—中医基础理论]